
/f<jy 

&wm° z^^ 

COPYRIGHT DEPOSfT, 



HANDBOOK 



OK 



MATERIA MEDICA, PHARMACY, AND 
THERAPEUTICS. 



POTTER. 



NOTICES OF THE PRESS 

OF PREVIOUS EDITIONS OF 

DR. POTTER'S HANDBOOK 



From the American Journal of the Medical Sciences : — 

"The author has very skilfully steered his course between the pessimism that marks 
a system of therapeutics based solely on the results given by experiments and observations 
in the chemical and physiological laboratories, and the optimism of hasty empirical general- 
izations upon meagre clinical data, and upon this we consider that the greatest claim can 
be made, that this book is a safe one for the junior practitioner. : . . The author, then, 
has fully attained the purpose which he set before him at the commencement." 

From the Medical Record : — 

"This is an old and valued friend which needs no commendation, much less an 
introduction. It ought to be in the library of every physician and student. It is the 
most convenient and most concise work on therapeutics and materia medica in the 
English language, and is at the same time thoroughly reliable. Though necessarily 
largely a compilation, nevertheless there is much that is original, the author being one 
of the most prominent of American therapeutists." 

From the Australasian Medical Gazette : — 

"We have pleasure in commending the fourth edition of this excellent work to our 
readers. It is a monument of persistent industry. There is no better book in the 
English language for the student and practitioner. . . . Dr. Potter's book is thoroughly 
practical, and Part III contains an enormous amount of information, for which the 
student ought to be grateful. . . . The chapter on prescriptions is especially well done, 
in fact, the best we have seen." 

From the Journal of the American Medical Association : — 

" Dr. Potter has embodied many original ideas in the preparation of this work, 
some, if not all of which will prove of very great value to the reader." 

Fro?n the Medical Bulletin : — 

" The author's statements are concise, exact, compact, and his diction faultless; no one, 
perhaps in this country at least, excels him in the perspicuity of his condensations and the 
completeness of his work in respect to the many details involved in authorship." 

From the New York Medical Journal : — 

" Dr. Potter's Handbook will find a place, and a very important one, in our colleges 
and the libraries of our practitioners. It contains almost everything that can be found in 
the larger works in a more concise form and brought up to a rather more recent date. . . . 
Under the head of prescription writing considerable attention is paid to the subject of in- 
compatibilities, and the student will here find many valuable hints for his guidance in this 
difficult subject. Besides this there are, under the head of special therapeutics, very many 
formulas for the treatment of particular diseases and abnormal conditions, arranged alpha- 
betically for easy reference. This will be especially valuable to young practitioners, and 
will frequently save the trouble of looking through large works and monographs for suit 
able formulae in the treatment of special cases. This department is fuller in this book 
than in any with which we are acquainted." 

From the Therapeutic. Gazette : — 

" The author has aimed to embrace in a single volume the essentials of practical 
materia medica and therapeutics, and has produced a book small enough for easy carriage 
and easy reference, large enough to contain a carefully-digested, but full, clear, and well- 
arranged mass of information. No new remedy of any acknowledged value is omitted 
from this list. Under each the section on physiological action and therapeutics has been 
written with care. ... In the enumeration of drugs suited to different disorders a very 
successful effort at discrimination has been made, both in the stage of disease and in the 
cases peculiarly suited to the remedy. It is no mere list of diseases followed by a cata- 
logue of drugs, but is a digest of modern therapeutics, and as such will prove of immense 
use to its possessor." 

***The price of this book is $4.00 in cloth binding, or $5.00 in full leather. Thumb 
Index in each copy. It may be had through any bookseller, or upon receipt of price will 
be sent, postpaid, to any address by the publishers. 



HANDBOOK 



Materia Medica, Pharmacy, and 
Therapeutics, 



INCLUDING THE 



PHYSIOLOGICAL ACTION OF DRUGS, THE SPECIAL THERA- 
PEUTICS OF DISEASE, OFFICIAL AND PRACTICAL 
PHARMACY, AND MINUTE DIRECTIONS FOR 
PRESCRIPTION WRITING. 



' 



7* 



SAM'L O.L.POTTER, A.M.,M.D.,M.R.C.P.Lond. 



%$,/£2^ 



LATE PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE IN THE COOPER MEDICAL COLLEGE 
OF SAN FRANCISCO, AND VISITING PHYSICIAN TO ST. LUKE'S HOSPITAL: AUTHOR OF "CjUlZ- 
COMPENDS" OF ANATOMY AND MATERIA MEDICA, "AN INDEX OF COMPARATIVE 
THERAPEUTICS," AND "A STUDY OF SPEECH AND ITS DEFECTS." 
FORMERLY A. A. SURGEON, U. S. ARMY, AND BRIGADE- 
SURGEON N. G. OF CALIFORNIA. 



FIFTH EDITION. REVISED AND ENLARGED. 



PHILADELPHIA : 

P. BLAKISTON, SON & CO., 

1012 Walnut Street. 
1894. 



\ Vl 






Copyright, 1 894. 
By P. BLAKISTON, SON & CO. 



Press of Wm. F. Fell & Co , 

1220-24 SANSOM ST., 

PHILADELPHIA. 



I*- 



^ 



TO MY WIFE 

WHOSE DEVOTED CARE AND 

PATIENT ENCOURAGEMENT, 

DURING THE PAST SIXTEEN YEARS, 

HAS SUPPORTED THE AUTHOR 

IN EVERY EXIGENCY OF 

HIS PROFESSIONAL LIFE. 



PREFACE TO THE FIFTH EDITION 



The last revision of the U. S. Pharmacopoeia included 89 additions 
to the official list of drugs and their preparations, 92 dismissals there- 
from, 282 changes of official titles and 40 changes in strength of the 
more important preparations, besides innumerable alterations in the 
solubilities of chemical substances, in specific gravities, botanical nomen- 
clature, constituents of preparations, etc. The incorporation of so many 
changes into this book has necessitated the complete rewriting of the 
pharmaceutical parts thereof; and in addition, the author has thoroughly 
revised the text wherever necessary to bring it up to the present require- 
ments of teachers, students and practitioners. Several articles, including 
those on Alcohol, Carbolic Acid, Creosote and Digitalis, have been 
entirely rewritten, and many others have been more or less expanded. 
New articles have been inserted on nineteen drugs which were not 
noticed in the previous editions. Eight new titles have been added to 
the section on Special Therapeutics, besides over two hundred brief 
references throughout its text. The article on the Treatment of Poi- 
soning has been enlarged and recast in a form which, it is hoped, will 
prove more useful for rapid reference than its former shape. By placing 
the articles on drugs of minor importance in a smaller type, and by the 
omission of some matter formerly included in the appendix, the increase 
in the text has been kept within the bounds of thirty-two additional 
pages. 

The Index has been materially curtailed by omitting the pharmaceu- 
tical names of preparations, also the old designations of salts (as Nitrate 
of Silver), rendered obsolete by the adoption of the new chemical 
nomenclature in the pharmacopoeia. Every index reference has been 
retained which could not be quickly found by the alphabetical arrange- 
ment of the text. 

It gives the author sincere pleasure to acknowledge here his indebted- 
ness to those reviewers and correspondents who have pointed out defects 
and errors in former editions. He has endeavored, in this edition, to 
profit by all such criticisms, without materially changing the original 
plan of the book, or those characteristic features which have proved 
important factors among the elements of its success. For the continued 
appreciation of his work by those for whom he designed it, the author 

ix 



X PREFACE. 

again expresses his gratitude, which he has sought to evince by making 
the book even more accurate and useful than when it first earned their 
favor. 

It is a source of much gratification to the undersigned to find that the 
use of the word " official " instead of " officinal," urged by him in the 
preface to the first edition of this book, has become official by adoption 
in the last revision of the pharmacopoeia. 

Sam'l O. L. Potter. 

San Francisco, California. 
September ist, 1894. 



EXTRACTS 

FROM THE 

PREFACE TO THE FIRST EDITION 



The author's intention has been to produce a book which would 
embrace in a single volume the Essentials of practical Materia Medica 
and Therapeutics, treating of each subject in as concise phraseology as 
possible consistent with the delineation of every important feature. He 
has also endeavored to formulate such minute and definite directions for 
the framing of Prescriptions as might eludicate what to many is a very 
difficult problem. Furthermore, he has tried to present as much infor- 
mation upon the subject of Pharmacy as every physician should possess, 
in order to handle the implements of his profession with confidence, and 
to direct their use by others with pharmaceutical accuracy. 

The complete fulfilment of these aims would be realized if the book 
should take rank as a working companion to the advanced student and 
the junior practitioner ; and be deemed by them a reliable guide through 
the forest of observations and experiments on drug actions and uses, 
which makes progress slow for the already over-burdened mind, when 
ploughing through the more exhaustive and exhausting text-books. 

Although this book is essentially a compilation, as all books of its class 
must be, there will be found in its pages much original matter derived 
from the writer's own experience in professional life. The arrangement 
of the matter will be found to be in some respects unique. After full 
consideration of the many arrangements of the Materia Medica in vogue, 
a modified alphabetical plan was adopted, by which the advantages of the 
alphabetical order might be retained, while permitting the grouping 
together of agents which are closely related, physiologically and thera- 



PREFACE. XI 

peutically, under the title of the principal member of the class — the 
chief, as it were, of that particular clan. Thus, under the title Amyl 
Nitris will be found mention also of the Ethyl, Sodium and Potassium 
Nitrites, and their congener Nitro-Glycerin, all of which are closely 
allied to the first-named and to each other, in respect of their actions 
and uses. A very elaborate section on Drug Classification is placed 
before the Materia Medica, in order to supplement such deficiencies in 
grouping as are inevitable in an alphabetical arrangement. 

In detailing the characteristics of an important drug, its physical pro- 
perties and chemical constituents are first briefly enumerated, then its 
preparations are described in the official language of the pharmacopoeia, 
usually somewhat abbreviated ; any important unofficial preparations 
being also noted, and all the compounds into which it enters enumerated. 
Next the physiological action is taken up, its characteristic features being 
first described ; then the actions resulting from an ordinary medicinal 
dose, next those produced by small doses continued, and finally those 
from a toxic dose. These are followed by a brief account of its antago- 
nists, antidotes and incompatibles, if any ; and a concise summary of 
its therapeutical applications closes the article; — the whole presenting, it 
is hoped, a clearly defined word-picture of the drug under considera- 
tion. Every article and preparation comprised in the last edition of the 
U. S. Pharmacopoeia is fully noticed, while all the prominent unofficial 
agents receive such mention as their respective importance seems to 
demand. 

The second part of the book is devoted to Pharmacy, and has been 
written from the standpoint of a conviction that many young practi- 
tioners would gladly dispense their own medicines, if provided with a 
few practical directions on the subject ; thereby saving many a dollar 
from the drug store, preventing in their own practices at least the " re- 
newals" which constitute so bad a feature of modern pharmaceutics, and 
gaining for themselves a practical acquaintance with their professional 
weapons which cannot but make them better physicians and more 
accurate prescribers. In this section of the book Prescription Writing 
receives full consideration, and many standard formulae are given as 
samples of prescriptions of each kind in extemporaneous use. 

In the third part the subject of Special Therapeutics is treated of elab- 
orately, and in the form of an alphabetically arranged Index to the 
treatment of diseases, as laid down by the most recent authorities. 
Every indication for the use of a drug is referred to its author by his 
initial, and to the most prominent articles are appended a few selected 
formulae, to serve as guides to the neophyte in prescribing. 

Nearly all the regular text-books have been laid under contribution in 
the preparation of the book, but especial use has been made of the 



Xll PREFACE. 

works of Brunton, Ringer, Wood, Phillips, Waring and Bartholow, in 
their latest editions; as well as of the writer's verbatim notes of two 
courses of didactic and clinical lectures delivered by Professors Da Costa 
and Bartholow in the Jefferson Medical College and Hospital and in 
the auditorium of the Pennsylvania Hospital. On page 502 will be 
found a full list of the authorities referred to by initials in the section 
on Special Therapeutics. 

The Appendix contains numerous tables, comprising diagnostic hints, 
Latin terms and phrases, formulae for hypodermic use, metric equivalents, 
and specific gravities and volumes ; also Notes on temperature in disease, 
the use of the clinical thermometer, the treatment of poisoning, and 
the examination of urine ; also formulae representing the most noted 
patent medicines. 

The Index has received special attention, from a conviction that, if 
well made, it is the best part of a good book. Every title, synonym 
and other reference of importance is included therein, double and 
treble entries being made in every instance which seemed to require such 
repetition. 

The term " officinal," as applied to drugs recognized by the pharma- 
copoeia, has been discarded, the word "official " being used instead ; for 
the simple reason that the idea to be conveyed is expressed more cor- 
rectly by the latter term than by the former one. When none but official 
drugs and preparations were kept in the officina or drug store, it was 
eminently proper to call them " officinal," but inasmuch as this class does 
not nowadays constitute much over one-fourth part of the officinal stock, 
it is a wilful debasement of our professional weapons, as well as an inex- 
cusable misnomer, to apply the shop-title to them any longer. 

Cooper Medical College, San Francisco, 
December, 1886. 



TABLE OF CONTENTS. 



PAGE 

INTRODUCTION, 17 

Materia Medica, '. 17 

Pharmacy, 17 

Therapeutics, 17 

Empirical Therapeutics, 18 

Rational Therapeutics, 18 

Administration of Medicines, 20 

Classification of Medicines, 23 

Stimulants and Sedatives, . 23 

Agents acting chiefly on the Nervous System, 24 

Agents acting on the Organs of Special Sense, 28 

Agents acting on Respiration, 31 

Agents acting on the Circulation, ^^ 

Agents acting on the Digestive System, 34 

Agents acting on Metabolism, 41 

Agents acting on Excretion, " 44 

Agents acting on the Generative Apparatus, 47 

Agents acting on the Cutaneous Surface, . 49 

Agents acting on Microbes, Ferments, etc., 52 

Agents acting upon each other, 53 

Dosage of Medicines, 55 

PART I.— MATERIA MEDICA AND THERAPEUTICS, 57 

Abrus to Zingiber, 57-43° 

PART II.— PHARMACY AND PRESCRIPTION WRITING, ... 431 

Constituents of Vegetable Drugs, 432 

Weights and Measures, 435 

Metric System, 436 

Approximate or Domestic Measures, . 438 

Specific Gravity and Specific Volume, 438 

Prescriptions, 439 

Analysis of a Prescription, 440 

Principles of Combination, 441 

Prescription Writing, 442 

Abbreviations, 443 

Prescription Blanks, 444 

Renewals, 445 

xiii 



XIV TABLE OF CONTENTS. 

PAGE 

Incompatibility, 446 

Chemical Incompatibility, 446 

Pharmaceutical Incompatibility, 449 

Therapeutical Incompatibility, 450 

Rules for Avoidance of Dangers, 450 

Extemporaneous Pharmacy, 452 

Filling a Prescription, 453 

Stock Solutions, 454 

Rules for the Pharmaceutical Student, 454 

Official Pharmacy, * 455 

Official Operations, 455 

Pharmaceutical Operations, 455 

Preparations, 464 

Pharmacopceial Preparations 464 

Pharmaceutical Preparations, '. . 465 

Aceta to Vina, 465-501 

Excipients for Emulsions, 470 

Excipients for Mixtures 481 

Excipients for Pills, 485 

PART III.— SPECIAL THERAPEUTICS, 502 

References and Bibliography, 502 

Abdominal Plethora to Yellow Fever 503-730 

APPENDIX 731 

Latin Terms, Phrases, etc., used in Prescriptions, 731 

Verbs, Participles, Prepositions, etc., 739 

Genitive Case-endings, 740 

Hypodermic Formulae, 741 

Chlorodyne, Comparisons of Ten Formula therefor, 743 

Patent Medicines, 744 

Tables of Differential Diagnosis, ' . . 748 

Notes on Temperature in Disease, 753 

Clinical Thermometry, -753 

Temperature in Phthisis, .... 755 

Temperature in Typhoid Fever, 755 

Temperature in Scarlatina, 7^5 

Temperature in Measles, 755 

Temperature in Diphtheria, 755 

Co-relation of Pulse and Temperature, 755 

Clinical Examination of the Urine 755 

Deposits in Urine, 757 

Necessary Apparatus, 757 

The Treatment of Poisoning, 758 

Antidotes and Antidotal Measures, 758 

Antagonists and Antagonistic Measures, 760 

Poisons, their Antidotes and Antagonists, 760 



TABLE OF CONTENTS. XV 

PAGE 

Table of Specific Gravities and Specific Volumes, 770 

Table of Drops in, and Weights of, a Fluidrachm of Various 

Liquids, 771 

Table of Weights and Measures, 771 

Table for Converting Apothecaries' Weights and Measures into 

Metric, 772 

Table of Prescription Doses and Quantities, ...... .... 772* 

INDEX, , 773 



EXPLANATION. 

Numerals unqualified, under the subtitles Preparations in Part I, denote grammes for 
solids and cubic centimeters for liquids. 

For Signs and Abbreviations used, see pages 435 to 437. 



ERRATA. 

Page 63, line 16 from bottom, — for " Impure'''' read " Crude.'''' 

Page 63, line 7 from bottom, — for " Creosol" read " Cresol." 

Page 113, line 13, — the dose of Sodium Nitrite should not exceed gr. iij. 

Page I49, line 8 from bottom, — strike out the word " Unofficial." 

Page 151, line 14 from bottom, — read "in one of the last chapters" etc. 

Page 161, lines 8 and 18, — for " Preparata" read " Prseparata." 

Page 171, line 9 from bottom, — strike out the hyphen after Carbonei. 

Page 185, under Aqua Chloroformi, — insert " Dose, Sjss-ij." 

Page 196, line 10, — for " alkaloid " read "substance." 

Page 254, line 13 from bottom, — for " Gatdtheriana" read " Gatttheriana." 

Page 290, line 22 from bottom, — for " % j " read " Jfj." 

Page 303, line II from bottom, — for " Mryrh " read " Myrrh." 

Page 325, line 13, — for " Caffeine Citrate " read " Citrated Caffeine." 

Page 345, line 4 from bottom, — after " gr. xx " insert "5jj as diuretic and refrigerant; 

3J-^j as purgative." 
Page 386, — after the Fluid Extract insert "Dose, gss-^ss," — after the Syrup insert 

"Dose SJ-^j." 
Page 396, line 1 1 from bottom, — insert the word " page " after " ante." 
Page 450, line II, — after " Strychnine " insert " Morphine." 
Page 765, lines 15 and 16, — strike out " Acid Carbonic," and after "Coal-gas" 

insert " Nitrous Oxide Gas." 



XVI 



INTRODUCTION 



Pharmacology, (Pharmakon, a drug, Logos, a discourse,) — is a gen- 
eral term which properly includes all matters pertaining to the study of 
medicinal agents in the widest possible sense, embracing all of Materia 
Medica and Pharmacy, with so much of Therapeutics as relates to drugs. 
The term is however frequently employed in a more restricted sense, 
including only the physiological action of drugs ; a subject to which the 
title Pharmacodynamics is much more appropriately applied. 

Materia Medica is that branch of medical science which treats of 
the substances used as medicines, their origin, composition, physical 
characteristics, chemical properties, modes of preparation and adminis- 
tration, physiological and toxicological actions. 

Pharmacodynamics, (Pharmakon, a drug, Dunamis, power,) — is the proper title for 
that portion of the Materia Medica which relates to the physiological action of drugs, 
that is, the influence of drugs upon the healthy human body to modify its physiological 
activity. 

Toxicology is another subdivision, and includes the effects of drugs when adminis- 
tered in poisonous doses, together with the study of the drug-antagonists for the most 
dangerous symptoms produced and the appropriate chemical antidotes. 

Pharmacy is the art of preparing medicines for use and dispensing 
them on the order of the therapeutist. It includes a knowledge of the 
Materia Medica, an acquaintance with the theories and manipulations of 
chemistry, andean intimate practical knowledge of many special opera- 
tions peculiar to itself. 

Therapeutics, (Therapeuein, to attend upon,) — includes all that re- 
lates to the science and art of healing; and embraces the application, 
not only of medicines, to the alleviation or cure a of disease, but of all 
other agents which may aid in the accomplishment of the same result. 

The operations of Nature herself, as well as of the substances described in the Materia 
Medica, and those of all other remedial measures, as food, climate, clothing, heat, cold, 
electricity, etc., are all embraced in the general term Therapeutics, which may be divided 
into two grand divisions, viz.: — 

Natural Therapeutics, including the operations of the Vis Medicatrix Naturae, — 
the modes and processes of healing which occur independently of Art, for the spon- 
taneous decline and cure of disease. There is no more completely established dogma in 
science, than that The Living Organism is in itself adequate to the cure of all its curable 
disorders. This Natural Law enables the homoeopath to relate his sugar cures, aids the 
medical skeptic to hold to his infidelity, and helps all physicians out of more close places 
than most of them are willing to acknowledge before their clientele. This part of the 
subject is not taught in the schools except in connection with pathology, and by the chair 
of Theory and Practice of Medicine. It is* deserving of a special chair and of more 
systematic treatment than it receives. 

17 



1 8 INTRODUCTION. 

Applied Therapeutics embraces the application by Art of agents foreign to the 
living organism, for the purpose of aiding Nature to restore the body to a healthy condi- 
tion. This division is the portion of the subject which is taught separately and systemati- 
cally in the schools, and therefore is alone considered in the following pages. 

Other divisions of the general subject of Therapeutics employed in 
professional literature and conversation are those entitled "Empirical" 
and "Rational Therapeutics." 

Empirical Therapeutics is a term applied to the use of medicinal 
or other therapeutical agents for the sole reason that they have been tried 
previously with successful results in cases apparently identical with the one 
under treatment. By those who advocate this method it is styled the 
Therapeutics of Experience, and claimed to be an accumulation of means 
of combating disease simply by observation and experiment, independ- 
ently of physio-pathological reasoning (Hartshorne). It was necessarily 
the original method in Therapeutics, has conferred many rich gifts upon 
medical science, and has been advocated by many great physicians, its 
latest and abiest expounder being the eminent and lamented Niemeyer. 

The use of Opium to relieve pain, — that of Cinchona for malarial fevers, — of Colchi- 
cum in gout, — of Potassium Iodide in syphilis, — of the Bromides in epilepsy, — of Cod- 
liver Oil in phthisis, — are examples of the empirical use of remedies. But, after all has 
been said for it that can be said, the fact remains that it is essentially an unscientific 
method, a mere elaboration of the prevailing popular habit of recommending Mrs. A. to 
use pepper tea, because it cured Mrs. B. of " the very same trouble." Permitted to reign 
supreme, it would be destructive to all exactness in therapeutical progress. The so-called 
"experience" of one observer is too often overbalanced by the experience of another 
equally competent and trustworthy; and as few are encouraged to record their failures 
with remedies, there can be no scientific comparison of the failures with the reported suc- 
cesses. For this reason empirical methods would tend to a minimum degree of accuracy 
in a science which, in the very nature of things, can never be an exact one; — though 
undoubtedly such methods will always prevail to some extent. 

Rational Therapeutics embraces the use of remedies for reasons 
based on a knowledge (i) of the pathological conditions present in the 
subject, and (2) of the physiological action of the agent employed. 
This method is the very antithesis of empiricism, and has been the lead- 
ing idea in every revolt against empirical therapeutics in the past. Humor- 
alism, Chemicism, Solidism, Stimulism, Galenism in the 2d century, 
Paracelcism in the 16th, and Hahnemannism in the 19th, all originated 
in efforts to find a more rational system of administering medicines than 
. the prevailing empiricism of the day. * 

The illustrious Albrecht von Haller, the father of Physiology and the 

author of the doctrine of Irritability, was the real originator of modern 

physiological therapeutics. In the preface to his Swiss Pharmacopoeia 

{circa A.D. 1755), occur the following remarkable directions, — the first 

recorded of their kind : — 

" Nempe primum in corpore sano medela tentanda est, sine peregrina ulla miscela; 
odoreque et sapore ejus exploratis, exigua illius dosis ingerenda et ad omnes quae inde 
contingunt affectiones, quis pulsus, quis calor, quae respiratio, qusenam excretiones, attend- 
endum. Inde adductum phenominorum in sano obviorum, transeas ad experimenta in 
corpore segroto." 



INTRODUCTION. 



19 



" In the first place the reiyiedy is to be tried on the healthy body, without any foreign 
substance mixed with it ; having been exa?nined as to its odor and taste, a small dose is 
to be taken, and the attention directed to all effects which theretipon occur ; such as ztpon 
the pulse, the temperature, the respiration, the excretions. Having thereby addticed their 
obvious phenomena in health, you may pass on to experiment upon the sick body" 

Forty or more years after these rules were laid down ex cathedra by 
Haller, the central idea contained in them was incorporated as one of 
the main pillars, into a medical edifice then being erected in Germany. 
In the course of construction this pillar became so hidden beneath a super- 
structure of palpable absurdities, that the medical profession, in its anxiety 
to steer clear of the whole mass, almost forgot the corner-stone of truth, 
appropriated from the teachings of one of its own greatest teachers. 
While, however, the masses of the profession, blinded by prejudice, 
turned away from everything which savored of drug-experiment, a few in 
every country were quietly working on the lines of Haller's dogma that 
Drug-proving is the only true basis of diug-using. As a result of their 
labor, the present generation sees the development of an idea, announced 
nearly 140 years ago, but now inspiring the minds of teachers and students 
all over the civilized world. Medical Colleges are recognizing physiologi- 
cal drug-experimentation as a part of their regular curricula ; — laboratories 
are fitted up in many of the schools with costly instruments of precision, 
for the more exact prosecution of this study ; and under the direction of 
such men as Wood, Ringer, Murrell, Brunton, Hildebrandt, Lieber- 
meister, Husemann, Schmiedeberg, etc., systematic researches are being 
conducted upon animals to ascertain the physiological action of every 
agent hitherto used in medicine. The alkaloids, and other component 
principles of vegetable drugs, are being subjected to the same rigid obser- 
vation, — as also every new compound which chemistry gives to medicine. 
Journals, in every civilized country, teem with the results of these labors ; 
and no medical student is permitted to pass the graduating ordeal until he 
has mastered the essential characteristics of the physiological action of 
the important medicaments so far as established. What has hitherto 
been the conviction of but a few, is daily growing into a fixed canon of 
professional belief, — that physiological experimentation with drugs must 
be the basis of their therapeutical employment, and that all real advance 
towards the establishment of Therapeutics as a science, must be made 
upon the lines laid down by Haller, i. e., drug-proving upon the healthy 
human organism. Still, in the words of Brown-Sequard, " Therapeutics 
will cease to be empirical, only when this last kind of knowledge shall 
be fully obtained; " — but its fulness will never be fully realized, unless 
the results have been thoroughly considered with full regard to the differ- 
ences due to the action of drugs in different doses on the human organism 
in health and disease. 



ADMINISTRATION OF MEDICINES. 



Medicines may be introduced into the circulation by various routes, as 
the gastro-intestinal tract, the rectum, the respiratory tract, the veins and 
arteries, the subcutaneous cellular tissue, and the integument itself. 

The Gastro-intestinal Route is the one most frequently employed, 
being the most convenient. The remedies after being swallowed, find 
their way into the current of the circulation, through the walls of the 
gastro-intestinal bloodvessels and the lacteals. When the stomach is 
empty and its mucous membrane healthy, crystalloidal substances in 
solution pass through the walls of its vessels with great rapidity. Col- 
loidal substances (fats, albumen, gum, gelatin, etc.) require to be digested 
and emulsified before they can be absorbed. 

The Rectum will absorb many substances applied in the form of 
Enemata or Suppositories. Those most suited to this route are the salts 
of the alkaloids in solution, especially those of Morphine, Atropine and 
Strychnine, the latter being absorbed more rapidly per rectum than by 
the stomach. Acid solutions, if not too frequently repeated, are also 
well administered by this channel. 

The Respiratory Tract admits of the rapid absorption of medicinal 
substances through its extensive blood-supply. The inhalation of vapors 
or atomized fluids, the insufflation of powders into the nares, fauces, 
larynx, etc., and the use of a medicated nasal douche, are methods 
whereby this channel may be utilized. 

The Veins are only used as a route of medication in emergencies, 
when the other channels are not available, and where immediate action 
is necessary to the preservation of life, the operation being a highly 
dangerous one. The injection intravenously of Saline Solutions in the 
collapse of cholera, diabetic coma, etc., — Blood or Milk as a last resort in 
excessive hemorrhage, epilepsy, uraemia, the collapse of cholera, etc., — 
and a solution of Ammonia for the bites of venomous reptiles, Hydro- 
cyanic-acid poisoning, Opium narcosis, Chloroform asphyxia, etc., are 
the instances admitted in practice. 

20 



ADMINISTRATION OF MEDICINES. 21 

Arterial Transfusion has also been performed successfully in a 
number of cases, and is considered safer than venous transfusion when 
a large quantity of fluid has to be introduced into the circulation. A 
special apparatus is employed for these purposes, known as Aveling's 
Transfusion Syringe, but the ordinary Dieulafoy's aspirator slightly 
modified, may be used with safety and convenience. The danger of the 
operation lies in the liability of the introduction of air into the circu- 
lation, an occurrence which may cause instant death in the human sub- 
ject. 

The Hypodermic Method is the introduction of medicines into 
the organism by injecting them into the subcutaneous areolar tissue, 
from which they are quickly absorbed by the lymphatic and capillary 
vessels. The great advantage of this method is the absolute certainty as 
to the quantity of drug actively affecting the organism, a very essential 
question when using small quantities, as with powerful alkaloids. Another 
is the avoidance of reactions between the drug and the secretions of the 
stomach, which may destroy the activity of the former, or seriously 
change its character. The medicines must be in solution, of neutral 
reaction and freshly prepared, the usual menstruum being distilled water ; 
though filtered spring water will answer just as well, and much better 
than distilled water which has been standing several days, and exposed 
from time to time to the air. The solution is to be injected beneath the 
skin, by a hypodermic syringe, care being taken to avoid puncturing a 
vein. The most suitable localities for the injection are the external 
aspect of the arms and thighs, the abdomen, the back, and the calves of 
the legs. On the external aspect of the thigh, just in front of the great 
trochanter, there is an area of some two inches square, over which the 
insertion of a fine hypodermic needle is not felt, so barren is the skin 
in that region of sensitive nerve filaments. 

After nearly filling the syringe with the solution to be used, the needle should be screwed 
on tightly; and with the instrument held in a vertical position, point uppermost, the 
excess of solution over the amount required should be ejected, thus expelling air-bubbles 
and filling the needle itself. A portion of skin may be grasped by the thumb and fore- 
finger at the site selected for the injection, into which the needle should then be quickly 
inserted until its point has passed beneath the skin, when the piston may be pressed down 
slowly, delivering the solution gradually so as to avoid rupturing the tissue. If the solu- 
tions are freshly prepared with clean water, the needles kept clean and sharp, and the 
injection be made beneath the skin not into it, there will be no risk of producing abscesses 
with the agents ordinarily employed. Tablets for hypodermic use are prepared by the 
prominent manufacturers, each containing one dose. They may be readily dissolved in a 
teaspoon at the bedside, or in the syringe itself, if one be used which has a screw-hole 
sufficiently large to admit the pellet before screwing on the needle. A regular line of 
Hypodermic Tablets includes the agents named in the following list, put up in tubes of 25 
each. 



ADMINISTRATION OF MEDICINES. 



List of Hypodermic Tablets. 

Morphine Sulphate, . 

Morphine & Atropine, No. I 
Morphine Sulph., 
Atropine Sulph., 

Morphine & Atropine, No. : 
Morphine Sulph., 
Atropine Sulph., 

Picrotoxin, 

Pilocarpine Hydrochlorate, 

Pilocarpine Nitrate, . 

Physostigmine Sulphate, . 

Sodium Arsenate, 

Strychnine Sulphate, 

Strychnine Sulphate, 

[For Formulae for Hypodermic Solutions, see Appendix.] 



Aconitine (crystals), . 
Apomorphine Muriate, 
Atropine Sulphate, . 
Atropine Sulphate, 
Cocaine Hydrochlorate, 
Coniine Hydrobromate, 
Colchicine, 


• gr-rk- 

• g r - to- 

• gr. A- 

• g r - iho 

• gr. i- 

• g r - h 

• g r - 3V 


Corrosive Sub. and Urea, 


• g r - T5- 


Digitalin (soluble), . 
Gelsemine Muriate, . 


• g r 'T<T0 

• g r - 30- 


Hyoscine Hydrobromate, 


• g r TF0 


Hyoscyamine, . 
Morphine Sulphate, . 


• g r - sV 



gr.f 

gr. I 
gr. 2 Ju. 

gr. i 
gr. tbu 
g^ t&- 

gr-i. 

g r - t<j<>- 
g r - to- 

g r - TtV 
g r - TITO- 



> 



Parenchymatous Injection is the delivery of a medicine deeply 
into the tissues, either to affect a muscle itself or to locally influence some 
important nerve-trunk. The principal agents used in this manner are 
Strychnine for palsied muscles, Chloroform for sciatic and other neuralgias, 
Salts of Cocaine for local anaesthesia, and Carbolic Acid for deep-seated 
inflammations. 

The Skin is an active absorbent of crystalloidal substances when its 
epidermis or cuticle is removed. By this route there are four methods of 
introducing medicaments into the circulation, viz. — the Enepidermic, 
Epidermic and Endermic Methods, and Inoculation. 

The Enepidermic Method consists in placing the medicine in 
simple contact with the epidermis, no friction being used to hasten its 
penetration. Chloroform and Oleic Acid solutions of the alkaloids pass 
by osmosis in this manner with comparative ease, but aqueous solutions 
act very slowly, and alcoholic ones with great difficulty if at all. 

The Epidermic Method consists in the use of friction to promote 
the passage of the medicament between the cells of the epidermis. Mer- 
curial Ointment, Cod-liver Oil, and other fats, Oleates, etc., are used in 
this way for their local and systemic effects. 

The Endermic Method obviates the difficulty of absorption through 
the cuticle by removing the latter through the agency of a blister, and 
then powdering the medicament over the surface of the denuded derma. 

An ordinary Cantharides-plaster, followed by a poultice to raise the blister, may be 
employed ; but a quicker method is to place upon the skin a piece of lint soaked in Stronger 
Water of Ammonia, covering it with a watch-glass or a piece of oiled silk to prevent 
evaporation. The blister raises rapidly and should then be removed with scissors. Mor- 
phine, Atropine, Quinine and Strychnine, are the agents generally used in this manner, 
but the method is painful and unpopular. 

Inoculation is the introduction of medicinal agents through the 
scraped or punctured skin by an operation similar to that employed for 
vaccination. 



CLASSIFICATION OF MEDICINES. 



In the present state of knowledge respecting the actions and uses of 
medicinal agents, no really scientific classification of these substances is 
possible. Some writers have adopted a system based on the natural rela- 
tions of the various articles to each other, while many classify them 
according to their effects on the human system, and others make no 
attempt at arrangement but treat of them in alphabetical order. The 
latter method has been followed in this work, from a conviction that every 
medicine should first be studied as an individual, both with respect to its 
physiological actions and its therapeutical applications. When the student 
has thus made himself familiar with the characteristic features of each 
article of the Materia Medica, he may begin, by comparing one with 
another, to seek acquaintance with their more delicate lights and shades. 
Some system of classification then becomes imperative as an aid to the 
memory, and as the titles of the groups to which the various agents belong 
in any physiological classification are also used to express their actions 
and uses, the following synopsis is inserted as an appropriate introduction 
to the section on Materia Medica and Therapeutics. 

Stimulants and Sedatives. 
These are general terms employed in various classifications with very 
little discrimination. 

Stimulant {Stimulus, a goad), — is a term which is used in various 
senses when applied to medicinal agents. Alcoholic preparations, which 
are true narcotics, are commonly termed "stimulants," and the same 
expression is employed to designate any agent which excites the organic 
action of a part of the economy. • 

Diffusible Stimulants are those which have a prompt but transient effect on the general 
system, such as Alcohol, Ammonia, Camphor, etc. Spinal Stimulants exalt the func- 
tions of the cord, as Strychnine, Picrotoxin, Ergot, Atropine, Phosphorus. Cardiac 
Stimulants increase the action of the heart, as Alcohol, Atropine and Morphine in small 
doses, Strychnine, etc., also Squill, Convallaria, Cimicifuga and Digitalis, which slow but 
strengthen the cardiac action. Respiratory Stimulants directly stimulate the respiratory 
centre, as Ammonia, Strychnine, Apomorphine, Belladonna, etc. Vaso-mptor Stimulants, 
as Alcohol, Chloroform, Ether, Ammonia, Strychnine, Digitalis and Squill, acting on the, . 
vaso-motor centre; and the Nitrites, Belladonna, Electricity, Volatile Oils, etc., acting as 
local dilators of the vascular system. Cerebral Stimulants, as Alcohol, Opium, Belladonna, 

23 



24 AGENTS ACTING ON THE NERVOUS SYSTEM. 

Caffeine, Cocaine, Theine, Cannabis, Chloroform, Ether, Tobacco, etc. Renal Stimulants, 
as the diuretic group. Stomachic Stimulants, as the Aromatics, Volatile Oils, Vegetable 
Bitters, Mineral Acids, Nux Vomica, Mustard, Capsicum, etc. Hepatic Stimulants, as 
Nitro-muriatic and Nitric acids, and the cholagogue purgatives Podophyllum, Jalap, Lep- 
tandra, Euonymin, Iridin, etc. Intestinal Stimulants, as Mercurials, Elaterium, Colo- 
cynth, Jalap, Scammony, Podophyllum, etc., which affect the glandular apparatus, — and 
Belladonna, Physostigma, Nux Vomica, Rhubarb, Senna, Aloes, Frangula, Cascara, etc., 
which chiefly affect the muscular fibres and the intestinal nerves. Cutaneous Stimulants, 
as the diaphoretic group, and the rubefacients Mustard, Capsicum, Turpentine, Ammonia, 
etc. All stimulation reacts into depression, and most of the agents which stimulate the 
nerve centres at first, soon depress and finally paralyze them. The action, in many cases, 
is one of progressive stimulation at first, and progressive paralysis afterwards, affecting the 
centres in the inverse order of their development, the highest or latest developed being 
affected first, the lowest or oldest last. These laws are well exemplified in the action of 
Alcohol upon the nervous system. [See the article Alcohol in Part I.] 

Sedatives (Sedo, I allay), — are agents which exert a soothing influ- 
ence on the system by lessening functional activity, depressing motility 
and diminishing pain. 

General Sedatives include the narcotics and anaesthetics. Local Sedatives include Aco- 
nite, Opium, Ice, etc. Pulmonary Sedatives, as Hydrocyanic Acid, Veratrine and the 
nauseants and emetics. Spinal Sedatives, as Physostigma, Gelsemium, Potassium Bro- 
mide. Stomachic Sedatives include Arsenic, Bismuth, Silver Nitrate, Sodium Bicar- 
bonate. Vascular Sedatives, as Digitalis, Tobacco, Aconite, Veratrum, and the emetics. 
Nervous Sedatives, among which are Potassium Bromide, Tobacco, Lobelia, and the 
group of spinal depressants. 

Agents Acting Chiefly on the Nervous System. 
Motor-Excitants are agents which increase the functional activity 
of the spinal cord and the motor apparatus, producing disturbances of 
motility, heightened reflex excitability, and tetanic convulsions when 
given in large doses, their ultimate effect being motor paralysis from over- 
stimulation. 

The most important members of this class are Nux Vomica and Ignatia, with their 
alkaloids Strychnine and Brucine, also Thebaine, the tetanizing alkaloid of Opium. It 
also includes Morphine and Atropine, which, though at first sedative, when given in large 
doses produce convulsions. The respiratory centre in the medulla is stimulated by Strych- 
nine, Atropine, Ammonia, and small doses of Alcohol, Ether and Chloroform. The 
motor convolutions in the brain are stimulated by Alcohol in moderate doses, as also for 
a brief period by Eiher and Chloroform. 

The end -organs of the motor nerves are stimulated by the local use of Electricity, Strych- 
nine and friction ; and are irritated by the internal administration of Aconitine, Nicotine, 
Camphor, Pilocarpine and Pyridine. Other members of this class are embraced in the 
following list : — 

Nux Vomica. Alcohol. f Ergot. Digitalis. 

Ignatia. Ether. f Ustilago. Convallaria. 

Strychnine. Chloroform.f Gossypium. Cimicifuga. 

Brucine. Ammonia. Picrotoxin. Pilocarpine. 

Thebaine. Absinthe. Aconitine. Pyridine. 

Morphine* Buxine. Nicotine. Rhus Toxicodendron. 

Atropine.* Calabarine. Camphor. Electricity. 

Motor-Depressants lower the functional activity of the spinal cord 
and motor apparatus, and in large doses paralyze them. Some act indi- 

* In large doses. f In small doses. 



AGENTS ACTING ON THE NERVOUS SYSTEM. 



25 



rectly by reducing the spinal circulation, as Digitalis, Aconite and large 
doses of Quinine ; others by directly paralyzant action on the centres. 
The principal members of this class may be enumerated as follows, viz. — 



Opium, Morphine. 

Gelsemium. 

Muscarine. 

Pulsatilla. 

Grindelia. 

Phytolacca. 

Physostigma. 

Belladonna. 

Stramonium. 

Hyoscyamus. 

Pilocarpus. 

Quebracho. 

Camphor. 

Aconite. 

Tobacco. 

Lobelia. 

Carbolic Acid. 



Curare. 

Conium. 

Chloral. 

Ergot (at last). 

Arnica. 

Ailanthus. 

Veratrum. 

Alcohol. * 

Ether. * 

Chloroform. * 

Bromides. 

Potassium. 

Lithium. 

Zinc. 

Hydrocyanic Acid. 

Potassium Cyanide. 



Amyl Nitrite. 
Sodium Nitrite. 
Methyl Strychnine. 
Ethyl Strychnine. 
Methyl Thebaine. 
Methyl Veratrine. 
Methyl Conilne. 
Other Methyl Compounds. 
Ammonium Cyanide. 
Ammonium Iodide. 
Ethyl Ammonium Chloride. 
Amyl Ammonium Chloride. 
Amyl Ammonium Iodide. 
Amyl Ammonium Sulphate. 
Other Compound Ammonias. 
Galvanism. 



The motor centres in the medulla are powerfully depressed by Opium, Morphine, Aco- 
nite, Conium, Chloral, Physostigma, and large doses of Alcohol, Ether, and Chloroform. 
These last three are also paralyzers of the motor convolutions in the brain, arresting all 
voluntary movements when administered in sufficient quantity. The anterior cornua of 
the cord are greatly depressed by Physostigma, Carbolic Acid, and other agents, and the 
motor nerves by Conium, Methyl-Strychnine, etc., both actions resulting in paralysis of 
the limbs. Curare, even in small doses, paralyzes the end-organs of the motor nerves, 
and Belladonna, the compound Ammonias, Methyl compounds, etc., exercise a similar but 
less powerful influence. Galvanism is also an effective local depressant of motor activity. 

Local Stimulants increase common sensibility to the extent of pro- 
ducing pain, chiefly by direct action upon the end-organs of the sensory 
nerves in the skin, though some act probably by stimulating the local cir- 
culation, as in inflammation. The principal members of this group are — 



( 



Faradism. 

Heat. 

Cold. 

Alcohol. 

Ether. 



Chloroform. 
Carbolic Acid. 
Creosote. 
Mineral Acids. 
Ammonia. 



Volatile Oils. 
Acrid Essential Oils. 
Metallic Salts. 
Veratrine (at first). 
Cantharis (at first). 



Local Anaesthetics and Anodynes (An, without, Aistheysis, per- 
ception, Odunay, pain), — reduce the functions of the sensory nerves until 
they lose the power of receiving or conducting sensations. Some act by 
direct depression of the end-organs in the skin, etc., others by impairing 
the conductivity of the sensory nerves, while some act indirectly by 
reducing the local circulation. The Anodynes diminish, and the Anaes- 
thetics destroy, for a time, the sensibility of the skin or mucous membrane. 
The chief agents of this class are — 

Local Anodynes. Local Anesthetics, 

Aconite, Aconitine. Extreme Cold, Ice. 

Belladonna, Atropine. Ether Spray. 

Opium, Morphine. Carbolic Acid. 



* In large doses. 



26 AGENTS ACTING ON THE NERVOUS SYSTEM. 

Local Anodynes. Local Ancesthetics. 

Carbolic Acid. Ouabain. 

Chloroform. Cocaine. 

Chloral. Erythrophloein. 

Veratrum, Veratrine. Hydrocyanic Acid. 

Volatile Oils. Creosote. 

Galvanism. Oil of Turpentine. 

Iodoform. 

Cerebral Excitants, — are remedies which increase the functional 
activity of the cerebrum, without producing any subsequent depression, or 
any suspension of the cerebral functions. They act partly by increasing 
the action of the heart and consequently the rapidity of the circulation, 
partly by a direct action upon the gray matter of the brain. The chief 
members of this group are — 

Alcohol (at first). , Ammonia (inhaled). Tobacco. 

Ammoniac. Coffee, Caffeine. Strychnine. 

Asafetida. Tea, Theine. Acetic Acid (inhaled). 

Camphor. Guarana, Guaranine. Valerian. 

Cannabis. Coca, Cocaine. 

Deliriants excite the functions of the higher brain to such a degree as 
to disorder the mental faculties, producing intellectual confusion, loss 
of will-power, delirium and even convulsions. They are all narcotics 
(though all narcotics are not deliriants), and may be listed as follows, 
viz. — 

Belladonna. Alcohol. Cannabis Indica. 

Stramonium. Chloral. Lupulus (at first). 

Hyoscyamus. Opium (at first). 

Cerebral Depressants lower or suspend the functions of the higher 
cerebrum after a preliminary stage of excitement. Under this head may 
be included the Narcotics, General Anaesthetics, and several of the Anti- 
spasmodics, all acting on the cells of the convolutions ; at first stimu- 
lating the brain-functions, they produce after a time stupor, coma and 
insensibility. 

The most useful of this class are the Bromides, Zinc and Caffeine, as they also diminish 
reflex excitability and thus secure rest of the nervous system. Some of them are decidedly 
dangerous, as they may paralyze the heart or the medulla and its centres of organic life 
before the consciousness is much disturbed ; such being Chloroform, Aconite, Opium, and 
the irritant poisons, also Carbolic Acid. 

Narcotics (Narkay, stupor), — are agents which, at first excitant to the 
higher brain, produce profound sleep, characterized by stupor, and if the 
dose be sufficient, coma, insensibility and death by paralysis of the medul- 
lary centres governing respiration and other functions of organic life. 
They are closely related to the stimulants, Opium and Alcohol being good 
illustrations, in the different stages of their action, of both stimulant and 
narcotic effects. The action of Alcohol particularly exemplifies the three 



AGENTS ACTING ON THE NERVOUS SYSTEM. 2J 

great Laws of Drug-Action, viz.— That all stimulation reacts into depres- 
sion, — that most agents which at first stimulate the nerve centres after- 
wards depress and finally paralyze them, — and that when drugs so affect 
the functions progressively, they do so in the inverse order of their 
development, the highest or latest developed function being affected first, 
the lowest or oldest last. [See the article Alcohol in Tart I.] 

These agents give us the power of lowering perception, inducing 
sleep and soothing the vital functions by rest, all of which are means of 
great therapeutical value. The chief narcotics are — 

Alcohol. Hyoscyamus. Cannabis Indica. 

Opium, Morphine. Stramonium. Chloroform, Ether, etc. 

Belladonna, Atropine. Humulus. Chloral-hydrate. 

Croton-chloral . 

Hypnotics {Heupnos, sleep), — are remedies which produce sleep, and 
in this wide sense of the term the class would include the Narcotics and 
the Anaesthetics, as well as those agents which may be termed Pure Hypnot- 
ics, which induce sleep by bringing the brain into a favorable condition 
therefor, rather than by direct soporific action. In this sense the purest 
hypnotics are the Bromides, but artificial sleep may be produced by 
many other agents. The principal members of this class are the follow- 
ing:— 

Bromides. Paraldehyde. Hypnone. 

Monobromated Camphor. Hyoscyamus. Methylal. 

Chloral -hydrate. Hyoscine. Humulus. 

Chloralamid. Sulphonal. Lettuce. 

Croton-chloral. Trional. Amylene Hydrate. 

Cannabis, Cannabin. Tetronal. Piscidia Erythrina. 

Opium, Morphine, Narceine. Urethan. General Anaesthetics. 

Analgesics or Anodynes {An, without, Algos, pain, Odunay, pain), 
— are remedies which relieve pain either by direct depression of the 
centres of perception and sensation in the cerebrum, or by impairing 
the conductivity of the sensory nerve fibres. Opium is the most 
efficient of all analgesics, because it arrests the afferent impressions at 
every step of their track — at their formation, along the course of their 
conduction, and at the point where they impinge on the sensorium. The 
Local Anodynes have been described, and the list of General Anodynes 
includes the following-named agents, viz. — 



Opium, Morphine. 


Antipyrin. 


Aconite. 


Belladonna, Atropine. 


Acetanilid. 


Chloroform, Ether, etc 


Cannabis Indica. 


Phenacetin. 


Conium. 


Stramonium. 


Phenocoll. 


Chloral-hydrate. 


Hyoscyamus. 


. Exalgin. 


Croton-chloral. 


Gelsemium. 




Lupulus. 



Anaesthetics {An, without, Aisthaysis, perception), — are agents which 
destroy sensation. Local Ancesthetics have been described. General 
Ancesthetics are certain volatile substances, mostly belonging to the classes 



28 AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 

of alcohols and ethers, which when inhaled produce complete uncon- 
sciousness and loss of sensation (anaesthesia), with lessened motor power. 
Narcotics also produce anaesthesia, but this term is usually restricted to 
the effects of the volatile agents referred to above. The principal mem- 
bers of 'this group are — 

Ether (Ethyl Oxide). Chloroform. 

Methylene Bichloride. Chlorinated Ethyl Chloride. 

Ethylene Bichloride. Ethyl Bromide. 

Nitrous Oxide. Pental (Tri-methyl- ethylene). 

The list of General Anaesthetics also includes many other substitution products derived 
from alcohols and ethers. 

Antispasmodics (Anti, against, Spasmos, a spasm), — are agents which 
prevent or allay spasm of voluntary or involuntary muscles in any portion 
of the organism. Some of the agents belonging to this class act by 
stimulation of the higher nervous centres, the coordinating power, and 
the circulation, as Alcohol and Ether in small doses, Camphor, Musk, 
Valerian, etc.; others by a depressant influence on the motor centres, as 
the Bromides, and still others by paralysis of the end-organs of the vaso- 
motor nerves, as Amyl Nitrite. A few depress all the vital functions, as 
Aconite, Tobacco, Lobelia, Hellebore, and Prussic Acid ; and a long list 
stimulate the bowels to expel gaseous accumulations, namely, Asafetida, 
Cajuput, Valerian, Musk, Aromatic Oils, etc. They are used in convul- 
sive affections, especially asthma and other spasmodic diseases of the 
respiratory organs, hysteria, chorea, angina pectoris, epilepsy, etc. The 
principal antispasmodics are as follows, viz. — 



Alcohol. 


Aconite. 


Ammoniac. 


Ether. 


Lobelia. 


Castor. 


Chloroform. 


Tobacco. 


Musk. 


Amyl Nitrite. 


Hellebore. 


Galbanum. 


Nitrites. 


Opium. 


Sumbul. 


Bromides. 


Belladonna. 


Ipecacuanha. 


Potassium Iodide. 


Stramonium. 


Senega. 


Potassium Nitrate. 


Hyoscyamus. 


Silver Salts. 


Arsenic. 


Hydrocyanic Acid. 


Zinc Salts. 


Valerian. 


Physostigma. 


Copper Salts. 


Conium. 


Curare. 


Asafetida. 



The Cerebellum is affected by a few drugs, their action upon its 
several lobes producing various disturbances of equilibrium. 

Alcohol is the principal agent acting upon this portion of the brain, and different pro- 
ducts of the still seem to affect different portions of the cerebellum. For instance, intoxi- 
cation by wine or beer is said to cause lateral falling, that by whiskey an inclination to fall 
face downwards, cider a backward tendency (Brunton). Apomorphine in large doses 
produces a tendency to move in a circle, and therefore probably affects the cerebellum or 
the corpora quadrigemina. 

Agents Acting on the Organs of Special Sense. 
Mydriatics (Meudos, moisture), — are agents which produce-dilatation 
of the pupil of the eye (mydriasis). Some act locally, others when given 



AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 29 

internally, and the principal ones (Atropine and its congeners) act both 
locally and internally, producing at the same time paralysis of the ciliary 
muscle resulting in temporary loss of accommodation, the eye remaining 
focussed for distant objects, and the intra-ocular tension being increased. 
The principal mydriatics are the following named, — 

Atropine. Homatropine. 

Belladonnine (internally only). Gelsemine (locally only). 

Hyoscyamine. Muscarine. 

Daturine. Cocaine. 

Duboisine. Anaesthetics (at last). 

The dilating action of Atropine and its congeners is due to stimulation of the end- 
organs of the sympathetic nerve, increasing the power of the radiating muscular fibres of 
the iris, and also to paralysis of the end-organs of the motor oculi (3d cranial) nerve, 
lessening the power of the circular fibres or sphincter iridis. When administered inter- 
nally the drug is carried by the circulation to the eye, acting thereon locally as if instilled 
directly upon the conjunctiva. Cocaine acts by stimulating the terminations of the sym- 
pathetic. Ancesthetics produce mydriasis late in their action, which is central. Atropine, 
Duboisine and Homatropine are the mydriatics used by ophthalmologists. 

Myotics (Meuo, I close), — are agents which produce contraction of 
the pupil. The alkaloid Physostigmine (Eserine) is the chief local 
myotic, and the only one used in ophthalmic practice. It acts by stim- 
ulating the circular muscular fibres of the iris, at the same time contract- 
ing the ciliary muscle so that the eye is accommodated for near objects 
only, and diminishing intra-ocular tension ; in all of which it exactly 
antagonizes the action of Atropine. 

Muscarine, Pilocarpine and Nicotine are also local myotics, acting upon the end- 
organs of the oculo-motor nerve. Anaesthetics in the early stage of their action cause 
contraction of the pupil by lessening reflex action ; later, when they begin to paralyze 
respiration the accumulation of venous blood irritates the centres and produces dilatation, 
which during anaesthesia is a sign of failing respiratory power. The myotic action of 
Opium is of central origin, probably paralysis of the local reflex excitability. The chief 
myotics are as follows : — 

Physostigma, Eserine. Muscarine. Lobeline (internally). 

Opium, Morphine. Gelsemine (internally). Nicotine (locally). 

Pilocarpus, Pilocarpine. Carbolic Acid (internally). Anaesthetics (at first). 

Accommodation is impaired or paralyzed by the following named 
drugs, acting upon the ciliary muscle, viz. — 



I 



Atropine. 


Homatropine. 


Cocaine. 


Daturine. 


Physostigmine. 


Gelsemine 


Hyoscyamine. 


Pilocarpine. 





Intraocular tension is increased by Atropine (large doses), Hyoscyamine and Daturine ; 
and is decreased by Physostigmine and by Cocaine. Gelsemine paralyzes the external 
ocular muscles, especially the levator palpebrae and external rectus, by its action on the 
terminal nerve filaments. 

The Sensibility of the Eye is increased by Strychnine, the field of 
vision becoming extended, and the vision rendered more acute. If the 
drug be administered hypodermically the improvement will be more 
marked in the eye corresponding to the side of the body where the injec- 
tion was made. 



30 AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 

The sensibility for color is affected by drugs, Strychnine increasing the field for blue, 
Eserine diminishing it for red and green, and Santonin causing objects to appear at first 
of a violet and afterwards of a greenish-yellow color. 

Visions are produced by several drugs, their action being probably 
on the cerebral sight-centres (angular gyrus and occipital lobes) rather 
than on the eye. Alcoholic delirium is a familiar instance, while Canna- 
bis Indica often causes pleasant visions, and Sodium Salicylate in some 
persons produces very disagreeable ones. Digitalis may produce subjec- 
tive sensations of the continued presence of light. JSromides in excess 
may produce visions of such intensity that their subject remembers them 
distinctly for years afterwards. 

Amblyopia, or impairment of vision from nerve-changes, is produced 
temporarily by Quinine, and may be permanently induced by Tobacco, 
Alcohol, Lead and Urea. 

The Ear is affected by several drugs. Strychnine and Morphine 
increase the excitability of either the auditory nerve or the centre for 
hearing (superior temporo-sphenoidal convolution), making that faculty 
much more acute. Quinine, Antipyrine and Salicylates produce hypere- 
mia of the auditory apparatus, causing subjective noises, as humming, 
buzzing or ringing, which are very unpleasant. Hydrobromic Acid and 
the B?'omides, also Ergot, will diminish the congestion and to a great 
extent will neutralize or prevent these noises. 

Quinine in large doses is believed by some to have produced permanent injury of the 
sight and the hearing, but authentic cases of such action are extremely rare, if indeed 
they can be found at all. Temporary deafness is often caused by Quinine, but it usually 
disappears soon after the administration of the drug is stopped. 

The Sense of Smell is also increased by Strychnine, and decreased 
by all cerebral depressants and by those agents which produce changes in 
the nasal mucous membrane, e. g., Potassium Iodide. 

The cerebral centre for this faculty is situated at the tip of the temporo-sphenoidal lobe, 
and the terminal branches of the olfactory nerve are distributed upon the mucous lining 
of the upper portion of the nasal fossae. Strychnine probably stimulates the former, and 
all drugs acting upon the latter region would have more or less effect upon the power of 
distinguishing smells. 

The Taste is not much affected by drugs except as each makes its 
peculiar impression on the nerves of taste, and may overcome that of 
another agent. Smell has much to do with taste in many instances, the 
expedient of holding the nose while swallowing Castor Oil being familiar 
to every one. 

The " after-taste" of drugs is often different to their original taste; thus Bitters are said 
to leave a sweet after-taste, and the same is claimed for Quinine if given in acid solution 
so as to be entirely dissolved, and if washed out of the mouth with water immediately after 
swallowing. Substances which are excreted from the system in the saliva (as Iodides) 
leave a very persistent after-taste. 



AGENTS ACTING ON RESPIRATION. 3 1 

Agents Acting on Respiration. 
The Respiratory Centre is situated in the medulla oblongata, close to 
the termination of the calamus scriptorius. It probably consists of thoracic 
and diaphragmatic Inspiratory centres, the act of expiration being consid- 
ered normally a passive one, due to the natural contraction of the walls 
of the air-vesicles, and the return of the diaphragm and thoracic walls to 
the position from which they were moved by the inspiratory effort. An 
Expiratory Centre must also exist for the initiation of forced expiration, 
as in the production of voice, cough, sneezing, etc. The chief Inspira- 
tory Nerves are the pulmonary branches of the vagus. The Expiratory 
Nerves are the nasal branches of the fifth, the superior and inferior laryn- 
geal, and the cutaneous nerves of the chest and abdomen. 

Respiratory Stimulants exalt the function of the respiratory centre, 
quickening and deepening the breathing. Such agents, besides Opium in 
small doses, are — 

Chloralamid. Brucine Digitalis. Quebracho. 

Strychnine. Thebaine. Zinc salts. Tobacco (briefly). 

Atropine. Apomorphine. Copper salts. Alcohol (briefly). 

Duboisine. Emetine. Ammonia. Ether (briefly). 

Strychnine also stimulates the vagus tract. Electricity applied to the nerve-trunks or 
to the inspiratory muscles, is a direct respiratory stimulant. Veratrine, Eserine, and Mus- 
carine stimulate the vagus terminations, quickening the respiration, but afterwards slow it 
by depressing the respiratory centre. Aconite stimulates the end-organs of the vagus 
when given in small doses. 

Respiratory Depressants lower the activity of the respiratory 
centre, rendering the respirations slow and shallow. The chief agents of 
this class are — 



i 



Cold. 


Gelsemium. 


Alcohol. 


Caffeine. 


Opium. 


Aconite. 


Ether. 


Colchicine. 


Physostigma. 


Veratrine. 


Chloroform. 


Nicotine. 


Muscarine. 


Hydrocyanic Acid. 


Chloral. 


Quinine. 


Lobeline. 


Conium. 


Saponin. 


Camphor. 
Carbolic Acid. 



The eleven last named first excite the centre for a brief period and then depress it. 

Pulmonary Sedatives diminish cough and dyspnoea by lessening the 
irritability of the respiratory centre or the nerves of respiration. Some 
act by directly depressing the respiratory centre, as those enumerated 
under the preceding head ; others by removing some irritant from the 
passages, or by lessening local congestion, as the expectorant group; and 
others by lowering the excitability of the vagus end-organs in the lungs, 
and of other afferent filaments throughout the respiratory tract. 

Opium has the most powerful influence as a sedative to the respiratory centre, and muci- 
laginous or saccharine substances soothe the local irritation, hence the latter are so fre- 
quently used as vehicles for the former in cough-mixtures. Hydrocyanic Acid has a 
similar sedative action, hence the use in coughs of Prunus Virginiana and other substances 
containing it. Belladonna stimulates the respiratory centre, but at the same time lessens 



32 AGENTS ACTING ON RESPIRATION. 

the excitability of the vagus terminations in the lungs, and completely arrests secretion 
from the 1 bronchi. Stramonium acts similarly. The principal pulmonary sedatives may 
be enumerated as follows : — 

Opium. Hydrocyanic Acid. Turpentine. 

Belladonna. Amyl Nitrite. Ethyl Iodide. 

Stramonium. Quebracho. Conium. 

Hyoscyamus. Cannabis. Tobacco. , 

Errhines and Sternutatories (En, in, Rhin, the nose; Sternuto, I 
sneeze), — are agents which produce increased nasal secretion and sneezing, 
when locally applied to the mucous membrane of the nose. The first term 
is usually applied to substances which cause increase of the mucus without 
sneezing, the latter to those which invariably produce sneezing. The drugs 
should be in powder for application. The stimulus produced by these 
agents is transmitted by the nasal branches of the fifth nerve to the respi- 
ratory centre, exciting the sudden and forcible expiratory effort called 
sneezing ; also to the vaso-motor centre, contracting the smaller vessels 
throughout the body and producing a general rise in the blood-pressure. 
The principal agents of this class are — 



Tobacco, as snuff. 


Euphorbium. 


Capsicum. 


Ipecacuanha. 


Sassy Bark. 


Hellebore. 


Sanguinaria. 


Saponin. 


Ammonia. 


Veratrum Album. 


Ginger. 


Cubebs. 



The last two named may be used as simple Errhines, as the vapor of dilute Ammonia - 
water or the smoke of burning Cubebs do not excite sneezing generally. 

Expectorants (Ex, out of, Pectus, the breast), — are remedies which 
modify the secretion of the broncho-pulmonary mucous membrane, and 
promote its expulsion. They may be divided into — 

Nauseating Expectorants, — in large doses act mechanically by expelling 
the mucus in the act of vomiting, in small doses by increasing osmosis 
from the inflamed mucous membrane. The members of this subdivision 
generally increase secretion and tend to lower the blood-pressure. The 
chief of them are the following named : — 

Antimony, Tartar Emetic. Apomorphine. Potassium Iodide. 

Ipecacuanha, Emetine. Quebracho. Lobelia. 

Pilocarpus (Jaborandi). Alkalies. Lobeline. 

Stimulant Expectorants, — are largely eliminated by the bronchial 
mucous membrane, which they stimulate, altering the secretion and facili- 
tating expectoration. These remedies generally diminish secretion and 
increase blood-pressure. They are — 



Ammonium Chloride. 


Acids. 


Nux Vomica. 


Ammonium Carbonate. 


Squill. 


Strychnine. 


Benzoin and Benzoic Acid. 


Garlic. 


Senega. 


Balsams of Peru and Tolu. 


Onion. 


Saponin. 


Wood Tar, and Tar. 


Turpentine. 


Liquorice. 


Oleum Pini Sylvestris. 


Sulphur. 


Saccharine Substances. 



AGENTS ACTING ON THE CIRCULATION. 33 

Besides the above many other remedies may act as expectorants, some by relieving 
bronchial spasm, as Opium, Stramonium and Tobacco, — others by soothing the irritable 
respiratory centre, as Opium and Chloral, — and the ciliary excitants by reflex action 
through their impression on the nerves of the mouth. 

Ciliary Excitants, — promote the expectoration of bronchial mucus 
by their reflex excitation of the tracheal and bronchial cilia, when dis- 
solved in the mouth. Gum Acacia, Ammonium Chloride, Potassium 
Chlorate, and native Chloride of Sodium have this action. 



Agents Acting on the Circulation. 
Cardiac Stimulants rapidly increase the force and frequency of the 
pulse in depressed conditions of the cardiac apparatus. One of the most 
useful agents of this class is Alcohol in some form, its action being largely 
due to a reflex influence excited through the nerves of the mouth and 
stomach. It should therefore be given in but slightly diluted form, and 
in small quantities frequently. Ether is next in value and still more rapid 
in action, and Heat is one of the most powerful and available of the class. 
Ammonia has an energetic action as a stimulant to the vaso -motor centre, 
as well as a reflex one upon the heart similar to that of Alcohol. The list 
of cardiac stimulants includes the following, viz. : — 

Alcohol. Cocaine. Sparteine. 

Ammonia. Ether. Camphor. 

Atropine. Chloroform. Aromatic Oil. 

Nitroglycerin. Heat. Turpentine. 

Hydrastinine. Continuous Galvanic Current, Opium and Morphine, in 

Counter-irritation. small doses. 

Cardiac Tonics, when given in moderate doses, stimulate the cardiac 
muscle, slowing and strengthening its contractions. In large doses they 
are apt to produce irregular action of the heart, and some of them have 
more or less of a tendency to cause sudden death by syncope if pushed to 
any great extent. The most important of these agents are — 

Digitalis. 
Convallaria. 
Cimicifuga. 
Sparteine. 

Digitalis acts partly by stimulation of the vagus end-organs in the heart, thus increasing 
cardiac inhibition, and partly by direct stimulation of the cardiac centre in the medulla, as 
well as by a direct influence on the heart muscle itself. Convallaria, Erythrophlcetim, 
Squill, and Cimicifuga act similarly but less powerfully, and are correspondingly safer. 
Strophanthus is still better, as it does not affect the vessels, and therefore does not raise 
the blood-pressure. 

Cardiac Sedatives lessen the force and the frequency of the heart's 
action and are used to control palpitation of that organ, and to slow the 
pulse in febrile conditions in sthenic subjects, especially when local inflam- 
mation is the exciting cause. The chief cardiac sedatives are — 
3 



Squill. 

Erythrophloein. 

Caffeine. 


Strophanthus. 

Strychnine. 

Helleborein. 


Saponin. 


Adonis vernalis. 



34 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



Aconite. 


Pilocarpine. 


Senega, Saponin. 


Antimony. 


Digitalis. 


Hydrocyanic Acid 


Veratrum Viride. 


Ouabain. 


Potassium Salts. 


Muscarine. 


Emetine. 


Cold. 



Aconite, Veratrum, Muscarine, Pilocarpine, Saponin, and Hydrocyanic Acid are 
direct cardiac poisons, depressing the heart muscle and the cardiac motor ganglia ; 
Muscarine and Pilocarpine also stimulate the inhibitory ganglia; Digitalis stimulates the 
vagus centre and the cardiac muscle, and acts as a sedative in many cases by slowing the 
rate and giving it a regular rhythm. Aconite is said by some authorities to relax inhibi- 
tion, by others to stimulate the vagus centre. Antimony depresses the motor ganglia, 
Potassium the cardiac muscle. 

Vascular Stimulants produce dilatation of the peripheral vessels, 
and increase the rapidity of the circulation, thus equalizing the blood- 
pressure and preventing internal congestions. The most useful are 
Alcohol and Ether, as they stimulate the action of the heart simultaneously 
with the vascular dilatation. The chief members of this group are: — 

Alcohol. Belladonna. Chloral. 

Ether. Stramonium. Chloroform. 

Nitrous Ether. Hyoscyamus. Liq. Ammonii Acetatis. 

Nitroglycerin. Opium (at first). Ipecacuanha. 

Amyl Nitrite. Hydrocyanic Acid. Heat, as Poultices, etc. 

Tartar Emetic. 

The dilating action of A ?ny I Nitrite and other Nitrites is due to weakening either of 
the muscular walls of the arterioles or to paralysis of the vaso-motor ganglia in them. 
Alcohol, Ether and Opium probably depress the vaso-motor centre. 

Vascular Tonics produce increased contraction of the arterioles and 
consequently increased blood-pressure. The most important are — 



Digitalis. 


Iron. 


Strychnine. 


Squill. 


Ergot. 


Lead and Silver. 


Strophanthus. 


Opium (in small doses). 


Hamamelis. 



These agents act upon the local vaso-motor mechanism in the walls of the vessels, 
which are also directly stimulated by cold produced in any way, as by Ether spray, or 
evaporating lotions containing Alcohol, Vinegar or Ammonium Chloride. 

Vascular Sedatives increase the contraction of the vessels and lessen 
the circulation through them. They are employed to check hemorrhage 
and to cut short a local inflammation. The chief agents belonging to 
this group are — 



Cold. 


Hamamelis. 


Opium. 


Ergot. 


Digitalis. 


Lead salts. 


Barium salts. 


Hydrastis. 


Cocaine (locally). 


Zinc salts. 


Sulphuric Acid. 


Antipyrin. 



Agents Acting on the Digestive System. 

Dentifrices (Dens, a tooth, Frico, I rub), — are medicated powders or 
pastes employed to cleanse the teeth and gums. Chalk is the basis gener- 
ally used, for its mechanical action and its alkaline quality. Antiseptics, 
as Borax, Quinine, Carbolic Acid, etc., should also be employed so as to 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 35 

prevent the acid fermentation of food products between the teeth and the 
consequent decay of the dentine. Tincture of Myrrh is an excellent 
ingredient, being an aromatic local stimulant and disinfectant. 

Many drugs affect the teeth injuriously, such being the Mineral Acids, Persalts of Iron 
and Alum. The first two should be taken through a glass tube, and the mouth should be 
afterwards rinsed with a weak alkaline wash. Opium, Chloral, Cocaine, Carbolic Acid, 
Creosote, Potassium Chlorate, and Aconite are the agents used as local anodynes in tooth- 
ache from caries exposing a nerve filament. Chloral should never be used for this pur- 
pose, for in solution sufficiently strong to be of any service it will cause sloughing of the 
gum, especially if injected thereinto with a hypodermic syringe, as is frequently done 
by ignorant dentists. 

Sialogogues (Seeaion, saliva, Ago, I carry off), — are agents which 
increase the secretion and flow of saliva and buccal mucus, either by reflex 
action from the local irritation produced when anything is taken into the 
mouth, or by stimulating the glands during their elimination. The . 
principal sialogogues are divided into two classes, the first (topical) 
acting by reflex stimulation, the second (general) acting through their 
systemic influence on the glands or their secretory nerves. They are as 
follows : — 

Topical Sialogogues. General Sialogogues. 

Acids and Alkalies. Pilocarpus (Jaborandi). 

Ether, Chloroform, etc. Muscarine. 

Mustard, Ginger. Physostigma. 

Pyrethrum, Mezereon. Mercurials. 

Tobacco, Cubebs. Iodine compounds. 

Capsicum, Rhubarb. Antimonials. 

Horse-radish. Tobacco, Ipecacuanha. 

Antisialics (Anti, against, Seealon, saliva), — are remedies which di- 
minish the secretions of the salivary glands. Atropine is the principal 
agent of this group, acting by paralyzing the terminations of the nerves of 
secretion. Physostigma counteracts this paralysis, but in large doses acts 
as an antisialic by lessening the blood supply to the glands. Opium dimin- 
ishes the reflex excitability of the reflex centre and also diminishes the 
secretion. Others acting locally are — 



Borax. 




Soda. 










Lithia. 


Potassium 


Chlorate. 


Lime. 










Magnesia. 




Insipid or 


nauseous artic 


es 


of food 


or 


med 


icine. 



Refrigerants (Refrigero, I cool), — are remedies which allay thirst and 
impart a sensation of coolness. They include the Vegetable Acids, the 
Mineral Acids (greatly diluted), Ice, Water if cold, Effervescing drinks, 
Fruit juices, and many diaphoretics. 

Gastric Tonics or Stomachics, — are agents which increase the 
appetite and promote gastric digestion. They include a number of sub- 
stances, dietetic and medicinal, some acting by stimulation of the pro- 



36 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

duction of gastric juice, others by stimulating the local circulation, and 
several by exciting the activity of the nervo-muscular apparatus of the 
stomach. 

The first indication is met by the use of dilute alkaline solutions before meals, — the 
second by administering any of the pungent carminatives, as the Aromatic Oils, Pepper, 
Mustard, etc., or by Alcohol and Ether in small doses, or by the Aromatic Bitters, as Gen- 
tian, Orange, etc., or the simple bitters, as Calumba ; — while the third desideratum is 
secured by the use of such agents as Nux Vomica, Hydrastis, Arsenic, the dilute Mineral 
Acids and the Volatile Oils. 

Adjuvants to gastric digestion are the digestion-ferments, Pepsin, Ingluvin, Papain, also 
dilute HCl acid ; which may be used to supplement the gastric juice when deficient in 
quantity or quality. The juice of the Pineapple contains a very active digestive principle, 
and may be employed as an aid to digestion with excellent results. Pepsin acts in acid 
media, and is only applicable to gastric indigestion; Pancreatin acts in alkaline media, 
is destroyed by acids, and is only applicable to intestinal indigestion ; while Papain 
exercises its proteolytic power in either acid, alkaline or neutral solutions, and is equally 
applicable to either gastric or intestinal indigestion. 

Acids, — considered therapeutically and physiologically, are medicines 
which in concentrated form act usually as caustics, and when given in 
medicinal doses internally check the secretions of organs producing acid 
secretions with which they come in contact, and increase those of organs 
producing alkaline secretions. Thus a dilute acid given before meals will 
check the production of the acid gastric juice, but will stimulate that of 
the alkaline pancreatic juice. 

The chief members of this group are the following, which should be given in very 
dilute form : — 

Acidum Aceticum. Acidum Nitricum. 

Acidum Citricum. Acidum Phosphoricum. 

Acidum Benzoicum. Acidum Sulphuricum. 

Acidum Hydrochloricum. Acidum Nitro-hydrochloricum. 

Ant-acids or Alkalies, — from the same stand-point, are remedies 
which neutralize acids, check alkaline secretions and stimulate acid secre- 
tions, when in contact with the ducts of the organs producing them. Thus 
a dilute alkali given before meals will stimulate the production of the acid 
gastric juice, and if applied to the mouth of the pancreatic duct will 
check the secretion of the alkaline pancreatic juice. The principal 
articles which belong to this group are the following, which should always 
be administered in dilute solution : — 

Liquor Potassae, Liquor Sodse. Potassium Acetate. 

Carbonates and Bicarbonates of Potassium, Potassium Citrate. 

Sodium, Lithium, Magnesium and Am- Potassium Tartrate. 

monium. Potassium Bitartrate. 

Calcined Magnesia (Magnesia). Sodium Acetate. 

Lime-water, Chalk. Sodium Citrate. 

Aromatic Spirit of Ammonia. Lithium Citrate. 

The substances in the first list are direct antacids, lessening the acidity in the stomach, 
and many of them also acting as remote antacids, lessening the acidity of the urine, as 
Potash and Soda, and their Carbonates and Bicarbonates. Ammonia and its Carbonates 
after absorption are eliminated as urea, and do not lessen the acidity of the urine. The 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 7)7 

salts in the second list are remote antacids, do not lessen acidity in the stomach, but do 
that of the urine, being oxidized in the blood and excreted as Carbonates. 

Emetics (Eemeo, I vomit), — are agents which produce vomiting. 
They may be subdivided into two groups, (i) Local Emetics, or those 
which act by irritating the end-organs of the gastric, pharyngeal or oeso- 
phageal nerves, and (2) General or Systemic Emetics, which act through 
the medium of the circulation. Both these classes produce the emetic 
action by irritation of the vomiting centre in the medulla, the first by 
reflex, the second by direct stimulation. The principal emetics are the 
following named : — 

Local Emetics. General Emetics. 

Alum, Mustard, Salt. Ipecacuanha, Emetine. 

Ammonium Carbonate. Ouabain. 

Zinc and Copper Sulphates. Apomorphine. 

Subsulphate of Mercury. Tartar Emetic. 

Tepid Water, in quantity. Veratrine. 

Vegetable Bitters, as Quassia, Senega. 

in strong infusions. Squill. 

Tartar Emetic, Ipecacuanha and probably Apomorphine, act locally as well as systemi- 
cally, for if injected subcutaneonsly they are excreted by the stomach in part, thus irritat- 
ing the gastric nerves as well as the vomiting centre. Pilocarpus is a local emetic, and 
Digitalis and its congeners, also Muscarine, are systemic emetics, but none of these 
agents are used medicinally for that purpose. Opium, Morphine and Codeine usually 
produce emesis as one of their after effects. 

Anti-emetics, — are agents which diminish nausea and vomiting, some 
by a local sedative action upon the end-organs of the gastric nerves, 
others by reducing the irritability of the vomiting centre in the medulla. 
The most efficient of the local sedatives is Ice, swallowed in small pieces. 
Astringents are very useful when there is congestion of the gastric mucous 
membrane, as in the vomiting of alcoholism and phthisis, where Silver 
Nitrate and Alum are respectively effective. The most important anti- 
emetics are the following, viz. : — 

Local Gastric Sedatives. General Sedatives. 

Alcohol. Creosote. Opium. 

Alum. Ether. Morphine. 

Arsenic. Ice. Hydrocyanic Acid. 

Belladonna. Opium. Bromides. 

Bismuth. Hydrocyanic Acid. Chloral. 

Carbonic Acid. Silver Nitrate. Nitro-glycerin. 

Cerium Oxalate. Calomel 1 small Food. 

Chloroform. Ipecac j doses. Alcohol. 

Carbolic Acid. Hot Water. Amyl Nitrite. 

Potassium Nitrate. Cocaine. 

Vomiting being set up by irritation of many afferent nerves from various regions of the 
body, or by impulses from the brain excited through impressions on the nerves of special 
sense, the measures for combating it are very diversified. (Compare the title Vomiting, 
in Part III.) 

Gastric Pain is best treated by such local sedatives as Bismuth, Hydrocyanic Acid, or 



I 



38 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

small doses of Morphine, Arsenic and Belladonna. Cocaine is one of the most efficient 
agents of this class, in 5 to 6 minim doses of a 4 per cent solution, every hour. As its 
general action is opposed to that of Opium, Bromides, etc., it must act locally, and 
therefore should be given by the mouth. 



Carminatives (Carmino, I soothe), — aid the expulsion of gas from 
the stomach and intestines by increasing peristalsis, stimulating the 
circulation, and relaxing the cardiac and pyloric orifices of the stomach. 
They also act as diffusible stimulants, both of the bodily and mental 
faculties. The principal carminatives belong to the aromatic oils, 
alcohols or ethers, and are embraced in the following list : — 



Asafetida. 


Mustard. 


Oil of Eucalyptus. 


Capsicum. 


Pepper. 


Oil of Fennel. 


Cardamom. 


Spirits. 


Oil of Peppermint. 


Chloroform. 


Oil of Anise. 


Oil of Spearmint. 


Ether. 


Oil of Cajuput. 


Oil of Nutmeg. 


Fennel. 


Oil of Caraway. 


Oil of Pimento. 


Ginger. 


Oil of Cinnamon. 


Oil of Valerian. 


Horse-radish. 


Oil of Cloves. 


Camphor. 


Mace. 


Oil of Coriander. 


Serpentaria. 



Cathartics or Purgatives (Kathairo, Purgo, I cleanse), —are agents 
which increase or hasten the intestinal evacuations. According to their 
respective degrees and direction of action they are subdivided into several 
groups, as follows : — 

Laxatives {Laxo, I loose), or Aperients {Aperio, I open), — include those 
which excite moderate peristalsis, and produce softened motions without 
irritation. Sulphur is the typical laxative. 

Simple Purgatives, — increase peristalsis actively, and stimulate the 
secretions of the intestinal glands, producing one or more copious and 
semifluid motions with some irritation and griping. Senna is the type of 
this group. 

Drastic Purgatives (Drao, I act), — act still more intensely, producing 
violent peristalsis and watery stools, with much griping pain, tenesmus, and 
borborygmi. They irritate the intestinal mucous membrane, cause exos- 
mosis of serum from its vessels, and in large dose set up inflammation and 
symptoms of irritant poisoning. Jalap is a typical drastic. 

Saline Purgatives, — consist of the neutral salts of metals of the alkalies 
or alkaline earths. They stimulate the glands, increase peristalsis, promote 
osmosis and cause free watery evacuations. Magnesium Sulphate is a 
typical saline. 

Hydragogue Purgatives {Heudore, water, Ago, I bring away), — include 
the most active of the drastic and saline groups, those which remove a large 
quantity of water from the vessels. Elaterium is a typical hydragogue. 

Cholagogue Purgatives {Kohlay, bile, Ago, I bring away), — are those 
agents which stimulate the flow of bile and produce free purgation at the 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



39 



same time, the stools being green-colored, or "bilious," and liquid. 
Podophyllin is the type of this group. 

The principal Cathartics are the following named : — 



Laxatives. 


Simple Purgatives. 


Drastics. 


Sulphur. 


Senna. 


Jalap. 


Magnesia. 


Aloes. 


Colocynth. 


Cassia. 


Rhubarb. 


Elaterium. 


Manna. 


Castor Oil. 


Scammony. 


Figs. 


Rhamnus Frangula. 


Gamboge. 


Prunes. 


Ox-gall. 


Croton Oil. 


Tamarinds. 


Calomel . 


Cathartic Acid, hypoder 


Honey. 


Small doses of drastics, 


mically. 


Olive Oil. 


salines or cholagogues. 




Cascara Sagrada. 




Hydragogues. 


Physostigma. 


Saline Purgatives. 


Elaterium. 


Ergot. 


Magnesium Sulphate. 


Gamboge. 


Belladonna. 


Magnesium Citrate. 


Potassium Bitartrate. 


Stramonium. 


Potassium Sulphate. 


Croton Oil. 


Hyoscyamus. 


Potassium Tartrate. 


Salines in large doses. 


Soap. 


Potassium Bitartrate. 




Almond Oil. 


Sodium Sulphate. 


Cholagogues. 


Taraxacum. 


Sodium Phosphate. 


Mercurials. 


Glycerin. 


Sodium Chloride. 


Aloes. 


Oatmeal. 


Pot. et Sodium Tartrate. 


Rhubarb. 


Bran Biscuit. 


Manganese Sulphate. 


Euonymin. 


Brown Bread. 




Podophyllin. 
Iridin. 



Intestinal Astringents, contract the walls of the intestinal vessels, 
diminishing the exudation therefrom, and lessening the fluidity of the 
faecal discharges. The more powerful members of this group have also a 
constringing action on the intestinal mucous membrane. The principal 
agents of this class are the following : — 



Astringents. 

Phosphoric Acid. 
Nitric Acid. 
Sulphuric Acid. 
Acetic Acid. 
Lead Acetate. 
Silver Nitrate. 



Diluted. 



Constringents. 

Tannic Acid. 
Vegetable Astringents. 
Alum. 
Zinc Oxide. 
Copper Sulphate. 
Persalts of Iron. 



Hepatic Stimulants and Cholagogues (Kohlay, bile, Ago, I bring 
away), — are two groups of agents acting upon the biliary secretion, the 
first-named increasing the functional activity of the liver and the amount 
of bile formed, the second removing the bile from the duodenum and 
preventing its reabsorption into the portal circulation. Some hepatic 
stimulants are also cholagogues, others are not, while cholagogues proper 
generally act as hepatic stimulants by carrying off the bile and so indirect- 
ly urging the liver to secrete more. The discovery of the entero-hepatic 
circulation of bile has cleared up many of the discrepancies formerly 
existing with regard to the action of drugs upon this gland and its secre- 



40 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



tion. The following list includes the principal drugs belonging to both 



groups : — 






Hepatic Stimulants. 


Cholagogues. 


Aloes. 


Potassium Sulphate. 


Aloes. 


Podophyllin. 


Sodium Sulphate. 


Podophyllin. 


Mercuric Chloride. 


Bicarbonate. 


Mercurous Chloride 


Sodium Benzoate. 


Ammonium Benzoate. 


Pil. Hydrargyri. 


Phosphate. 


Chloride. 


Mercury with Chalk 


Salicylate. 


Nitric Acid (dilute). 


Sodium Phosphate. 


Nitro-hydrochloric Acid. 


Benzoic Acid. 


Sulphate. 


Euonymin. 


Baptisin. 


Potassium Sulphate. 


Iridin. 


Hydrastin. 


Colchicum. 


Phytolaccin. 


Juglandin. 


Colocynth. 


Sanguinarin. 


Leptandrin. 


Rhubarb. 


Antimony. 


Jalapin. 


Arsenic. 


Arsenic. 


Scammony. 


Euonymin. 


Ipecacuanha. 


Guaiac. 


Scammony. 


Colchicine. 


Sarsaparilla. 


Baptisin. 


Colocynth. 


Physostigma. 


Jalapin. 


Rhubarb. 


Rochelle Salt. 


Iridin. 



Those in the first column are the most powerful of the stimulant group, the second 
column including the less efficient agents. To secure the best cholagogue effect it is ad- 
visable to combine an hepatic stimulant with an intestinal stimulant which shall produce 
increased secretion from the intestinal mucous membrane and excite peristalsis. 

The Glycogenic Fu?iction of the liver, and the production of urea are 
stimulated by the following-named drugs : — 



Increasing Glycogen. 
Amyl Nitrite. 
Sodium Bicarbonate. 
Nitro-hydrochloric Acid. 



Increasing Urea. 
Arsenic. Iron. 

Antimony. Phosphorus. 

Ammonium Chloride. 



Hepatic Depressants are agents which lower the functional activity 
of the liver, reducing the quantity of bile secreted, and lessening the pro- 
duction of glycogen and urea. They are as follows, viz. : — 



Lessening Bile. 
Opium. Morphine. 
Many Purgatives. 
Lead Acetate. 
Quinine (?) 
Alcohol (?) 



Diminishing Glycogen. 
Opium. 

Morphine, Codeine. 
Phosphorus. 
Arsenic. 
Antimony. 



Lessening Urea. 
Opium. 
Morphine. 
Colchicum. 
Alcohol. 
Quinine. 



Many purgatives act as hepatic depressants and diminish the secretion of bile by lower- 
ing the blood pressure in the liver, and by carrying off the materials from which bile 
might be formed. 

Pancreatic Stimulation may be obtained by the administration of 
Ether, or by Galvanism of the gland itself. The secretion is depressed 
by Atropine and by inducing nausea and vomiting. 

Anthelmintics (Anti, against, Helmins, a worm), — are agents which 
destroy (vermicides) or cause the expulsion of intestinal worms (vermi- 
fuges). The chief vermifuges are Castor Oil, Jalap and Scammony, 
while the vermicides may be enumerated as follows, viz. : — 



AGENTS ACTING ON METABOLISM. 4 1 

Thread Worms Round Worms Tape Worms 

(Oxyuris Vermiat/aris). (Ascaris Ltimbricoides). (Teenies, etc.}. 

Alum. Santonica. Filix Mas. 

Sulphate of Iron. Santonin. Kamala. 

Lime Water. Spigelia. Kousso. 

Quassia. Chenopodium. Granatum. 

Eucalyptol. Azedarach. Pelletierine. 

Sodium Chloride. Senna. | with the Pepo. 

Tannin. Calomel. J above. Turpentine. 

Veg. Astringents. Naphtalin. Chloroform. 

Naphtalin. Naphtalin. 

The substances enumerated in the first column are all used locally by enema. Adjuncts 
to these remedies are such agents as prevent the excessive secretion of intestinal mucus, 
which affords a nidus for the worms. Such are Bitter Tonics and preparations of Iron, 
also Ammonium Chloride and Sodium Chloride. 



Agents Acting on Metabolism. 

Restoratives, — are agents which promote constructive metamorpho- 
sis, including the Foods, Haematics, and Tonics, as well as many agents 
called Stimulants in other classifications. 

Foods, — are substances which, when introduced into the body, supply 
material to renew some structure or to maintain some vital process ; being 
distinguished from medicines in that the latter modify some vital action 
but supply no material to sustain such. 

The food of man is derived from all three of the kingdoms of nature, viz., the mineral, 
vegetable and animal, and includes many substances treated of in the Materia Medica, 
as Oils and Fats, Sugar, Starch, Gum, Alcohol, Beverages like Coffee and Tea, Water, 
Phosphate of Lime, Sodium Chloride, etc. 

Hozmatics (JTaima, the blood), — are medicines which augment the quan- 
tity of hsematin in the blood, and thus restore the quality of that tissue 
by enriching its red corpuscles. They consist chiefly of Iron and Man- 
ganese and their compounds. 

Tonics ( Tonnos, tension), — are agents which improve the tone of the 
tissues on which they have specific action, restoring energy and strength 
to debilitated subjects, by a scarcely perceptible stimulation of all the 
vital functions, their effects being apparent in an increased vigor of the 
entire system. The chief tonics are enumerated in the foregoing lists 
under the heads of the organs, or tissues particularly affected by them. 
(Compare the titles Stimulants, Respiratory Stimulants, Cardiac 
Tonics, Vascular Tonics, Gastric Tonics, etc.) 

The most typical medicinal agents which impart a general sense of tone and strength 
are Strychnine, Quinine, Iron and Vegetable Bitters. Those especially acting upon the 
stomach, are Arsenic, Bismuth, Cinchona, Hydrastis and Nux Vomica, — on the spinal cord 
and general circulation, Strychnine, — on the heart, Digitalis, Squill, Convallaria and Cimi- 
cifuga, — on the nervous system, Phosphorus, Quinine and the Valerianates, — on muscular 
tissue, Tannin, — on the blood, Iron, Manganese, Cod-liver Oil, and other fats. 



42 AGENTS ACTING ON METABOLISM. 

Alteratives, — are certain remedies which alter the course of morbid 
conditions in some way not yet understood, perhaps by promoting meta- 
bolism. They certainly modify the nutritive processes and thereby cure 
many diseases of chronic type. Mercury and Iodine are the most promi- 
nent agents of this class, the former being endowed with the power of 
breaking up newly deposited fibrin, and disorganizing syphilitic deposits, 
while the latter acts energetically upon the lymphatic system and promotes 
absorption. Arsenic also is almost specific in many chronic skin affec- 
tions, and has remarkable power over chronic pulmonary consolidations, 
probably producing fatty degeneration and softening of the effusion, so 
that it may be absorbed or expectorated. The principal alteratives are : — 

Arsenic. Mercury. Iodine. 

Antimony. Colchicum. Iodides. 

Aurum. Guaiacum. Stillingia. 

Mezereum. Sanguinaria. Sarsaparilla. 

Sulphur. Xanthoxylum. Cod-liver Oil. 

Sulphides. Calcium Chloride. Phosphorus. 

Certain therapeutists of laboratory type have, of late years, seen fit to denounce the 
term Alterative as " a cloak for ignorance," but have never been able to present a better 
designation for a class of agents whose effects are among the most thoroughly established 
of clinical facts. 

A subdivision may be made of the Resolvents or Discutients {Resolvo, 
I unbind, Discutio, I dissipate), — agents which promote the absorption of 
inflammatory products or other materials of morbid origin, apparently by 
stimulation of the lymphatic system. They include Mercury, Arsenic, 
Iodine, and Cadmium, as well as such local measures as Poulticing and 
Counter-irritation. 

Destructive Metamorphosis of the tissues is promoted by a num- 
ber of agents, most of which are classed as Alteratives or as Astringents, 
the most important of which are the following-named: — 

Alkalies. Sulphides and Iodides. 

Vegetable Acids. Sarsaparilla. 

Metals and their salts. Stillingia. 

Colchicum. Xanthoxylum. 

Tannic and Gallic Acids, and substances containing them. 

Destructive Metamorphosis may be diminished by many substances, the 
following-named being the chief ones: — 

Resorcin. 
Chinolin. 
Cocaine. 

Antipyretics (Anti, against, Reurelos, fever), — are agents or measures 
which reduce the body-temperature when abnormally high. This may be 
done by two principal methods, and the agents doing either accomplish 
the result by different actions, as follows, viz. : — 



Alcohol. 


Salicin. 


Glycerin. 


Salicylates. 


Oils and Fats. 


Quinine. 



AGENTS ACTING ON METABOLISM. 



43 



r)r . jj t) j ,- r zr . 7 \ i. Diminishing tissue-change. 

By Lessening the Production of Heat, by { „ t> , . .? . n .. fe 

' s \ 2. Reducing the circulation. 



or by 
Promoting the Loss of Heat, by 



f 3. Dilating cutaneous vessels, and producing increased 
radiation. 

4. Producing perspiration, and its evaporation. 

5. Abstracting heat from the body. 

The following list contains nearly all the antipyretics, the number 
following each referring to its proper method of action, as enumerated 
above : — 



Quinine. 1 
Quinidine. 1 
Cinchonine. 1 
Cinchonidine. 1 
Berberine. 1 
Benzoic Acid. 1 
Carbolic Acid. 1 , 3 
Picric Acid. 1 
Salicin. 1 
Salicylic Acid. 1 
Sodium Salicylate. 1 , 
Quinine Salicylate. 1 
Methyl Salicylate. 1 

(Oil of Gaultheria. 
Trimethylamin. 2 
Acetanilid. 1 , 4 



Chinolin. 1 
Resorcin. 1 
Kairin. 1 , 4 
Kairolin. 1 , 4 

Antipyrin. 1 , 4 

Hydroquinon. 1 

Thallin. 1 , 4 

Pyrocatechin. 1 

Pheno- resorcin. 1 

Camphor. 1 

Eucalyptol. 1 

Thymol. 1 

Other Essential Oils. 

Alcohol. 1 , 3 

Digitalis. 2 

Salol. 1 



Phenacetin. 1 . 4 
Aconite. 2 
Antimonials. 2 , 4 
Veratrine. 2 
Colchicum. 2 
Leeching. 2 
Cupping. 2 
Blistering. 2 
Poulticing. 2 
Nitrous Ether. 3 , 4 
Dover's Powder. 4 
Cold Bath. & 
Cold Drinks. 5 
Ice to Surface. 5 
Cold Sponging. 5 
Wet Packing. 5 



Purgation and Venesection produce antipyretic results, but their mode of action is doubt- 
ful (Brunton). 

The Body Temperature is raised by Belladonna (or Atropine) and by Cocaine, but not 
to such a degree as to constitute fever or enable them to be classed as pyretics. Tubercu- 
lin, various albumoses, and certain animal poisons, as that of shell fish, will also produce 
a rise of temperature. 

Antiphlogistics (Anti, against, Pfleggo, I burn), — are measures and 
medicines which are supposed to have some specific power in reducing 
inflammation. The term is becoming obsolete, but frequent references 
are seen yet to the influence of Mercury and Opium in inflammations of 
serous membranes, Antimony and Aconite in inflammations of the respir- 
atory tract and organs, and to the power of Veratrum Viride over puer- 
peral metritis. The chief antiphlogistics are the following : — 



Aconite. 

Veratrum Viride. 
Tartar Emetic. 
Mercury. 
Opium. 
Gelsemium. 



Digitalis. 

Ergot. 

Ipecacuanha. 

Potassium Nitrate. 

Rest, recumbent position. 



Venesection. 
Local Depletion. 
Purgation. 
Counter-irritation. 
Cold. 



Antiperiodics, — are remedies which affect certain periodical febrile 
diseases, lessening the severity of their paroxysms or preventing their 
return. They act probably by arresting the development in the blood of 
successive crops of pathogenic organisms, upon which the disorders are 
supposed to depend. The principal antiperiodics are : — 



Cinchona Bark and its Alkaloids. 
Bebeeru Bark and its Alkaloid. 
Salicin, Salicylic Acid, Salicylates. 



Arsenic. 

Eucalyptol. 
Iodine. 



44 



AGENTS ACTING UPON EXCRETION. 



Agents Acting upon Excretion. 
Diuretics (Z>eeouraysis, urination), — are remedies which increase the 
renal secretion. They may act in several ways, namely : — 

1. By raising the general blood-pressure by contraction of efferent vessels or vessels in 

other regions of the body. 

2. By dilating the renal arteries and increasing the renal blood-supply, raising the pres- 

sure in the glomeruli. 

3. By stimulating the secreting nerves or cells of the kidney. 

4. By simply washing out the kidneys, as by Water in quantity. 

The following list contains the most important agents of this class, 
which are usually subdivided into the two groups indicated by the sub-titles. 
The numbers refer to the modes of action of the drug in the above 
synopsis: — 



Refrigerant Diuretics. 


Stimulant Diuretics. 


Potassium Acetate. 3 


Alcohol. 2 


Gin. 2 


Potassium Bitartrate. 3 


Cantharides. 3 


Carrot. 3 


Potassium Citrate. 3 


Turpentine. 3 


Fennel. 3 


Potassium Chlorate. 3 


Juniper. 3 


Mustard. 3 


Potassium Nitrate. 3 


Savine. 3 


Asparagus. 3 


Sodium Acetate. 3 


Copaiba. 3 


Uva Ursi. 3 


Calomel. 1 


Cubebs. 3 


Buchu. 3 


Digitalis. 1 


Pepper. 3 


Sarsaparilla. 3 


Erythrophlceum. 1 


Matico. 3 


Pareira. 3 


Caffeine. 3 


Kava. 3 


Chimaphila. 3 


Theobromine. 3 


Guaiac. 3 


Santonica. 3 


Broom. 3 


Parsley. 3 


Lobelia. 3 


Squill. 1 , 2 


Taraxacum. 3 


Aconite. 3 


Nitrites. 2 


Jaborandi. 3 


Tobacco. 1 , 3 


Colchicum. 3 


Dulcamara. 3 


Volatile Oils. 


Strychnine. 1 


Bryonia. 3 


Oleo- resins. 3 


Stigmata Maidis. 1 , 2 







Diuretics are employed for the following purposes, namely, (1) to 

remove the excess of fluid in dropsies, — (2) to hasten the elimination of 

waste products and other poisonous substances from the blood, — (3) to 
dilute the urine. In — 

Cardiac Dropsy, — or other dropsies due to venous congestion, the best diuretics are 
those which act on the general vascular system, as Digitalis, Squill, etc. Calomel is very 
efficient here, so also is Theobromine Sodio salicylate (Diuretin). 

Dropsy from Renal Disease, — Diuretin, Broom, Nitrous Ether, Oil of Juniper, Digitalis 
and Squill are the most reliable diuretics, in the order named. 

Hepatic Dropsy, — Copaiba is considered especially suitable. In this and the previous 
form a little Pil. Hydrargyri occasionally often aids the diuretic action of other agents. 

To Eliminate Solids, — Potassium Nitrate and Bitartrate, Turpentine, Juniper, Caffeine 
etc., are the most efficient. [Compare Antilithics.] 

To Dilute the Urine, — Water is the best diuretic, and the most efficient form is Dis- 
tilled Water acidified with Carbonic Acid Gas. 



Renal Depressants, — are such agents as directly diminish the 
activity of the renal cells, and lessen or suspend the secretion of urine. 
Morphine, Quinine and Ergot act in this way through the circulation, 



AGENTS ACTING UPON EXCRETION. 45 

and Digitalis, instead of acting as a diuretic, may arrest the renal circu- 
lation by stimulating the vaso-motor centre, and thus by contracting the 
vessels may stop the secretion altogether (Brunton). The same is true of 
Caffeine and Strychnine, hence it is well to combine these with other 
diuretics (Nitrous Ether, Alcohol), which dilate the renal arteries. 

Alkalinizers of the Urine, — are agents which produce an alkaline 
reaction of the urine when taken internally. They include the alkalies, 
particularly Potassium and Lithium salts, but excepting Ammonia, which 
is broken up in the organism. Sodium salts, being partly excreted by 
the bile and the bronchial mucus, and partly locked up in the system as 
the neutral chloride, while Sodium Urate is insoluble, are not as efficient 
in this regard as are other alkalies. Fruits, milk and fish also act 
in the same manner by means of the salts which they convey into the 
economy. 

Acidifiers of the Urine, — are Benzoic and Salicylic Acids, and 
several of their salts, Vegetable Acids in excess, also excess of proteids, 
sugar and starch in the food, and certain wines and spirits. The Mineral 
Acids have little or no influence on the acidity of the Urine, being 
excreted as neutral sulphates, chlorides, phosphates, etc. 

Salol is much quicker in its action upon the urine than is Ammonium Benzoate ; as, in 
a day or so, ordinarily, under its administration, the urine in chronic cystitis loses its 
alkalinity and foul odor, and becomes clear (Dr. Mansel Sympson). 

Vesical Sedatives, — are substances which lessen irritability of the 
bladder, relieving pain and increasing the desire to micturate. Opium, 
Belladonna, Hyoscyamus, Stigmata Maidis, Cannabis, etc., lessen the 
irritability of the nerves, Calcium Carbonate that due to the presence of 
calculi, — and mucilaginous drinks, such as Barley-water or Linseed tea, 
also astringents like Buchu, Uva Ursi, Pareira, etc., diminish the irrita- 
tion due to chronic cystitis, and antiseptics, as Copaiba, and Cubebs, also 
act in like manner. 

Vesical Tonics, — increase the contractile power of the muscular 
fibres in the wall of the bladder. Cantharides, Potassium Bromide, 
Strychnine and Belladonna are the most prominent members of this class. 

Urinary Sedatives and Astringents, — act sedatively upon the 
whole extent of the urinary tract through the medium of the urine charged 
with them when administered internally. Some of the members of this 
class may be administered locally, but only to the urethral and vesical 
mucous membranes, which are accessible to direct local medication. 

Instances of the application of these agents are in the use of Potassium and Lithium 
Salts to diminish the acidity of the secretion, — Cubebs, Copaiba and Sandal-wood Oil as 



46 AGENTS ACTING UPON EXCRETION. 

antiseptics and astringents, — and urethral injections of Alum, Zinc and Lead Acetates, 
Boracic Acid, Chloral and Zinc Chlorides, etc., for a similar purpose. Copaiba is one of 
the most efficient agents for rendering the urine antiseptic, and should be more employed 
in cystitis and urethritis than it is. Oil of Eucalyptus is nearly as efficient, and Stigmata 
Maidis (Corn Silk), in tincture, is beginning to be well thought of for a general alterative 
influence on the urinary tract. 

Antilithics or Lithontriptics {Anti, against, Leethos, a stone, Treebo, 
I wear down), — are agents supposed to prevent the formation of concretions 
in the excretory passages (antilithics) or to dissolve them when formed 
(lithontriptics). The terms are generally restricted to remedies affecting 
the urinary calculi, but those directed against the biliary form' are in- 
cluded in this arrangement for the sake of consistent classification. The 
chief agents coming under this title are — 

Biliary Calculi. Uric Acid Calculi or Urates. 

Ether and Turpentine. Distilled Water. 

(Durande's Solvent.) Potassium Salts. 

Sodium Bicarbonate. Lithium Salts. 

Sodium Salicylate. Potassium Tartraborate. 

Sodium Phosphate. Magnesium Citroborate. 

Castile Soap. Piperazin. 

Alkaline Waters, especially Vichy. Tetraethyl-ammonium. 

Calcium Oxalate Calculi. Phosphatic Calculi. 

Dilute Nitro-Hydrochloric Acid. Ammonium Benzoate. 

Carbonated Water. Benzoic Acid. 

Lactic Acid (for digestion). Dilute Nitric Acid. 

There is probably little or no solvent value to the agents recommended for biliary cal- 
culi. In the case of Uric Acid the administration of Potash or Lithia is based on their 
combining with the acid forming the calculus, and forming Urate of Potassium or Lithium, 
which salts are more soluble than the Uric Acid itself. Piperazin is, however, still more 
efficient in this respect, forming a piperazin urate which is seven times more soluble than 
lithium urate. 

Diluents (Diluo, I dilute), — are agents which, after their absorption, 
dilute the excretory fluids and enable the latter to hold more solid ma- 
terial in suspension. Water is the one true diluent, whatever form it may 
be disguised in, as teas, weak fluid foods, acid drinks, etc. 

Diaphoretics and Sudorifics (Deeaphorheeo, I carry through ; 
Sudor, sweat ; Facio, I make), — are remedies which increase the action of 
the skin and promote the secretion of sweat. When they act energetic- 
ally, so that the perspiration stands in beads upon the surface, they are 
known as Sudorifics. They may be subdivided into the following groups, 
viz. : — 

1. Simple Diaphoretics, which enter the circulation and are eliminated by the sudor- 
iferous glands, which they stimulate to increased action. 

2. Natiseating Diaphoretics, which produce relaxation and the dilatation of the super- 
ficial capillaries. 

3. Refrigeratit Diaphoretics, which reduce the circulation, at 'the same time acting 
directly on the sweat centres in the spinal cord and medulla. 



AGENTS ACTING ON THE GENERATIVE APPARATUS. 47 

The principal diaphoretics are enumerated as follows, the figures refer- 
ring to their respective supposed modes ofactionas indicated above, viz.: — 

Jaborandi, 1 - 3 Ether. 2 ' 3 Lobelia. 2 - 3 

Pilocarpine. 1 - 3 Alcohol. 2 - 3 Sarsaparilla. 1 

Salicylic Acid. 1 Nitrous Ether. 2 - 3 Guaiacum. 1 

Salicylates. 1 Ammonium Acetate. 1 Serpentaria. x 

Ipecacuanha. 2 Ammonium Citrate. 1 Sassafras. 1 

Tartar Emetic. 2 Dover's Powder. 2 Senega. 1 

Sulphur. 1 Aconite. 3 Vapor Bath. 2 

Opium 2 - 3 (large doses). Veratrum Viride. 3 Turkish Bath. 2 

Camphor. 1 Potassium Salts. 3 Wet Pack. 2 

Tobacco. 2 - 3 Mezereon. 1 Warm Drinks. 2 
Cocaine. 3 

Anhidrotics (An, without, Heedroce, sweat), — are agents which check 
perspiration. They may act — 

1. By depressing the action of the sweat-glands. 

2. By depressing the excitability of the sweat-centres. 

3. By reducing the circulation in the skin. 

The most important agents of this class are the following-named, the 
figures indicating their mode of action as above arranged, viz. : — 

Belladonna. 1 Acids, locally. 3 Chloralamid. 

Atropine. 1 Jaborandi. Quinine? 

Hyoscyamus. 1 Pilocarpine. Picrotoxin. 

Stramonium. 1 Nux Vomica. Dover's Powder. 

Muscarine. 2 Strychnine. Opium 2 (small doses). 

Agaricus Albus. 2 Ergot. 3 Zinc Salts. 3 

Salvia (Sage). Sulphuric Acid. Local Cold. 3 

Strychnine, Atropine, Dover's Powder, Jaborandi, Picrotoxin and Zinc Salts are all 
respiratory stimulants, and very efficient against the sweating of phthisis, though most of 
them are classed as diaphoretics. This is explained on the theory of accumulation of 
Carbonic Acid in the blood by depressed respiration caused by severe coughing, this 
stimulating the sweat centres, and being opposed by agents which stimulate the respiratory 
centre. 

Agents Acting on the Generative Apparatus. 
Aphrodisiacs (Aphrohdeetay, Venus), — are medicines which stimulate 
the sexual appetite and power. They act by reflex or central action upon 
either the cerebral or the spinal genital centre. Tonics are indirectly 
aphrodisiac, as are all measures which promote the general bodily nutri- 
tion. The chief agents used as direct aphrodisiacs may be enumerated 
as follows, viz. : — 



\ 



Nux Vomica. 


Cimicifuga. 


Ergot. 


Strychnine. 


Serpentaria. 


Iron. 


Cannabis. 


Sanguinaria. 


Alcohol. 


Cantharis. 


Opium (at first). 


Bitter Tonics. 


Phosphorus. 


Camphor (at first). 


Flagellation. 


Aurum. 


Damiana (?). 


Meat Diet. 



Strychnine acts by increasing general nutrition and exalting the reflex excitability of the 
genital centres. Hemp probably only causes a mild delirium which may or may not take 
a sexual direction. Cantharides acts by direct irritation of the mucous lining of the 
urethra, and is dangerous in aphrodisiac doses. Alcohol in small doses excites the genital 



48 AGENTS ACTING ON THE GENERATIVE APPARATUS. 

centre in the brain ; so, also Opium and Camphor, the latter being decidedly anaphro- 
disiac after a time. The power of Damiana is doubtful. Urtication and Flagellation of 
the nates produce priapism by irritation of the genital centre in the cord through the 
sensory nerves of the part. Ergot is considered useful by contracting the dorsal vein of 
the penis, preventing its emptying too rapidly. 

Anaphrodisiacs (An, without, Aphrohdeetay, Venus), — are medicines 
and measures which lower the sexual function and diminish the sexual 
appetite. They act by lessening' the excitability of the nerves of the 
genital organs, by depressing the genital centres in the brain and cord, 
or by decreasing the local circulation. The principal anaphrodisiacs are 
enumerated as follows, viz. : — 

Bromides. Tobacco. Nauseants. 

Potassium Iodide. Digitalis. Purgation. 

Camphor (at last). Conium. Venesection. . 

Opium (at last). Belladonna. Ice, locally. 

Lupulin. Stramonium. Cold Baths. 

Cocaine. Gelsemium. Vegetable Diet. 

Emmenagogues (Emmayneeah, the menses; Ago, I move), — are 
remedies which restore the menstrual function, either directly by stimu- 
lation of the uterine muscular fibre, or indirectly by improving the blood 
and toning up the nervous system. The direct emmenagogues are ecbolic 
in large doses. The principal members of this class are enumerated in 
the following list, viz. : — 

Direct Emmenagogues. Indirect Emmenagogues . 



Ergot. 


Rue. 


Iron. 


Quinine. 
Savine. 


Apiol. 
Borax. 


Manganese. 
Cinnamon. 


Digitalis. 
Cantharis. 


Myrrh. 
Guaiacum. 


Strychnine. 
Aloetic Purgatives. 


Pulsatilla. 
Asafetida. 
Alcohol. 


Polygonum Hydrop. 
Potass. Permang. 
Cimicifuga. 


Cod-liver Oil. 
Hot Hip-baths. 
Leeching the genitals. 


Indigo. 


Oxalic Acid. 


Rubefacients to thighs. 


Hydr. Biniod. 


Hedeoma. 


Tonic Remedies. 


Caulophyllum. 
Tansy. 


Origanum. 
Viscum Flavescens. 





Oxytocics or Ecbolics (^Ockseus, quick, Tokos, childbirth ; Ekbolay, 
abortion), — are agents which stimulate the muscular fibres of the gravid 
uterus to contraction, and may produce abortion. In small doses the same 
remedies are emmenagogue as a rule. Their mode of action has not been 
clearly made known, but it is generally believed to be due in some cases 
to direct stimulation of the uterine centre in the cord, in others to con- 
gestion of the uterus producing reflex stimulation. The principal oxytocics 
are those enumerated in the following list, viz. : — 

Ergot. Hydrastis. Oil of Rue. 

Ustilago. Quinine. Pilocarpine. 

Savine. Borax. Viscum Flavescens. 

Potass. Permanganate. Cotton-root bark. Strong Purgatives. 



AGENTS ACTING ON THE CUTANEOUS SURFACE. 49 

Any drastic purgative, or gastro-intestinal irritant, may produce abortion by reflex 
action. The Volatile Oils act in this manner, also Colocynth and many other agents used 
by women to produce abortion, as Tansy, Pennyroyal, etc., all of which are dangerous 
to life in doses sufficient to excite the action of the gravid uterus. 

Uterine Depressants lower the activity of the nervo-muscular appa- 
ratus which controls the uterine contractions. The most important of 
these agents are : — 

Opium. Chloral. Tobacco. 

Bromides. Chloroform. Sulphate of Copper. 

Cannabis. Tartar Emetic. Emetics. 

Viburnum Prunifolium. Piscidia Erythrina. 

Uterine Tonics and Alteratives, — are medicines which are con- 
sidered to have such specific influence over the uterus. Authorities differ 
very much regarding the value of these agents, but those enumerated in 
the following list are generally considered to have considerable value in 
uterine therapeutics, viz. : — 

Uterine Tonics. Uterine Alteratives. 

Potassium Bromide. Iodine. 

Potassium Chlorate. Iodoform. 

Pulsatilla. Iodized Phenol. 

Helonias Dioica. Glycerin. 

Cimicifuga. Hydrastis. 

Savine. Silver Nitrate. 

Astringents (locally). Galvanism. 

Those in the first list, except Astringents, are used internally; those in the second 
column as topical applications to the uterine cavity or cervix. 

Galactagogues (Galla, milk, Ago, I bring away), — are medicines 
which increase the lacteal secretion, as Ricinus, Tea, Anise, Fennel, 
Potassium Chlorate, etc. The value of many so-called galactagogues is 
extremely doubtful, the best being the local application of the leaves of 
the Castor- oil plant (Ricinus communis), and a good black Tea internally, 
with Milk, Beer or Porter as a beverage. Pilocarpus comes the nearest 
to being a true galactagogue, but its influence is very transient. (Com- 
pare Lactation in Part III.) 

Antigalactagogues decrease the secretion of milk. Belladonna is 
the typical and most potent agent for this purpose, and acts when given 
internally or applied locally. Antipyrin has given evidence of similar 
power, also Camphor locally, and Potassium Iodide internally. 



Agents Acting on the Cutaneous Surface. 

Irritants are substances which, when applied to the skin, produce a 

greater or less degree of vascular excitement. When used to produce a 

reflex influence on a part remote from their site, they are termed Coun- 

ter-Irritants, and may be subdivided into the following groups, viz. : — 

4 



50 



AGENTS ACTING ON THE CUTANEOUS SURFACE. 



Rubefacients {Rubefacio, I make red), — produce temporary redness and 
congestion of the skin, unless left too long in contact with the surface, 
when they may cause exudation between the cuticle and the true skin 
(vesicants), or may destroy the tissue and form a slough (escharotics). 
They may induce muscular atrophy. 

Vesicants, Epispastics or Blisters, — produce decided inflammation of 
the skin, and outpouring of serum between the epidermis and derma. 
Cantharides is the agent generally used for this purpose. 

Pustulants, — affect isolated parts of the skin, as the orifices of the 
sudoriferous glands, giving rise to pustules. 

The following list embraces the principal agents and measures belong- 
ing to these groups, viz. : — 



Rubefacients. 


Rubefacients. 


Vesicants. 


Mustard. 


Oil of Cajuput. 


Cantharides. 


Capsicum. 


Oil of Turpentine. 


Euphorbium. 


Camphor. 


Volatile Oils. 


Mezereon. 


Ammonia. 


Pitch. 


Iodine. 


Mezereon. 


Friction, 


Rhus Toxicodendron. 


Arnica. 


Hot Water. 


Ammonia (the confined vapor). 


Alcohol. 




Glacial Acetic Acid. 


Ether. 


Pustulants. 


Volatile Oil of Mustard. 


Chloroform. 


Croton Oil. 


Heat / Boilin S Water. 

\ Corrigan's Hammer. 


Iodine. 


Tartar Emetic. 


Menthol. 


Ipecacuanha. 
Silver Nitrate. 





Escharotics or Caustics (Eskahrah, a slough or scab; Kaioh, I 
burn), — are agents which destroy a tissue to which they are applied, and 
produce a slough. They act usually in one of three modes, viz. : — 

i. By abstracting the water of the tissue. 

2. By combining with the albumen of the part. 

3. By corrosive oxidation. 

The principal escharotics are enumerated in the following list, the 
numbers affixed to each pointing out its mode of action as stated 
above. 



Mineral Acids. 1 
Glacial Acetic Acid. 1 
Carbolic Acid. 1 
Chromic Acid. 3 
Arsenious Acid. 1 
Antimony Chloride. 1 



Caustic Potash. 1 
Caustic Soda. 1 
Lime. 1 

Dried Alum. 2 
Silver Nitrate. 2 
Copper Sulphate. : 



Mercuric Chloride*. 2 
Mercuric Oxide. 2 
Mercuric Nitrate. 2 
Zinc Sulphate. 2 
Zinc Chloride. 2 
Bromine. 3 



Astringents {Ad, to, Stringo, I bind), — are agents which produce 
contraction of muscular fibre and condensation of other tissues, the first 
probably by direct irritation, the second by precipitating its albumen 
and gelatin. They also lessen secretion from mucous membranes. The 
principal astringents may be enumerated as follows, viz. : — 



AGENTS ACTING ON THE CUTANEOUS SURFACE. 5 1 



Acids. 


Tannic Acid. 


Bismuth Subnitrate, etc 


Alcohol. 


Gallic Acid. 


Cadmium Sulphate. 


Alum. 


Catechu. 


Copper Sulphate. 


Chalk. 


Galls. 


Ferric Chloride. 


Lime. 


Kino. 


Lead Acetate. 


Creosote. 


Oak-bark. 


Silver Nitrate. 


Carbolic Acid. 


Uva-Ursi. 


Zinc Sulphate. 



Sulphuric Acid, Gallic Acid and Lead Acetate are examples of Remote Astringents, 
acting on internal organs through the blood. Those which affect the part to which they 
are applied are Local Astringents, and include most of those enumerated above. 

Styptics and Hemostatics (Steufihoh, I contract; Haimah, blood; 
Staksis, a standing), — are agents which arrest hemorrhage, Styptics being 
those which are applied locally, and Hemostatics those which are admin- 
istered internally. Some of the former act mechanically, by promoting 
the formation of a clot in the mouths of the bleeding vessels ; others 
cause the vessels themselves to contract, checking the flow of blood. The 
principal members of this class are the following-named : — 

Styptics. Hemostatics. 

Acids. Cold. Ergot. 

Alum. " Matico. Digitalis. 

Cautery. Spider's-web. Gallic Acid. 

Collodion. Tannic Acid. Lead Acetate. 

Ferric Chloride. Lead Acetate. Dilute Sulphuric Acid. 

Ferric Sulphate. Zinc Sulphate. Ipecacuanha. 

Silver Nitrate. Vegetable Astringents. Hamamelis. 

Oil of Turpentine. 

Emollients (Emollio, I soften), — are substances which soften and 
relax the tissues to which they are applied. They relieve tension, dilate 
vessels, diminish pressure on the nerves, and protect inflamed surfaces 
from the air and from friction. The principal articles which may be 
classed under this heading are the following : — 

Hot Fomentations. Linseed Oil. Petroleum. 

Poultices. Olive Oil. Soap Liniment. 

Glycerin. Spermaceti. Starch. 

Lard. Almond Oil. Cacao Butter. 

Demulcents {Demidceo, I soothe), — are substances, generally of a 
mucilaginous nature, which soothe and protect the parts to which they 
are applied. This term is generally used for substances employed for 
mucous membranes, and the term Emollients for similar agents used on 
the skin. The chief agents belonging to this class are : — 



Acacia. 


Starch. 


Honey. 


Olive Oil. 


Cetraria. 


Glycerin. 


Marsh-mallow. 


Isinglass. 


Barley. 


Flaxseed. 


White of Egg. 


Tragacanth. 


Liquorice. 


Gelatin. 


Almond. 


Bland Oils. 



Protectives, — are agents of a mechanical nature employed to cover 
and protect an injured part from the air, water, etc. Collodion and 



52 AGENTS ACTING ON MICROBES, GASES, FERMENTS. 

Gutta-ftercha are those in general use, but certain plasters, as the Adhe- 
sive, the Lead or the Soap Plaster, may be employed for this purpose, 
also Cotton Wool. 

Agents Acting on Microbes, Gases, Ferments, etc. 

Antizymotics (Anti, against, Zeumoksis, fermentation), — are agents 
which arrest fermentative processes, which may depend upon the action 
of unorganized ferments (enzymes), as diastase, ptyalin, pepsin, etc., or 
upon that of organized ferments, as the yeast-plant, bacteria, etc. The 
Antizymotics may be subdivided into two groups, Antiseptics and Disin- 
fectants. 

Antiseptics (Anii, against, Sayplekos, putrefaction), — prevent or retard 

septic decomposition, by destroying the bacilli which produce it, or by 

arresting their .development. The chief antiseptics are : — 

Mercuric Chloride. Potassium Chlorate. Quinine. 

Mercuric Iodide. Zinc Chloride. Salicin. 

Mercuric Oxide. Carbolic Acid. Thymol. 

Potassium Permanganate. Creosote. Borax. 

Sulphurous Acid. Alcohol. Chlorine. 

Sulphites and Hyposulphites. Eucalyptol. Hydronaphthol. 

Sulpho-carbolates. Hydrogen Dioxide. etc. 

Disinfectants destroy the specific germs of communicable diseases, 
many of which belong to the microbe class, hence many antiseptics are 
also disinfectants. They act in several modes, some as oxidizants, others 
by combining with albumen, others by chemical combination forming 
substitution-compounds, others by arresting molecular changes, and still 
others by altering the reaction of the media containing the germs. The 
principal disinfectants are: — 

Heat, 230°-250° F. Zinc Chloride. Bromine. 

Sulphurous Acid Gas. Carbolic Acid. Lime. 

Nitrous Acid Gas. Potass. Bichromate. Osmic Acid. 

Chloride of Lime. Potass. Permanganate. Ferrous Sulphate. 

Mercuric Chloride. Iodine. Zinc Sulphate. 

Aluminum Chloride. Chlorine. Hydrogen Dioxide. 

Condy*s Fluid is an aqueous solution of Potassium Permanganate, 2 parts in ioo, or 
gr. 176 in ^xx, Burnett 's Fluid is a solution of Zinc Chloride, containing about 50 per 
cent, of the salt, and equivalent to the official Liquor Zinci Chloridi. Labarraque 1 's 
Solution is the official Liquor Sodse Chlorate. Sanilas is an aqueous solution of oxidized 
turpentine, containing Hydrogen Dioxide, Thymol, Camphor, etc. Other disinfectants 
are Creolin, Lysol, Saprol, Solutol, Solveol, — described under Acidum Carbolicum, in 
Part II. 

Deodorants, — are agents which destroy foul odors. The Volatile De- 
odorants are chiefly oxidizing and deoxidizing substances, acting chemic- 
ally on the obnoxious gases ; while the Non-volatile ones are mainly 
absorbents, which condense and decompose the effluvia. The deodorants 
in general use are the following named : — 

Chlorine Gas. Hydrogen Dioxide. Charcoal. 

Sulphurous Acid Gas. Potassium Permanganate. Earth, Lime. 

Nitrous Acid Gas. Coffee, freshly roasted. Ferrous Sulphate. 



AGENTS ACTING UPON EACH OTHER. 53 

Parasiticides (Parrakseetos, a parasite, Ccedo, I kill), — are agents 
which destroy the animal and vegetable parasites found upon the human 
body. They are generally applied in the form of lotions, ointments or 
oleates, and include the following substances, viz. : — 

Sulphur. Mercury. Carbolic Acid. 

Sulphides. Ammoniated Mercury. Petroleum. 

Sulphurous Acid. Mercuric Chloride. Storax. 

Sulphur Iodide. Mercuric Nitrate. Staphisagria. 

Iodine. Mercuric Oxide. Balsam of Peru. 



Agents Acting upon Each Other. 
Antidotes and Antagonists are terms frequently confounded with 
each other, and rarely defined with sufficient lucidity to enable a clear 
distinction to be drawn between them. An Antidote is a substance which 
affects a poison either physically or chemically, or both, and in such a 
manner as to remove the poison from the body or to form with it an 
insoluble salt or an inert compound, with the object of preventing its 
toxic action upon the organism. 

Thus Tannic Acid is an antidote to Digitalis, as it forms therewith a compound (tan- 
nate), which is soluble with difficulty and therefore comparatively innocuous. But as 
'this tannate is not wholly inert, another antidotal measure must be employed, viz. :: — 
evacuation of the stomach, which may be accomplished by the administration of Zinc 
Sulphate or any other emetic, or by the use of a stomach pump. 

Antagonists, on the other hand, are agents which directly oppose each 
other in some or all of their physiological actions, and may be used 
against each other to counteract their effects on the system. Antidotal 
action takes place in the alimentary canal, and is applicable to vegetable 
as well as mineral poisons. Antagonism takes place in the blood and 
tissues, and so far as antagonistic drugs are concerned, is applicable 
almost wholly to vegetable poisons, as these produce their effects after 
absorption. The heart and respiratory apparatus are the principal object- 
ive points for the antagonism of drugs, but the spinal cord, the cerebrum, 
the muscular tissue and the glandular system are also affected by most of 
them. 

Antagonistic Measures are such proceedings as may tend to antagonize 
certain effects of poisons, and include Artificial Respiration, — Faradism 
of the respiratory muscles, — Constant motion, — Douching, — Rest, etc. 

Thus, to refer to the case of Digitalis again, Saponin (or Senegin) is its most complete 
physiological antagonist, the counteraction extending throughout the whole range of its 
effects. Aconite and Morphine antagonize its cardiac action, the former being considered 
the best antagonist to the effects of large doses, and the latter to those of its long- con- 
tinued use. Alcohol is also indicated in Digitalis-poisoning, and absolute Rest in the 
recumbent posture is an antagonistic measure of great importance, by reason of the lia- 
bility of the heart to cease its action on assuming the erect position, when much lowered 
by the drug. 

In the Treatment of Poisoning, whether from mineral or vegetable sub- 



54 AGENTS ACTING UPON EACH OTHER. 

stances, the first indication is to administer the appropriate chemical anti- 
dote, so as to render the poison harmless or comparatively so. Next, the 
stomach should be emptied and washed out, lest the newly-formed com- 
pound be absorbed after a time, and also to remove any of the poison 
which may have escaped the action of the antidote. Next, the antagonist 
should be administered, in order to counteract the effects of such portion 
of the poison as may have been absorbed. Lastly, the appropriate antag- 
onistic measures should be employed to sustain the action of any organic 
function which may show signs of failure. In most cases of alkaloidal 
poisoning absorption has proceeded so far before assistance is obtained 
that antidotes are of no value, and reliance can only be placed upon the 
physiological antagonist and such supporting measures as will tend to 
maintain vitality until the poison has been eliminated by the natural 
channels. 

In the following pages the antidotes and antagonists for each poisonous 
substance in the Materia Medica are enumerated under their proper titles, 
and in the Appendix the same agents are tabulated in a suitable form for 
reference. A few examples are appended below, to illustrate the princi- 
ples above stated, and to point out some of the most prominent instances 
of physiological antagonism at present known. 

Atropine, Belladonna, etc. 

Antidotes, — Tannic Acid, to form an insoluble tannate. Zinc Sulphate, as an emetic, 
or Apomorphine hypodermically, or the stomach-pump. Purgation. Antagonists, — 
Muscarine. Physostigmine. Pilocarpine. Morphine. Quinine. Aconite. Antagonistic 
Measures, — Artificial respiration. Faradism of respiratory muscles. 

Strychnine, Nux Vomica and Ignatia. 

Antidotes, — Animal Charcoal suspended in water. Emesis, as above-mentioned. An- 
tagonists, — Chloral, or Chloroform, to muscular relaxation. Curare. Amyl Nitrite. 
Potassium Bromide. Antagonistic Measures, — Artificial respiration. Perfect quiet. 

Morphine and Opium. 

Antidotes, — Emesis or stomach-pump. Potassium Permanganate. Antagonists, — 
Atropine. Strychnine. Black Coffee. Caffeine. Ammonia, inhaled. Amyl Nitrite. 
Antagonistic Measures, — Cold douche. Artificial respiration. Continued movement. 

Potassium Cyanide. 

Antidotes, — Iron Sulphate, to form Prussian Blue. Emesis. Antagonists, — Atropine. 
Ammonia. Alcohol. Antagonistic Measures, — Artificial respiration. Faradism. 

Arsenic and its Compounds. 

Antidotes, — Hydrated Iron Oxide. Dialyzed Iron. Magnesia. Chalk. Lime-water. 
Emetics, or stomach-pump. Oil or Mucilage to protect the mucous membranes. Diluents. 
Potassium Iodide, to promote elimination. Antagonists, — none. 



DOSAGE OF MEDICINES. 



The Doses given throughout this book are for adults ; for children the 
following rule (Young's) will be found the most convenient. Add 12 to 
the age and divide by the age, to get the denominator of a fraction, the 
numerator of which is 1. Thus, for a child two years old, 2 + 2 1 2 - = 7, 
and the dose is one-seventh of that for an adult. Of powerful narcotics 
scarcely more than one-half of this proportion should be used. Of mild 
cathartics, two or even three times the proportion may be employed. 

Children bear Opiates badly : — but on the other hand they stand comparatively large 
doses of several other drugs ; such being Arsenic, Belladonna, Calomel, Ipecacuanha, 
Squill, Rhubarb, and several other purgatives. 

For Hypodermic Injection, the dose should be two-thirds or three-fourths of that 
used by the mouth; by rectum five-fourths of the same. Strychnine acts more actively 
when given per rectum than by the stomach. 

Conditions which modify the action of medicines, and therefore 
affect their dosage, are — age, body-weight, temperament and idiosyncrasy, 
drug-habits, intervals between doses, time of administration, condition of 
the stomach, temperature of the body, cumulative drug-action, mode and 
form of drug-administration, disease, climate, race, etc. 

The Dosage of Medicines is the weakest part of the therapeutic arma- 
ment, the flaw in our weapons which may be the cause of their failure at 
any moment, perhaps the most critical one for a life. If the accumulated 
rubbish of ages, which has been called therapeutic knowledge, is ever to 
be given scientific shape, ever placed in process of becoming a science, 
the question of dosage must form one of the principal corner-stones in 
the foundation. Drugs have widely differing actions on the human 
organism in health and in disease, according as they are administered in 
different doses, in different menstrua, and during different conditions of 
the subject's health. This difference, when between extremes of dosage, 
is often so wide as to separate actions directly contrary to each other, — 
that of the very large one opposing the action of the very small dose : — 
a truth hidden by one set of dogmatists under their former "doctrine," 
now "rule," of " similars," and avoided by the great mass of the medical 
profession, through dread of the bogy-name, "irregular." 

A thoroughly-prepared materia medica of half-a-dozen standard drugs, 
such as Aconite, Arsenic, Belladonna, Mercury, Opium and Quinine, — 
based upon their actions and uses in different doses and under different 

55 



56 DOSAGE OF MEDICINES. 

states of the organism, — would be of more real value to the physician 
who wishes to do his work accurately and with his eyes open, than all 
the contents of the dispensatories, plus the entire literature of the " new 
remedies," and every symptom in the ten quarto volumes of the largely 
discredited and partly repudiated homoeopathic Materia Medica. 

If our medical students would each devote but one month, of his 
annual college vacation, to the personal investigation of some one feature 
of the action of some one drug, under such safe-guards against error as 
would secure the acceptance of the resulting observations, — what a mine 
of therapeutic gold would soon yield its solid truth to eager eyes ! 
Formally laid down by Haller {see ante, page 18) in 1755, cultivated to 
some extent by Alexander in 1768, Crumpe in 1793, Thommassini, Curtis, 
etc., — urged by John Hunter, Sir Thomas Watson, Dr. King Chambers, 
and many other luminaries of the medical profession, — the scientifically 
guarded proving of drugs on the human organism has lain, like the 
similar work of Jenner, neglected all these years, waiting for another 
Koch to re-inaugurate the work. 



PART I. 



MATERIA MEDICA AND THERAPEUTICS. 



ABRUS, Jequirity (Unofficial), — is the seed of Abrus iprecatorius, 
or Wild Liquorice, a plant of the nat. ord. Leguminosae, indigenous in 
India, but growing wild in most tropical countries. The seeds are small, 
hard, of a bright scarlet color, with a black spot around the hilum, and 
contain an alkaloid, some fixed oil, sugar, a principle resembling Gly- 
cyrrhizin, and Abric Acid, C 12 H 24 N 3 ; but neither of these is believed 
to be the active principle. 

Preparation. 

Infusum Abri, Infusion of Jequirity (Unofficial), — prepared by macerating tbree 
powdered seeds in ^ ss of cold water for twelve hours, adding ^ ss of boiling water, 
and filtering when cold. It should be used while fresh, as after two or three days it is 
worthless. 

Another formula contains gr. ix of Jequirity to the 25 , with gr. iv of Boric Acid to pre- 
vent decomposition. 

Physiological Action and Therapeutics. 

Jequirity seeds, when moistened with water, become highly poisonous. 
If applied to the conjunctiva, a severe inflammation is set up, with oedema 
and false membrane, ulceration of the cornea, and extension to the lids, 
face, neck and submaxillary glands. Inserted into a wound in cattle, 
they cause death in a few hours. The irritant action is believed to result 
from the presence in the seeds of some ferment, or perhaps great numbers 
of gonidia, which develop rapidly on a suitable tissue. The infusion, in 
a short time, swarms with bacteria. 

Jequirity is used for the purpose of producing a purulent or croupous 
conjunctivitis, by which to destroy old granulations (trachoma) and pan- 
nus. A mild infusion is applied to the eye two or three times a day for 
two days, and followed by weak solutions of Alum or Borax. This should 
be repeated after three weeks if necessary. An emulsion of the seeds in 
water is a useful application to unhealthy ulcers arid lupus. 

57 



i 



58 ABSINTHIUM — ACETANILIDUM. 

ABSINTHIUM, Wormwood, — the leaves and tops of Artemisia Absinthium, a 
perennial garden herb of the nat. ord. Composite, indigenous in Europe, but cultivated in 
the United States. The leaves are about 2 inches long, hoary, silky-pubescent, petiolate, pin- 
nately two or three-cleft; heads numerous, with small, pale-yellow florets, odor aromatic, 
taste persistently bitter. It contains a volatile oil and a bitter principle, Absinthin. Dose, 
gr. xx-xl, in infusion. There are no official preparations, but of the formerly official 
Vinum Aromaticum, Absinthium constituted one per cent. 

Absinthe, the French liqueur, is an alcoholic solution of the oil, containing also extracts 
of Anise, Marjoram and Angelica. Its continued use produces various nervous symptoms, 
morning nausea and vomiting, also a tendency to epileptiform convulsions. 

The bitter constituent of Absinthium is stimulant to the digestive organs, but the oil is a 
narcotic poison, increases the cardiac action, and produces tremor, stupor, epileptiform 
convulsions, involuntary evacuations, and stertorous breathing. It is but little used in 
medicine, and only as a stomachic tonic in dyspepsia. 



ACACIA, Gum Arabic, — is a gummy exudation from Acacia Sene- 
gal, a small tree of the nat. ord. Leguminosae, indigenous in Africa. It 
occurs in spheroidal tears of various sizes, breaking with a glassy, some- 
times iridescent fracture; insoluble in alcohol, but soluble in water, 
forming a thick and mucilaginous liquid. It consists oi Arab in ox Arabic 
Acid, C^H^On, combined with calcium, potassium, and magnesium. 

Preparations. 

Mucilago Acaciae, Mucilage of Acacia, — has of Acacia 34, Water to 100 parts. It 
should not be prescribed with tinctures or spirits except in very small quantity. Dose, 
indefinite. 

Syrupus Acaciae, Syrup of Acacia, — has of the Mucilage 25, Syrup 75. Should be 
freshly made. Dose, indefinite. 

Acacia enters into the composition of Mistura Amygdalae, Mistura Glycyrrhizae Com- 
posita, Pulvis Cretae Compositus, Trochisci Cretse, Trochisci Cubebse, and Trochisci 
Glycyrrhizae et Opii. 

Gum Arabic has no activity except the negative one of a demulcent, 
and is chiefly used in coughs, sore throats, catarrhal inflammation of the 
stomach and intestines, and irritant poisoning. It is much employed in 
pharmacy to suspend insoluble powders in mixtures, for which purpose 
the mucilage is generally used. 



ACETANILIDUM, Acetanilid, {Antifebrin).— Like the major 
number of the newest antipyretics, which are related either to Chinolin 
or to Phenol, Acetanilid is a derivative of Anilin, from which it is ob- 
tained by the action thereon of glacial acetic acid, substituting the organic 
radical Acetyle for an atom of hydrogen. Chemically, it has the name 
Aceta?iilid or Phenyl-acetamide, and the formula C 6 H 5 NHC 2 H 3 0. 

The name Antifebrin is copyrighted by its original promoters for trade purposes, and 
therefore should be dropped from professional usage. 

It is a pure white and crystalline powder, of neutral reaction, odorless, 
but of slightly burning taste. It melts at 235 F., and distils at 557 F., 
— is soluble freely in alcohol, wine, etc., but very sparingly (1 in 200) 



ACETANILIDUM. 59 

in cold water, more readily in hot water. It is a neutral substance, being 
unaffected by hydrochloric or sulphuric acids, and ordinarily so by 
alkalies. 

The dose ranges from gr. ij to gr. x, repeated twice, and not exceeding gr. xxx in the 
24 hours. As much as gj has been swallowed without ill effects supervening. It may 
be administered in the very convenient form of compressed tablets ; — also in powders, or 
in dilute alcoholic solution, gj may be dissolved in % ivss of brandy, to which, if we 
add g vj each of simple syrup and water, we get a six-ounce mixture, of which a table- 
spoonful (^ss) contains 5 grains of Acetanilid, a fair adult dose. As an antipyretic, 
gr. iij may be administered every % to ]/ 2 hour, until 12 or 15 grains have been given, 
which will usually be a sufficient quantity, especially if given at the acme of the febrile 
movement. 

Unofficial Derivatives and Allied Compounds. 

Antikamnia is a proprietary preparation widely advertised as an antipyretic and anal- 
gesic, of equal power in the latter respect with morphine. Analyses of several samples 
have been made by different chemists, all of which agree in finding the chief ingredients 
to be Acetanilid and Sodium Bicarbonate in varying proportions. By some observers 
Caffeine was detected, also Tartaric Acid, etc. The preparation is formulated by the 
earliest analysis as a mixture of Acetanilid 70, Sodium Bicarbonate 20, and Caffeine 10 
parts. Dose, gr. v-xv. 

Antinervin is a mixture of Acetanilid, two parts, with 1 each of Ammonium Bromide 
and Salicylic Acid (Ritsert). It is also called by the names Salbromalide and Salicylbro- 
malide. Dose, gr. v-xv. ' 

Phenolid is a preparation consisting of a mixture of Acetanilid 58, and Sodium Salicy- 
late 43. It competes with Antikamnia as a universal panacea against pain. 

Exodyne is a mixture of Acetanilid 90, Sodium .Salicylate 5, and Sodium Bicarbonate 
5. The name (from ef, out of, odvvr], pain) sufficiently states its claims to medicinal 
virtue. 

Exalgin, Methyl-acetanilid, — is a crystalline compound allied to Acetanilid, occur- 
ring in acicular needles, readily soluble in dilute alcohol, less so in warm water, and 
with difficulty in cold water. Dose, gr. j-v, in wine, or other dilute alcoholic mixture. 
Alcohol 3SS, and Water ^j form a permanent solution with gr. xvj. 

Exalgin resembles Acetanilid and Antipyrin in its antipyretic and analgesic powers. 
Compared with the latter it is less efficiently antipyretic, but more powerful as an anal- 
gesic and antiseptic. In overdose it is highly dangerous, having produced symptoms 
resembling those of angina pectoris, also toxic effects resembling those of carbolic acid, 
with delirium, dyspnoea, cyanosis, and renal disturbances. It has been used with most 
excellent results in neuralgias; also in chorea. In the latter affection daily doses of 3 
grains were sufficient. Its name, derived from e£ , out of, aXyog, pain, denotes its princi- 
pal therapeutic action. 

Phenacetin and Methacetin are closely allied to Acetanilid, both chemically and 
medicinally. They are described under the title Phenacetinum. 

Physiological Action. 

Acetanilid is strongly analgesic, hypnotic and antispasmodic, also a 
moderately efficient antipyretic. It lessens the reflex action of the spinal 
cord, and inhibits the sensibility of the sensory nerves. It raises arterial 
tension somewhat, and slows tjie heart in a corresponding degree, quiet 
sleep often following. 

Compared with the action of Antipyrin, the effect of Acetanilid on 
the body-temperature is manifested more slowly (1 hour against ^ hour), 
but lasts a longer time (6 against 2 hours). It is markedly diuretic, 






: 



60 ACETANILIDUM. 

somewhat diaphoretic ; is a cerebral, muscular and vaso-motor stimulant, 
and leaves no ill after-effects ; — while Antipyrin is powerfully diaphoretic, 
a cerebral sedative, and produces great depression. Furthermore, Ace- 
tanilid frequently produces nearly the same degree of reduction of body- 
temperature as Antipyrin, with the ingestion of but *^th the dose; and, 
like the latter agent, it has little or no effect on the normal temperature, 
and its continued use begets tolerance of its action. Its antipyretic 
action is, however, less reliable than that of Antipyrin, and corresponds, 
in degree and in duration, to the size of the dose. There is neither 
vomiting nor diarrhoea afterwards, but there is a tendency, in some cases, 
to collapse, with chills and cyanosis, especially the latter, during the 
period of depressed temperature. 

A toxic dose destroys the ozonizing function of the blood, decolorizing 
it, and forming methyl-haemoglobin. The heart, liver and kidneys are 
found in a state of acute fatty degeneration, in animals poisoned thereby. 
Its continued use in large doses is highly injurious to the blood, especially 
in diseases (as typhoid fever) which are themselves destructive to the 
blood-elements. 

Therapeutics. 
Besides being a fairly efficient antipyretic, Acetanilid has marked 
analgesic and antispasmodic powers ; and these, together with its great 
advantages of a small dose, comparative efficiency and safety, and the 
absence of the severe rigors and cardiac depression which mark the 
chinolin derivatives, — combine to make it one of a wider therapeutical 
range than most of its analogues. It is especially useful in phthisis and 
typhoid fever, for the hyperpyrexia, thereby relieving wakefulness, les- 
sening delirium, and upholding a failing heart ; but if long used in large 
doses in the latter disease it may increase the liability to serious sequelae, 
especially periostitis of the ribs, gangrene of tissues, etc. For the pains 
of locomotor ataxia, and in those of rheumatic origin, sciatica, lumbago, 
etc., it is a most efficient remedy. In acute rheumatism, influenza and 
scarlet fever it is highly praised ; and in acute bronchitis doses of four 
grains every two hours have often arrested the attacks within twenty-four 
hours. In epilepsy, it is being tried, with the view of moderating reflex 
excitability. Added in minute proportion to aqueous solutions for hypo- 
dermic use, it is said to preserve them from decomposition more efficiently 
than any other agent hitherto employed for that purpose. It acts very 
well with children, when used in proper doses ; but in all cases, overdosing 
must be avoided, both as to quantity and repetition thereof. 

Antinervin attracted much attention, during the recent epidemic of influenza in Scot- 
land, as an analgesic and antipyretic. It relieved the pains in the back and head, reduced 
the fever and produced copious perspiration, without being followed by unfavorable 
sequelae. It has proven to be of great benefit in acute rheumatism, and may be used with 



ACIDUM ACETICUM. 6l 

• 
advantage in all abnormal excitement of the nervous system, either against neuralgia or 
as a general nerve sedative. The best way to prescribe it, is as an extemporaneous mix- 
ture, containing the proper proportions of its ingredients, viz. : — Acetanilid 50, Salicylic 
Acid 25, and Ammonium Bromide 25 per cent., mixed secundum artcm, and adminis- 
tered in doses of gr. v-xv every two hours until relief is obtained. 



ACIDUM ACETICUM, Acetic Acid,— is a liquid composed of 
36 per cent, of absolute Acetic Acid, HC2H3O2, and 64 per cent, of water. 
It is a clear, colorless liquid, of a distinctly vinegar odor, a purely acid 
taste, and a strongly acid reaction ; sp. gr. 1.048 at 59 F.; miscible in 
all proportions with water and alcohol, and wholly volatilized by heat. 
It is prepared from wood by destructive distillation and purification. 
Acetic Acid is also official in two other degrees of concentration, viz. : — 

Acidum Aceticum Glaciale, Glacial Acetic Acid, HC 2 H 3 2 , — is nearly or quite 
absolute Acetic Acid, solid below 59 F., above that temperature a colorless liquid of sp. 
gr. 1.056 to 1.058. Is strongly escharotic and only used locally. 

Acidum Aceticum Dilutum, Diluted Acetic Acid, — consists of Acetic Acid 10, 
Distilled Water 50 parts, contains 6 per cent, of absolute Acetic Acid, and has a sp. gr. 
of 1.008. Dose, 3J-ij. 

Acetum, Vinegar (Unofficial), — is an impure diluted Acetic Acid, produced by the 
acetous fermentation of any liquid susceptible of the vinous fermentation. 

Diluted Acetic Acid is used in the preparation of the two official Aceta (Vinegars). 



Physiological Action and Therapeutics. 

Acetic Acid, like the other vegetable acids, in concentrated form is 
escharotic and produces gastro-enteritis if swallowed. In dilute form it 
acts as a refrigerant, diminishing thirst and allaying restlessness. It 
forms salts in the stomach, thus enters the blood,. and is there oxidized, 
producing carbonic acid, and thereby increasing the acidity of the urine. 
It is also diuretic. Long used, it causes emaciation and poverty of the 
blood, producing a general scorbutic condition. It is hemostatic and 
anthelmintic, and the vapor inhaled causes reflex contraction of the vessels 
and raises the blood-pressure. Lately, investigations into its germicidal 
powers have given it high rank among germ-destroyers, a solution con- 
taining 7 per cent of this acid proving as efficient as mercuric chloride. 

The glacial acid is used as a caustic in many skin affections, as warts,, 
condylomata, etc., and to destroy the parasite in ringworm and pityriasis. 
It has been employed locally in carcinoma, with the view of dissolving 
the supposed cancer-cells. The dilute acid is used locally in superficial 
inflammations of the skin, and may be sponged over the body to check 
perspiration and reduce the surface temperature in fevers. It is often 
administered internally to reduce obesity, which it does by impairing 
digestion. Locally, it may be employed to arrest slight hemorrhages, 
as epistaxis ; and is occasionally used by enema for the destruction of 
ascarides. 



62 ACIDUM BORICUM. 

« 

ACIDUM BORICUM, Boric (Boracic) Acid, H 3 B0 3 ,— is a 
weak acid occurring in transparent, colorless, six-sided plates, of unctuous 
touch, odorless, of a cooling and slightly bitter taste, soluble in 25 of 
water, in 15 of alcohol and in 10 of glycerin. Its solubility is increased 
by the addition of HC1. It is produced from Borax by the action of 
sulphuric acid ; also by the purification of the native acid. Dose, gr^ 
v-xv. There are 2 official Borates, viz. : — 

Sodii Boras, Sodium Borate, Borax, Na 2 B 4 7 -j- ioH 2 0, — colorless, transparent 
prisms, of cooling and sweetish, afterwards alkaline taste and alkaline reaction, soluble 
in 16 of water at 59 F., and in 0.5 of boiling water ; insoluble in alcohol. Occurs 
native in ancient lake beds in the Death Valley region, California, and various other parts 
of the world. Dose, gr. v-xxx. 

Glyceryl Borate, Boroglycerin, — official in the following preparation, viz. — 
Glyceritum Boroglycerini, Glycerite of Boroglycerin, Glycerite of Glyceryl Borate, 
Solution of Boroglyceride, — prepared by heating together Boric Acid 310 and Glycerin 
460, until reduced to 500 grammes, then adding an equal weight of Glycerin. 

Unofficial Preparations. 

Boroglyceridum, Boroglyceride, — is a solid chemical compound, prepared by heating 
together Boric Acid and Glycerin. It is soluble in water, but is generally used in solution 
with glycerin, as the above official glycerite. It combines readily with Chrysarobin, Car- 
bolic Acid, Atropine and Morphine, and is used as a local application in eye diseases and 
skin affections. 

Boracic Ointment, — has of Boracic Acid 1, White Wax 1, Paraffin 2, Almond Oil 2, 
thoroughly mixed together. 

Boracic Lotion, — is a saturated solution of the acid in water. 

Boracic Lint, — prepared by steeping lint in a boiling saturated solution and drying. 
It contains nearly one-half its weight of the acid. 

Magnesii Boro-citras, Magnesizim Borocitrate, — prepared extemporaneously thus, 
— R. Magnesii Carbonatis ^j, Acidi Citrici gij, Sodii Biborat. 5 ij, Aquae Bullientis 
^ viij. A tablespoonful three or four times daily as a solvent of acid calculi. 

Potassii Tartra-boras, Potassium Tariraborate, — is a better solvent of uric acid 
calculi than the Magnesium salt, and is soluble in 2 parts of cold water. Prepared by 
heating together Boracic Acid I, Potassii Bitartras 4, Water 10 parts. Dose, gr. xx, 
largely diluted with water, three or four times a day. 

Sodium Tetrabofate is a new preparation (or salt ?) obtained by heating together 
equal parts of Boric Acid, Borax and Water. The resulting compound is neutral, and is 
supposed to be an entirely new salt, named as. above. It was introduced to furnish a 
more soluble form of Boric Acid, and may be used wherever the latter is indicated, but 
it has the disadvantage of forming hard crusts upon dressings, which irritate abraded 
surfaces. 

It has long been known that the addition of Borax to Boric Acid in aqueous solution 
greatly increases the solubility of the acid, — and the above may explain the observed fact. 

Physiological Action and Therapeutics. 

Boric Acid is an efficient antiseptic, disinfectant and deodorant, ar- 
resting fermentation and putrefaction, and very destructive to all low 
organisms. A solution of 1 in 133 arrests the activity of bacteria. It is 
feebly acid and but slightly irritant, and is used as a surgical dressing for 
its antiseptic and unirritating qualities. Its lotion and ointment have 
been successfully employed in ulcers, eczema, burns and scalds, pruritus 
ani, fetid perspiration, wounds, tinea tonsurans, and tinea circinata. 

Sodium Borate is antiseptic and disinfectant, as it also destroys low 



ACIDUM CARBOLICUM. 63 

vegetable organisms. It removes the epidermis when locally applied, has 
power to increase uterine contraction, and aids the solution of Benzoic 
and Boric Acids. It is employed as a wash to remove the epidermis from 
the skin, and as a lotion in acne, freckles, chloasma, leucorrhcea, aphthae, 
etc., also to allay itching in urticaria, psoriasis, impetigo, and in pruritus 
pudendi, scroti et ani. It has been used internally in amenorrhcea, dys- 
menorrhea, puerperal fever, and puerperal convulsions, for its supposed 
specific action on the uterus ; and has- been found highly efficient in 
epilepsy. 

Boro-glyceride in solution (1 to 40), or as the official Glycerite, is 
also a powerful antiseptic, and is used as a lotion in purulent ophthalmia 
and in the treatment of wounds, also as a local application to diphtheritic 
membranes. It is an efficient preservative of milk and food against putre- 
factive changes, and is entirely harmless. 

An elegant cosmetic cream may be made by dissolving Boric Acid in 
Glycerin, and then incorporating it with White Wax and Almond Oil. 

ACIDUM CARBOLICUM, Carbolic Acid, Phenol, Phenic 
Acid, Phenyl Alcohol, C 6 H 5 OH, — occurs in Castoreum, in the urine of 
man and of herbivorous animals, and in the products of the dry distillation 
of various organic substances, such as resin, bones, wood and coal. It 
is obtained by the fractional distillation of coal-tar, and subsequently 
purified ; occurring in colorless, interlaced, needle-shaped crystals, of 
characteristic, aromatic odor, deliquescent on exposure to damp air, and 
acquiring a reddish tint with age and light. When copiously diluted 
with water it has a sweetish taste, and a slightly burning after-taste. 
Soluble in about 15 of water, very soluble in alcohol, ether, chloroform, 
benzol, glycerin, oils and carbon disulphifie ; almost insoluble in benzin. 
Is melted by gentle heating, and liquefied by the addition of about 8 per 
cent, of water. Dose, gr. ^-ij, well diluted. 

Acidum Carbolicum Crudum, Impure Carbolic Acid, — is obtained 
as above stated, but by a lower degree of heat ; and contains various 
other constituents of coal-tar besides Phenol, chiefly Cresol (Cresylic 
Acid) and Xylic Acid, in varying proportions. Is used as a disinfectant. 

Peculiarities about Carbolic Acid are that the addition of about 8 per cent, of water 
liquefies it, while a further addition of water produces a turbid mixture, until about 15 
parts of water to I of the acid is reached, when a stable and clear solution is formed. 
One volume of the liquefied acid, containing 8 per cent, of water, forms with one volume 
of Glycerin a clear mixture, which is not rendered turbid by the addition of 3 volumes of 
water (absence of Creosote and Creosol). 

Hitherto described as neutral to litmus paper, it is now officially given a faintly acid 
reaction. Its claims to be considered an acid are, however, very feeble, as, though it com- 
bines with salifiable bases, it is incapable of neutralizing the alkalies, and its combinations 
are decomposed by the feeblest acids (carbonic, etc.), sometimes, it is asserted, even by 
water. Chemically, it is considered to be the Hydroxyl (HO) derivative of Benzene 
(C 6 H 6 ), which would ally it to the alcohols ; but as it does not yield the same products on 



I 



64 ACIDUM CARBOLICUM. 

oxidation (yielding finally oxalic instead of acetic acid), it is taken as the type of a class 
called phenols, which are simple HO derivatives of the aromatic hydrocarbons. [For the 
chemical theory of the Benzene derivatives see the sub-title Substitutes for Quinine, 
under the title Cinchona.] 

Carbolic acid is converted, by concentrated sulphuric acid into Sulpho-carbolic Acid, 
C 6 H 5 HS0 4 ; by nitric acid into several substitution-products, the most important of which 
is Picric Acid. The reddish tint which it acquires with age and light, does not impair 
its properties ; but is unaccounted for satisfactorily, though supposed to be due to the 
presence of Aurin and Rosolic Acid, impurities which form a red compound by the ab- 
sorption of C0 2 and oxygen. 

Carbolic Acid coagulates albumen and collodion, Creosote does not. 

Allied Products and Derivatives. 

Creosotum, Creosote, — is a similar product, obtained from wood-tar. It consists of 
a mixture of phenols, chiefly Guaiacol (C 7 H 8 2 ), and Creasol (C 8 H ]0 O 2 ) ; and by the 
action of nitric acid is converted into oxalic acid principally, while Carbolic Acid is con- 
verted into picric acid by that reagent. Creosote does not coagulate albumen or collodion, 
Carbolic Acid does. Creosote is described under its own title. - " 

Resorcinum, Resorcin, C 6 H 6 2 ,— is also a phenol, obtained from certain resins by 
the action of fusing alkalies, and is described under its own title. 

Sodii Sulpho-carbolas, Sodium Sulpho-carbolale, NaS0 3 C 6 H 4 (OH) -f 2H 2 0, — is 
prepared by dissolving Carbolic Acid in an equal part of strong Sulphuric Acid, thus 
forming sulpho-carbolic acid, which is neutralized with barium carbonate, and then treated 
with water and sodium carbonate, forming a solution of Sodium Sulpho-carbolate, which 
is evaporated to crystallization. It occurs in transparent, rhombic prisms, soluble in 5 of 
water, less freely in alcohol and in glycerin. Dose, gr. x-xxx. 

Sulpho-carbolates of Ammonium, Magnesium, Potassium and Sodium crystallize in 
tufts of acicular crystals, more or less white; Sulpho-carbolate of Copper, in transparent, 
light blue, interlacing prisms ; of Iron, in small brown, micaceous crystals ; of Zinc, in 
transparent, rectangular, colorless plates. That of Sodium is the only one official. 

Preparations. 

Unguentum Acidi Carbolici, Oint?jient of Carbolic Acid, — strength 5 per cent. 
Carbolic Acid 5, Unguentum 95. For external use. 

Glyceritum Acidi Carbolici, Glycerite of Carbolic Acid, — has of Carbolic Acid I, in 
Glycerin 4. Dose, rr\y-x in water. Should be diluted with an equal quantity of water 
for external use. 

Aqua Acidi Carbolici, Carbolic Acid Water (Unofficial), — has of the Glycerite 5 x 
to Aquae Oj. Dose, gj-iv. 

Carbolic Acid Solutions (Unofficial), — for antiseptic surgery, are : — 
5 per cent, in Water, as a spray or wash. Is decidedly irritant. 
2y z per cent, in Water, for sponges, hands, or as a lotion. 
5 per cent, or less in Olive Oil, as a special dressing. 

Carbolic Acid Gauze, is Gauze medicated with Carbolic Acid 1, Resin 5, Paraffin 7, 
and is used as a surgical dressing. 

Carbolic Acid Plaster, — an unofficial plaster composed of Carbolic Acid 25, Shellac 
75, coated with Gutta-percha dissolved in Carbon Disulphide. 

Phenol Sodique (Unofficial), — is composed of Carbolic Acid, gr. 188, Caustic Soda, 
gr. 31, Distilled Water, ^iv. 

Phenol-camphor (Unofficial) — has of Carbolic Acid and Camphor, equal parts. A 
colorless, refractive liquid ; soluble in alcohol, ether, chloroform and oils ; insoluble in 
water or glycerin. Used as a local anaesthetic, chiefly for toothache. In the proportion 
of Carbolic Acid I, Camphor 3, an application to false membrane in diphtheria, and as 
subcutaneous and intrapulmonary injections in phthisis. 

Phenol Iodatum, Iodized Phenol (Unofficial), — a mixture of Iodine and crystallized 
Carbolic Acid. See under Iodum. 



Physiological Action. 
Carbolic Acid is a powerful antizymotic and antiseptic, a good disin- 
fectant, somewhat antipyretic, also a local anaesthetic, and a depressant 



ACIDUM CARBOLICUM. 65 

of the cardiac, respiratory, cerebral and spinal functions. It is destructive 
to all low forms of life, rapidly destroying all organized ferments, both 
animal and vegetable. On unorganized ferments (enzymes), such as 
pepsin and ptyalin, it does not act so readily, but in large doses it like- 
wise destroys their activity ; and is an efficient parasiticide against certain 
vegetable parasites which infest the skin. The foregoing is true of the 
liquefied acid and its aqueous and glycerin solutions, but not of its 
solutions in oils, which have no antizymotic properties. 

Applied to the skin in weak or moderately strong solutions, it produces 
local anaesthesia, with a sensation of numbness, which lasts for several 
hours. Applied in concentrated form, it is irritant and superficially 
escharotic, with burning pain of brief duration, and produces at the point 
of application a white spot, changing to red if the acid is soon removed. 
It does not vesicate, but if the application be prolonged, a white eschar or 
slough results, from the coagulation of the albumen of the tissue, and this 
is bordered by a red zone of inflammation. 

Taken internally, the concentrated acid has the same effect on the 
mucous membranes as on the skin, producing white, superficial eschars, 
after burning pain of short duration, in the mouth, gullet and stomach. 
To the latter viscus it is a powerful irritant, and causes a violent gastritis. 
In medicinal doses, when acted upon by the gastric secretions, it is 
converted into a sulpho-carbolate, and is so diluted by the contents of 
the stomach that it loses its antizymotic power, and hence is of no value 
as an internal antiseptic remedy. In the blood it probably circulates as 
an alkaline carbolate, in medicinal doses having no effect upon the circu- 
lation or respiration. Its antipyretic power is incapable of being utilized, 
requiring a dosage which would be dangerous. 

A toxic dose paralyzes the vaso-motor centre in the medulla before 
markedly affecting the heart. The blood-pressure and body-temperature 
fall ; the respiration, at first accelerated by stimulation of the vagi, is 
quickly depressed and ultimately paralyzed ; cardiac inhibition is stimu- 
lated, the heart being first slowed and then depressed. The anterior 
cornua of the spinal cord are first stimulated, producing convulsions ; and 
subsequently depressed, causing suspension of reflexes, impaired motility 
and sensibility, and finally paralysis of both motion and sensation. The 
cerebrum is profoundly depressed, producing stupor deepening into 
coma, with minutely contracted pupils. Death occurs, in most cases, by 
paralysis of respiration ; in a few, by paralysis of the heart. 

Carbolic Acid is readily absorbed, and rapidly diffused ; many fatal 
cases having resulted from its external use in undiluted form. A single 
vaginal injection of a moderately weak solution has produced very severe 
constitutional results. It is partly oxidized in the blood, and partly 
eliminated by the lungs and kidneys. It imparts to the urine a peculiar 

5 



( 



66 ACIDUM CARBOLICUM. 

smoky or olive-green color, which is not due to blood, and may be seen 
after moderate doses, or even as a result of its absorption from dressings. 
When ingested in a large dose, the acid itself may appear in the urine ; 
but the smoky color is due to the presence of its intermediate oxidation 
products, viz., pyrocatechin (only in alkaline urine), and hydrochinon, 
also salts of sulpho-carbolic acid and glycuronic acid. In poisoning 
thereby the sulphates are absent from the urine. 

A case of poisoning by Carbolic Acid shows white, corrugated eschars in 
the mouth and fauces, if the drug has been swallowed in concentrated 
form. These eschars are also found on the mucous lining of the oesopha- 
gus and stomach, at the autopsy. The patient has complained of an 
intense, burning sensation along the same tract, immediately after the 
ingestion of the poison, and soon passes into a state of collapse; the 
skin being cold and clammy, the pupils contracted, respiration becomes 
more and more feeble and shallow; the urine, if not entirely suppressed, 
is of a dark-green color ; reflexes are then abolished, stupor and coma 
supervene, and finally the breathing ceases. The blood, after death, is 
dark in color, and coagulates imperfectly ; and fatty degeneration of the 
liver and kidneys may be found. When poisoning occurs by absorption, 
an early symptom is the peculiar, smoky color of the urine. There may 
be pain in the lumbar region, indicating renal irritation, and»slight rest- 
lessness or cerebral disturbance; after which come the impairment of 
respiration and stupor. 

A toxic dose of Carbolic Acid, taken internally, is one of the most 
rapidly acting poisons known, sometimes equalling Prussic Acid in this 
respect. The symptoms develop almost immediately, and death may 
occur in a very few minutes ; but usually the patient lives from one to ten 
hours ; rarely over two days. In some cases, a great amendment has 
occurred, with restoration of consciousness, but after some hours sudden 
and fatal collapse has supervened. The minimum fatal dose is not deter- 
mined, but gss has frequently caused death ; and doses as small as tt\,vj 
have given rise to dangerous symptoms. Cases of suicidal and accidental 
poisoning by this drug are very frequent, by reason of the facility with 
which it may be obtained for use as a disinfectant. - 



Treatment of Poisoning by Carbolic Acid. 

If the case is seen shortly after ingestion, Apomorphine may be administered hypoder- 
mically, as a rapidly acting emetic ; but, in any case, the stomach should be washed out 
freely. The chemical antidote is any soluble sulphate to form the harmless sulpho-car- 
bolates; as Magnesium Sulphate §j, or Sodium Sulphate ^ss, dissolved in y z pint of 
water. Even if several hours have elapsed since the ingestion of the poison, the sulphates 
should be used, as their antidotal action proceeds in the blood current. In one case 
where 25 ss of the 95 per cent, acid had been taken, nearly ^iij of Magnesium Sulphate 
(Epsom salts) were used, resulting in complete recovery from an apparently hopeless con- 
dition. Stimulants, as ether or brandy hypodermically, should also be used freely; also 
hot water bottles and hot blankets if signs of collapse appear. Vegetable demulcents 



ACIDUM CARBOLICUM. 6j 

may be given (but no oils or glycerin), to protect the mucous surfaces. Liquor Calcis 
Saccharatus, or Syrupus Calcis, is also antidotal to the poison in the stomach, but is much 
less efficient than the sulphates. Atropine, hypodermically, is a very complete physiologi- 
cal antagonist to the systemic symptoms, maintaining the heart and respiration until 
elimination occurs (Post). Cider Vinegar may prove antidotal, as it removes the effects 
of the local application of the strong acid. Soap, in strong, watery mixture (suds), is 
said to have acted as a perfect antidote ; but its action would be confined to the poison in 
the stomach. 

Therapeutics. 

Carbolic Acid owes its prominence to its having been the principal 
agent used in the antiseptic method of treating wounds ; but its employ- 
ment in that connection has become much restricted, and many of the 
most prominent surgeons have abandoned it altogether in favor of other 
germicides. In the estimation of many, however, it still retains high 
favor as a surgical antiseptic lotion ; and it is in general use as a disin- 
fectant for surgical instruments, hospital apparatus, soiled linen, etc. 
The carbolic spray, formerly so commonly used during operations, has 
been entirely discarded. For disinfectant purposes about drains, privies, 
on floors, walls, etc., the crude acid is to be preferred, not only on account 
of its less cost, but also for the reason that its principal impurity, Cresol 
(Cresylic Acid), has very high power as a disinfectant. 

As a local application, Carbolic Acid has extensive and varied uses. 
It relieves pruritus of almost any form, if applied in 5 per cent, aqueous 
solution over the itching surface ; -and a lotion, composed of gr. xx to 
gss each of water and glycerin, makes a very efficient application for the 
itching of jaundice. The glycerite, diluted, effectively destroys the 
fungus of tinea tonsurans or tinea versicolor, and may be applied as a 
stimulant to indolent ulcers, or to the patches of aphthous stomatitis. A 
one per cent, solution in water and glycerin (n^v to gj) makes an excel- 
lent anaesthetic and cleansing gargle for the painful sore throat of 
diphtheria, tonsillitis, etc. Cotton soaked in the strong acid will stop the 
pain of a decayed tooth, but care must be taken, by covering it with dry 
cotton, to prevent its access to the gams, or sloughing thereof may result. 
For burns, one of the best dressings is carbolized sweet oil (3J to ^vj) to 
relieve the pain. For local anaesthesia in minor surgical operations, such 
as that for ingrowing toe-nail or opening a felon, the part may be soaked 
for ten minutes in a 30 per cent, solution, or the pure acid may be 
brushed over the line of incision. 

As a parenchymatous injection, which should be not over^ss of a 2 per 
cent, solution, Carbolic Acid has been employed with much success in 
combating deep-seated inflammations. The skin being first anaesthetized 
by the local application of the acid, a hypodermic needle is introduced 
obliquely, to the centre of the inflamed tissue, and should not be connected 
with the syringe if any blood escapes through it, lest the infection be in- 
troduced into a vein. This method has been successfully used in glandular 



68 ACIDUM CARBOLICUM. 

swellings, 5 to 10 minims of the solution for each gland being sufficient, in 
phlegmons of every grade and character, erysipelas, poisoned wounds, in- 
flamed bursae, hydrocele, acute and subacute rheumatism, chronic synovitis, 
buboes, and in some severe cases of tetanus. 

Internally, Carbolic Acid is not much employed. It has been given to 
relieve flatulence and dyspepsia, and is often an efficient remedy against 
vomiting. It has proven of considerable temporary benefit in diabetes of 
hepatic origin ; and has been used against intermittents, typhoid fever, 
and various zymotic diseases ; but is probably of no efficacy in constitu- 
tional affections. In phthisis and other chronic pulmonary diseases, it 
has been much employed as a spray by inhalation, and certainly does do 
good therein by relieving cough and irritation of the throat. In these 
affections, Creosote is preferred to it for both internal and local use. An 
acute conjunctivitis is greatly relieved by holding the open eye in the 
spray of a steam atomizer, the cup of which contains a 5 per cent, solu- 
tion of carbolic acid. This measure may be also used for acute coryza 
with beneficial results; or a mixture of Carbolic Acid and Tincture of 
Iodine may be dropped on to a sponge in a wide-mouthed bottle and 
volatilized for inhalation by being wrapped in a cloth wrung out of hot 
water, or even by being held in the hand. 

Sulpho-carbolates of Sodium, Potassium, etc., have been employed 
internally with advantage in the septic diseases, as the exanthemata, diph- 
theria, puerperal fever, etc., — the object being to obtain the antiseptic 
action of carbolic acid without the dangers attending its use in efficient 
doses. They may be used locally with good results in aphthse, tonsillitis, 
otorrhcea, gonorrhoea, and for inflamed mucous membranes generally. 

Creolin (Unofficial), — was the first form in which the cresols were presented in a liquid 
condition for use in medicine. It is a coal-tar product, occurring as a dark-brown, alka- 
line, semi-fluid substance, of the consistence of honey. It forms a white cloud when 
added to water, with which, however, it is miscible, as an emulsion, up to about 10 or 12 
per cent, strength. The Solutions in general use vary from ^ to 2 per cent. ; the Oint- 
ments to 5 per cent., and Creolin Gauze is prepared of 10 per cent, strength of the drug. 
Dose, mjij-v, in capsules. 

Creolin was highly vaunted, by Professor von Esmarch and other authorities, as the 
ideal antiseptic for external use, being possessed of great germicidal power, and a most 
efficient deodorant and disinfectant, while its absorption caused no toxic results whatever. 
Experience has justified these claims in the main, but the drug has, however, given rise 
to serious symptoms, when used to excess. As a vaginal wash, in puerperal cases, the 2 
per cent, solution is reported as fully equal to sublimate solutions, while better as a de- 
odorant, and free from danger by absorption. The weaker solutions have given satisfac- 
tion as local applications in the treatment of otorrhcea, nasal ulcers, rhinitis (1 to 1000), 
blepharitis, keratitis, etc.; and in female cystitis a I per cent, solution as a vesical wash, 
gradually increased to 2 per cent., is highly praised by Parvin. The Ointments and 
Gauze are used for wounds and other solutions of continuity, in the same manner as car- 
bolized preparations, and with better satisfaction, Creolin being less volatile than Carbolic 
Acid, and of a more agreeable, though powerful, odor. Internally it has been employed 
in gastric fermentation, dysentery, and typhoid fever. 

Lysol (Unofficial), — one of the latest disinfectants and antiseptics, is a saponified 
product of coal-tar, chiefly composed of the cresols ; and occurs as a clear, brown, oily 
liquid, mixible readdy with Water, and forming clear solutions with glycerin, alcohol, 



ACIDUM CHROMICUM. 69 

chloroform and various other fluids. As a microbicide it is superior to carbolic acid, 
creolin, and the other analogous coal-tar products, but has no advantage over the anti- 
septics of established reputation ; and is only really efficient in solutions of such strength 
as to be irritating or caustic. Although not destined to play any great part in surgery, 
it may be useful in the prophylaxis and arrest of epidemics; and is likely to be particu- 
larly serviceable in the disinfection of premises, privies, ships and stables, being readily 
soluble, reasonably active, and very cheap (Squibb). Dr. Pee, who has had very favor- 
able results from Lysol, recommends a one percent, solution in obstetrics and gynecology, 
and says that a solution of one part in 200 destroys streptococci in fifteen minutes. 

Saprol, Disinfection (^'/(Unofficial), — is a dark brown, oily mixture, highly inflam- 
mable, and composed of the crude cresols in a great excess of the liquid hydrocarbons 
obtained from the refining of petroleum. It floats on water and yet gives up its soluble 
constituents as disinfectants to the offending fluid, leaving the remainder as an oily film on 
the surface to hinder the escape of disagreeable odors, and the spread of infecting'spores. 
It is a cheap disinfectant, and can be employed on a large scale in barracks, prisons, 
schools, etc., if no light or fire is brought into proximity with it. Sewage treated with it 
still retains its value as a manure ; and so small a quantity as one per cent, of it will 
effectually sterilize urine and fecal matter impregnated with micro-organisms like the 
bacilli of cholera and typhoid fever (Laser). * 

Solutol and Solved (Unofficial), — are disinfectants of the same class as the preced- 
ing, both being soluble forms of the insoluble Cresol (Cresylic Acid). Solutol is an alka- 
line solution of Sodium Cresylate in an excess of Cresol, and is not suited for surgical 
use, by reason of its caustic alkalinity ; but is of marked utility in the preservation of 
the cadaver, and for general and copious use in disinfecting water-closets, sinks, infected 
bed-clothing, sputa and deleterious discharges of all kinds. 

Solveol differs from Solutol in containing Sodium Cresotate instead of sodium cresylate, 
is devoid of the causticity so characteristic of the latter substance, and is also free from 
the greasiness of Creolin and Lysol. It is a dark-colored, nearly odorless liquid, of 
neutral reaction, soluble in water in all proportions. It is especially applicable to surgical 
uses, a x / z per cent, solution being employed for dressings, being more active (it is claimed) 
antiseptically, than a 2 per cent, solution of carbolic acid. 



ACIDUM CHROMICUM, Chromic Acid, Cr0 3 — is obtained 
by the action of Sulphuric Acid upon Potassium Chromate, and occurs in 
small crimson needle-shaped crystals, deliquescent and very soluble in 
water. Brought in contact with alcohol mutual decomposition takes place. 
A similar result and perhaps sudden combustion occurs when it is placed 
in contact with other easily oxidizable substances, such as Glycerin, Spirit 
of Nitrous Ether, etc. It is not used internally. 

Potassii Bichromas, Potassium Bichromate, K 2 Cr 2 7 , — large, orange-red prisms of 
disagreeable, metallic taste and acid reaction, soluble in 10 of water at59° F., and in \y z 
of boiling water, insoluble in alcohol. Used locally in aqueous solution (gr. v-^j to the 
^ ), and internally in doses of gr. jg-ij in trituration. 

Physiological Action and Therapeutics. 
Chromic Acid is a powerful escbarotic, penetrating deeply, but slow 
of action and not very painful. It coagulates albumen and parts readily 
with its oxygen, oxidizing organic matter and decomposing ammonia and 
sulphuretted hydrogen ; and is therefore an energetic disinfectant and 
deodorizer. When used as a caustic it is mixed with sufficient water to 
make a paste, which may be employed for the destruction of warts, hem- 
orrhoids and other superficial growths ; the neighboring parts being pro- 



1 



I 



70 ACIDUM FLUORICUM ACIDUM GALLICUM. 

tected by cotton soaked in a strong alkaline solution. For syphilitic warts 
and condylomata, lupus, tinea tonsurans, etc., a solution of ioo grains to 
the g of distilled water is generally used. A solution of i in 40 is an 
excellent and inexpensive antiseptic lotion for putrid sores and wounds, 
syphilitic affections of the tongue, mouth and throat, ozaena, leucorrhoea, 
and gonorrhoea. In uterine catarrh and hemorrhages a solution of 120 
grains to the g has been injected into the uterine cavity with good results. 
Potassium Bichromate is a good antiseptic and an escharotic of milder 
action than the acid. In doses of 313— iv it has proved fatal to life in 
adults, with symptoms of gastro-enteritis, suppression of urine, and cardiac 
paralysis. It is chiefly employed as a local application in saturated solu- 
tion to warts and venereal condylomata ; and in dilute solution (gr. j-x 
to the ^) for catarrhal conditions of the nasal, buccal or vaginal mucous 
membrane. Internally it has been employed with benefit in locomotor 
ataxia and in dyspepsia simulating gastric cancer; also in chronic gastric 
catarrh, the tongue having a thick yellow coat, in chronic diarrhoea from 
intestinal ulceration, and in chronic ulcers of the pharynx and mouth. It 
is a good remedy in syphilitic sore throat, local rheumatism of the fibrous 
tissues, periosteal and syphilitic rheumatism, and acute catarrh and influ- 
enza, chronic nasal catarrh, chronic laryngitis, and chronic catarrhal 
affections of the bronchial mucous membrane, especially when the expecto- 
ration is tough and stringy. It has also been used with some success in 
membranous croup and diphtheria. In pharmacy it is employed in the 
preparation of Chromic Acid and Valerianic Acid, and as a test solution. 
Most of the medical galvanic and faradic batteries are run by a mixture 
of this salt with Sulphuric Acid. Poisoning by it should be treated as 
directed for mineral acids. 

ACIDUM FLUORICUM, Fluoric Acid, HF (Unofficial),— is a strong escharotic, 
acting deeply and leaving a dry and painful slough. The dilute acid (1 in 200) is pre- 
pared by acting on fluor spar by Sulphuric Acid, the resulting gas being dissolved in 
water. Its dose is TTLxx-xxx, well diluted. 

Dilute Fluoric Acid has been successfully used as an internal remedy in goitre, and the 
gas has been inhaled with benefit in diphtheria and membranous croup. 

ACIDUM GALLICUM, Gallic Acid, HC 7 H 5 5 H 2 0,— is a 
nearly colorless solid in long needles or triclinic prisms, having a slightly 
acid and astringent taste, soluble in 100 of water and in 5 of alcohol at 59 
F., and in 3 of boiling water. It is prepared from a paste of powdered 
galls (see Galla), by fermenting for six weeks, boiling and reboiling in 
water, filtering and crystallizing. According to some authorities the 
Tannic acid of the galls is split up into Gallic Acid and glucose by fer- 
mentation ; but according to others the glucose is an impurity and the 
Tannic Acid is simply converted into two parts of Gallic Acid, C u Hi O 9 
~ T H 2 — (HC 7 H 5 5 \. Dose, gr. v-xv, in solution, pill or powder. 



ACIDUM GALLICUM. 7 I 

Pyrogallol, Pyrogallic Acid, Tri-hydroxy- benzene, C 6 H 3 (OH) 3 , — is a 
triatomic phenol, obtained chiefly by the dry distillation of Gallic Acid. 
Light white, shining laminae, or fine needles, of bitter taste ; soluble in 
water, alcohol and ether. Dose, gr. j-ij. 

Vegetable Astringents depend for their medicinal value upon the Gallic and Tannic 
Acids contained in them. Such are — 

Alnus, Alder Bark. Heuchera, Alum Root. 

Castanea, Chestnut Leaves. Kino, Kino. 

Catechu, Catechu. Krameria, Rhatany. 

Diospyros, Persimmon. Myrica, Wax Myrtle. 

Galla, Nut Galls. Nymphsea, Pond Lily. 

Geranium, Cranesbill. Quercus Alba, Oak Bark. 

Granatum, Pomegranate. Rosa Gallica, Red Rose. 

Hamamelis, Witch Hazel. Rubus, Blackberry. 

Hsematoxylon, Logwood. Statice, Marsh Rosemary. 



Physiological Action. 

Gallic Acid, and its congener Tannic Acid, are astringents, the former 
being the more feeble of the two. They differ in that Tannic Acid coagu- 
lates albumen and gelatin, while Gallic does not. Tannic Acid is con- 
verted by the organism into Gallic and Pyrogallic Acids, in which forms 
it is absorbed and excreted. According to some authorities the difference 
between Gallic and Tannic Acids is one of oxidation, according to others 
of hydration ; the latter assuming Tannic Acid to be simply Gallic Acid 
Anhydride. They constringe the muscular tissue in the walls of the 
minute vessels, thus checking secretion and hemorrhages and cutting 
short local inflammations. Except in enormous doses they are harmless. 
[Compare Acidum Tannicum.] 

Pyrogallol may act as an intense poison. It has been absorbed from 
the surface with fatal results, preceded by vomiting and diarrhoea, rigors, 
and fever, black urine full of globulin, and disorganization of the blood- 
corpuscles. It has great affinity for oxygen and may be used as an anti- 
septic and disinfectant in i to 2}^ per cent, solutions. 

Antagonists and htcompatibles. 

Mineral acids, alkalies, per-salts of iron, and salts of antimony, lead, and silver are 
chemically incompatible. 

Therapeutics. 

Gallic Acid is preferred to Tannic Acid when an astringent action 
is desired upon remote parts, as the lungs, kidneys, etc., which can only 
be reached through the circulation. In hematuria, distant passive hem- 
orrhages, albuminuria, diabetes insipidus, bronchorrhcea, night-sweats, 
chronic diarrhoea, and chronic cystitis, it is a most useful remedy. 

Pyrogallol has been used internally in two-grain doses for internal 
hemorrhages. As an ointment fej-^j) it ranks next to Chrysarobin as 



72 ACIDUM HYDROCHLORICUM. 

an efficient palliative in psoriasis, and has been used with good results in 
lupus and epithelioma, being supposed to attack the diseased nodules 
only, leaving the adjacent skin uninjured. 



ACIDUM HYDROBROMICUM DILUTUM, Diluted Hydrobromic Acid,— 

is composed of io per cent, of absolute Hydrobromic Acid (HBr), and 90 per cent, of 
water. It is a clear, colorless, and odorless liquid, of a pungent acid taste, produced by 
decomposing Potassium Bromide by Sulphuric Acid and distilling. Dose, ttVxx-gij, 
every three hours. 

The action of Hydrobromic Acid on the nervous system and circulation is identical with 
that of the Bromides. Added to a mixture of Quinine and water (mjj to each grain of 
Quinine) it will produce a clear solution. 

In hysteria, congestive headaches, neuralgia, and nervous exhaustion, Hydrobromic 
Acid has been found useful. Used as a solvent of Quinine it retards cinchonism, and pre- 
vents the headache resulting from the full action of Quinine and Iron. As a substitute 
for the Bromides of Sodium and Potassium it is highly recommended, being much less 
depressant. It has been especially recommended in tinnitus aurium. Fothergill uses it 
for coughs of reflex or spasmodic nature, also for simple continued fever where there is 
cerebral disturbance. 



ACIDUM HYDROCHLORICUM, Hydrochloric Acid, Mu- 
riatic Acid, — is a liquid composed of about 32 per cent, of absolute 
Hydrochloric Acid Gas, HC1, and 68 per cent of water. It is colorless 
and fuming, of specific gravity 1.163, pungent odor, intensely acid reac- 
tion and taste, and is obtained by the action of Sulphuric Acid upon 
Sodium Chloride, the resulting gas being carried through water, which 
dissolves it. It is sometimes used as a caustic. Its union with basic 
substances forms salts, called Hydrochlorates (Muriates), of which four 
are official, viz. — Apomorphine, Morphine, Pilocarpine, and Quinine 
Hydrochlorates, described under the titles of their respective bases. 

Preparations. 

Acidum HydrochloricumDilutum, Diluted Hydrochloric Acid, — is a 10 per cent, 
solution of the absolute acid in water. Dose, n\iij-x. 

Acidum Nitro-hydrochloricum, Nitro-hydrochloric Acid, — see under Acidum 
Nitricum. 

Physiological Action of the Mineral Acids. 

The mineral acids (Hydrochloric, Sulphuric, Nitric, Nitro-hydrochloric, 
and Phosphoric) resemble each other in general action so closely that they 
may all be described in this place. 

The strong acids are escharotic, abstracting the water of the tissues, 
combining with the albumen and other bases, and destroying the proto- 
plasm. They are very diffusible, redissolving the albumen after precipi- 
tating it (except Nitric Acid). Sulphuric and Phosphoric have a strong 
affinity for water, completely decomposing tissues to which they are 
applied, and are therefore the most powerfully escharotic. Nitric Acid 
does not readily redissolve the albumen precipitated by it, which thus 
forms a barrier against the deep action of the acid. Sulphuric Acid 



AC1DUM HYDROCHLORICUM. 73 

chars or carbonizes the tissues black, while Nitric and Hydrochloric tan 
them yellow. 

The dilute acids produce a peculiar taste in the mouth and a sensation 
of roughness on the teeth. They stimulate the flow of saliva from the 
parotid and submaxillary glands, but have no action on the sympathetic 
saliva. They promote the alkaline intestinal secretions and excite the 
flow from glands having an alkaline secretion (bile, etc.), when applied to 
the mouths of their ducts, but check that from those whose secretion is 
acid (gastric, etc.). Secretion generally is promoted by Nitric Acid, and 
lessened by Sulphuric, Hydrochloric acting between the other two. Given 
before meals, in small doses, they relieve acidity of the stomach by check- 
ing the production of the acid gastric juice. At first they aid digestion, 
being synergistic to the action of pepsin, but if continued they impair 
digestion by lessening the production of the gastric juice. They check 
fermentation and constipate the bowels, except Nitric Acid, which relaxes 
them. They render the urine slightly more acid than its normal reaction, 
but do not acidify alkaline urine as the vegetable acids do. They are all 
astringent to the tissues, Hydrochloric being weakest and Sulphuric the 
strongest in this respect. 

Antagonists and Incompatibles. 

Alkalies to neutralize the acid ; oil, albumen, or milk, to protect the mucous mem- 
brane; stimulants, Opium, A?nmonia (intravenously), to combat the resulting depression 
of the vital powers. 

Therapeutics of the Mineral Acids. 

All the members of this group are useful in fevers, if well diluted, 
Hydrochloric being usually preferred, especially in typhoid. In atonic 
dyspepsia, acidity of the stomach, and locally in ulcerations of the throat, 
Hydrochloric Acid is best used. Nitric is the acid generally preferred as 
a caustic, its action being effectual and superficial. As such it is applied 
undiluted to phagedenic ulcers and sloughs, warty growths, and to the 
cavity of the womb in chronic inflammation thereof. Dilute Nitric Acid 
is used internally in oxaluria and lithsemia, intermittent and remittent 
fevers, and aphonia of singers. Dilute Nitro-hydrochloric is more suitable 
in chronic hepatic disorders due to malaria ; Sulphuric in hemorrhages, 
diarrhoeas, colliquative sweating, and as a prophylactic against lead- 
poisoning. Dilute Sulphuric Acid is used as an acid drink in fevers, and 
before meals in acidity of the stomach. It is very doubtful whether the 
latter has any special influence on the nervous or osseous systems. 

All these acids act injuriously on the teeth, by attacking the enamel. 
They should always be administered largely diluted, taken through a straw 
or glass tube, and the mouth should be thoroughly rinsed at once with an 
alkaline solution. 



1 



1 



74 ACIDUM HYDROCYANICUM DILUTUM. 

ACIDUM HYDROCYANICUM DILUTUM, Diluted Hy- 
drocyanic (Prussic) Acid, — is a liquid composed of 2 per cent. Of 
absolute Hydrocyanic Acid, HCN, and 98 per cent, of water. It is 
colorless, faintly acid, of peculiar odor, and is prepared by distilling 
solutions of Potassium Ferrocyanide and Sulphuric Acid together, or 
extemporaneously by adding 6 grammes of Silver Cyanide to a solution 
of 5 Cc. of Hydrochloric Acid in 55 of distilled water, shaking together 
and pouring off the supernatant liquid, r^xl have proved fatal. Dose, 
ftkj-v, of a recent preparation ; as, even under the most favorable condi- 
tions, it will decompose within a year. 

Preparations containing Hydrocyanic Acid. 

Aqua Laurocerasi, Cherry. laurel Water (Unofficial),— is a water distilled from the 
fresh leaves of Prunus laurocerasus, the common Laurel or Cherry Laurel, a small tree 
of the nat. ord. Rosacese, sub-order Amygdaleae. The leaves contain a variable amount 
of Hydrocyanic Acid and a volatile oil. Dose, rtpv-xxx, cautiously. 

Scheele's Dilute Hydrocyanic Acid (Unofficial), — is a 4 or 5 per cent, solution, 
and is highly dangerous even by inhalation. 

Amygdala Amara, Bitter Almond [see its title) and its essential oil; also, various 
other members of the sub-order Amygdalese, including the official Prunus Virginiana, 
perhaps the unofficial Prunus laurocerasus, and the leaves and kernels of the peach and 
cherry trees, contain a proximate principle Amygdalin, and a ferment Emulsin, which in 
the presence of water react on each other, forming Hydrocyanic Acid, a volatile oil, and 
glucose. C 20 H 27 NO U (Amygdalin) 4- 2H 2 = C 7 H 6 (Oil of Bitter Almond) + HCN 
(Hydrocyanic Acid) -J- 2C 6 H 12 6 (Glucose). 

Other Cyanogen Compounds. 

Potassii Cyanidum, Potassium Cyanide, KCN, — a white, opaque salt, of alkaline 
reaction, bitter-almond taste and a peculiar odor when moist ; soluble in 2 of water, 
sparingly soluble in alcohol. Dose, gr. ^-\. Locally, a solution of gr. j— v to the J, 
is as strong as should be employed. 

Potassii Ferrocyanidum, Potassium Ferrocyanide, K 4 Fe(CN) 6 3H 2 0, — large, lemon- 
yellow prisms or tablets, efflorescent, odorless, of sweetish taste and neutral reaction, soluble 
in 4 of water, insoluble in alcohol. Employed in pharmacy as a test solution, and in the 
preparation of Iron Ferrocyanide, Diluted Hydrocyanic Acid and Potassium and Silver 
Cyanides. Rarely used medicinally. Dose, gr. v-xv. 



Physiological Action. 
Hydrocyanic Acid is one of the most powerful and rapid poisons known , 
half a grain having proved fatal almost immediately. Its action on the 
organism is one peculiar to itself, the inhalation of a strong preparation 
producing rapid insensibility and almost immediate exhaustion ; — death 
from a full dose occurring by sudden paralysis of the heart, from a less 
but still a fatal dose, by paralysis of respiration. The symptoms are those 
of sudden and complete asphyxia, and some volitional movements may 
be made before death, unless the dose be very large. In cases in which 
the dose, though fatal, permitted of the observance of its effects, they 
were usually divisible into two marked stages, viz. : (1) Dyspnoea, slow 
and full pulse, giddiness, loss of muscular power; — (2) Vomiting, dilated 
pupils, unconsciousness, spasms, muscular rigidity, and cessation of the 



ACIDUM HYDROCYANICUM DILUTUM. 75 

heart's action. In poisonous, but not fatal doses, the following effects 
have been observed : feeble pulse, dilated pupils, turgid and dusky face, 
insensibility, convulsions or rigidity, but no paralysis. Large medicinal 
doses may produce salivation, irritation of the throat, dizziness, buzzing 
in the ears, headache, numbness, dusky countenance, staggering gait, 
sense of constriction of the chest, palpitation of the heart, a frequent or 
an abnormally slow pulse, a sense of great weariness and drowsiness. 
Post-mortem examination usually shows dilated pupils, the eyes having a 
marked glassy lustre, the cadaveric rigidity very great. The blood, in 
cases which have been rapidly fatal, may show the arterial color in both 
the arterial and the venous systems ; but in slower cases it is dark and fluid, 
engorging both sides of the heart, the venous trunks, and the cerebral 
sinuses. The paralyzant action of the drug is chiefly exercised on the 
nerve-centres in the medulla ; next on the peripheral afferent nerves, the 
spinal cord, the motor nerves, and finally on the muscular tissue. It stops 
the heart by irritation of the vagus-roots in the medulla, as well as by 
paralyzing the cardiac motor ganglia. It is said to form with haemoglobin 
a compound (cyan-haemoglobin), which does not readily give up oxygen. 
The odor of the acid is fragrant, resembling that of bitter almonds or 
peaches, and may be detected in the lungs shortly after death. The effects 
of a medicinal dose pass off in an hour at the farthest. 

Locally applied to the skin, Hydrocyanic Acid penetrates the epider- 
mis and paralyzes the end-organs of the sensory nerves in the derma. It 
is rapidly absorbed from mucous surfaces. 

Potassium Cyanide has similar action, but in addition has some few 
peculiar to itself. Locally used it produces dermatitis, with an eczema- 
tous eruption, and if applied to an abraded surface freely may cause fatal 
effects. Internally it has proved fatal in doses of 3 to 5 grains, with all 
the symptoms of Hydrocyanic Acid poisoning, but its action is less rapid. 
It is much used in photography, and many cases of poisoning by it have 
occurred in persons employed in that art. 

Antagonists and Antidotes. 

Atropinehzs antagonistic action, but is too slowly diffused to be of any value. Ammonia 
by inhalation, by the stomach, and by intra- venous injection, with cold affusion to the 
spine, and artificial respiration, are the measures most likely to avail in cases of poisoning 
where there is time to do anything. In poisoning by Potassium Cyanide give Ferrous 
Sulphate, producing Ferrocyanide of Iron (Prussian Blue). Then evacuation of the 
stomach, artificial respiration, and Ammonia by intra-venous injection. 

Therapeutics. 

Hydrocyanic Acid is used for its anti-spasmodic and sedative effects. 

In vomiting, whooping-cough, and coughs of spasmodic character, in 

asthma and other neuroses of the respiratory organs, in affections involving 

the pneumogastric nerve, vertigo and headache from stomachal derange- 



1 



i 



y6 ACIDUM LACTICUM ACIDUM NITRICUM. 

ments, gastralgia, painful dyspepsia, vomiting, etc., it is very efficient as 
a palliative. In acute mania and melancholia it has been used with 
advantage ; and in various skin diseases, accompanied by itching, tingling, 
etc., its use as a lotion (n^xxx-^j ad ^j Aquae Rosae) to the unbroken 
surface is prompt in relieving the pruritus and other distressing sensations. 
Only when recently prepared is it of any service; as, even under the most 
favorable conditions, it will undergo decomposition within a year. 

Potassium Cyanide in ointment (gr. v ad ^j) is used to allay pruritus, 
and in solution (gr. iij-v ad ^j) is applied locally with benefit in reflex 
headaches, and is used as a wash to remove nitrate of silver stains. It 
has been used internally in doses of gr. j for acute articular rheumatism, 
but such employment of it is highly dangerous. In smaller doses (gr. 
%-}()} it is a useful ingredient of cough mixtures, where Opium or its 
alkaloids are not admissible. 

Potassium Ferrocyanide has been used in doses of 8 to 15 grains as 
an astringent and anodyne, but it is seldom employed in medicine. 

Cherry-laurel Water has been extensively used as a flavoring agent, 
having a very agreeable taste. It is official in the British Pharmacopoeia, 
and is supposed to be a rather elegant mode of administering Prussic Acid ; 
but the uncertainty of its strength is such that it should never be used 
internally, except in very small quantities. It has been employed as an 
anaesthetic injection into the urethra prior to catheterization, and was 
formerly employed by ophthalmologists as an eye-wash in painful affec- 
tions of that organ. 



ACIDUM LACTICUM, Lactic Acid, — is a liquid composed of 75 per cent, of 
absolute Lactic Acid (HC 3 H 5 3 ) and 25 per cent, of water; nearly colorless, syrupy, 
odorless, of acid taste and reaction, freely miscible with water, alcohol and ether, but 
nearly insoluble in chloroform. It is produced by the lactic fermentation of sugar of 
milk or grape-sugar, has a sp. gr. of 1.2 1 3, and is difficult to obtain pure. It enters into 
Syrupus Calcii Lactophosphatis. Dose, gss-^ss, well diluted. 

Physiological Action and Therapeutics. 

Lactic Acid is found in the stomach as a product of the food, and combines with bases 
in the blood, forming lactates, which, being oxidized, are converted into carbonates. It 
aids digestion and promotes the appetite, but, in large doses, causes flatulence and much 
epigastric pain. Injected into the peritoneal cavity of animals, it excites endocarditis, and 
given in diabetes it has produced acute rheumatism and rheumatic endocarditis. Hence 
its supposed causation of acute rheumatism when in excess and free in the blood. It dis- 
solves false membranes and also calcium phosphate. 

It is used with benefit in diabetes, atonic dyspepsia, oxaluria, and in the lithic and 
phosphatic diatheses when due to imperfect digestion and assimilation. As a solvent of 
false membrane in croup and diphtheria it is unquestionably of great service but painful. 
In chronic cystitis it arrests the ammoniacal decomposition of the urine. As the acid found 
in the shops is generally of poor quality, disappointment in its use may be expected. 



ACIDUM NITRICUM, Nitric Acid,— is a liquid composed of 
68 per cent, of absolute Nitric Acid, HN0 3 , and 32 per cent, of water. 



ACIDUM OLEICUM. 77 

It is colorless, fuming, very caustic and corrosive, of sp. gr. 1.414, strongly 
acid in reaction, and is obtained by the action of Sulphuric Acid on 
Potassium Nitrate. Is only used externally as a caustic. 

Preparations. 

Acidum Nitricum Dilutum, Diluted Nitric Acid, — has of the above 10 parts in 58 
of Distilled Water, and contains 10 per cent, of absolute Nitric Acid. Dose TrLiij-xv, 
well diluted. 

Acidum Nitrohydrochloricum, Nitrohydrcchloric Acid, Nitromuriatic Acid, Aqua 
Regia, — a golden-yellow, fuming, corrosive liquid, composed of Nitric Acid 18 vols., 
Hydrochloric Acid 82 vols. Is wholly volatilized by heat, readily dissolves gold-leaf, and 
a drop added to test-solution of Potassium Iodide liberates Iodine in abundance. Dose, 
Try-viij, well diluted. 

Acidum Nitrohydrochloricum Dilutum, Diluted Nitrohydrochloric Acid, — con- 
sists of Nitric Acid 4, Hydrochloric Acid 18, Water 78 vols. Dose, ir^ v-xx, well 
diluted. 

Physiological Action and Therapeutics. 

The action and uses of these agents are described with those of the 
other mineral acids, under the title Acidum Hydrochloricum. Some 
special properties are as follows : — 

Nitric Acid is an exceedingly powerful escharotic, but, as it coagulates 
and does not redissolve the albumen of the tissues, it forms a barrier to 
its own excessive action. The vapor may cause oedema of the glottis, 
intense bronchitis, etc., and death from suffocation. It is used for the 
destruction of chancres, warts, hemorrhoids, phagedenic ulcers, etc. ; arid 
internally in dilute form for bilious affections, as it is supposed to have a 
selective action on the liver. It also lessens phosphatic deposits in the 
urine, and acts as an astringent in the system, diminishing profuse secre- 
tion in bronchorrhcea and phthisis. 

Nitrohydrochloric Acid is also supposed to specially affect the liver. 
It is usefully employed in jaundice, dyspepsia, and the so-called bilious 
condition ; also in frontal headache, situated just above the eyebrows, 
when unaccompanied by constipation, and in acidity of the stomach. 
In hepatic disorders it may be used in dilute form as baths, or applied to 
the hepatic region on compresses. The official dilute acid is of little use 
therapeutically, as it rapidly deteriorates, and the same may be said of the 
strong acid when standing long enough for the color to change to a lemon- 
yellow. The most efficient preparation is the strong acid freshly prepared, 
when it is of an orange-red color. This should be properly diluted when 
required for use, and should be constantly protected from light. 



ACIDUM OLEICUM, Oleic Acid, HC 18 H 33 2 — is one of the 
constituent acids of oils and fats, obtained commercially as a secondary 
product in the manufacture of stearin candles. ' It is a yellowish oily liquid, 
semi-solid at 57 F., odorless, tasteless, and of neutral reaction, insoluble 
in water but soluble in alcohol, chloroform, benzol, benzin, turpentine, 



1 



1 



?S ACIDUM PHOSPHORICUM. 

and the fixed oils. It dissolves most of the metallic oxides and the un- 
combined alkaloids, forming the so-called Oleates, which, however, are 
not pure chemical compounds, but merely compounds of the oxides or 
alkaloids, as the case may be, with oleic acid, dissolved in a great excess 
of the latter. Three of these are official, viz. : — 

Preparations. 

Oleatum Hydrargyri, Oleate of Mercury, — has 20 of the Yellow Oxide of Mercury, 
wiih 80 of Oleic Acid. 

Oleatum Veratrinae, Oleate of Veratrme, — has 2 of Veratrine in 98 of Oleic Acid. 
Oleatum Zinci, Oleate of Zinc, — has 5 of Zinc Oxide in 95 of Oleic Acid. 

Unofficial Preparations. 
Oleates (Oleata) of Aconitine (2 per cent.), Atropine (2 per cent.), Morphine (10 per 
cent.), Morphine and Mercury (2 per cent, morphine and 20 per cent, mercuric oxide), 
Quinine (25 per cent.), Strychnine (2 per cent.), Arsenic (gr. xx of oleate of arsenic to 
the j| ), Aluminum, Bismuth, Copper, Iron, Lead, Silver, etc., are prepared by the manu- 
facturing pharmacists, and are to be obtained in the shops. Most of them answer to the 
description given above, but several are Oleo-palmitates, or double salts of Oleic and Pal- 
mitic Acids, being prepared from oils which yield the latter acid in considerable quan- 
tity. Drs. Shoemaker and Wolff, of Philadelphia, have introduced, under the above 
names, several solid or semi-solid preparations, which they claim to be chemically true 
oleates, salts having no excess of either their acid or basic radicals. They are produced 
by the double decomposition of sodium oleate with solutions of neutral salts, the precipi- 
tates, washed and dried, being the oleates required. These oleates are claimed to be 
more stable than the official oleic solutions, and using less oleic acid are much less 
costly. Many of them may be used as dusting powders, or mixed with oil or lard to 
form ointments. 

Physiological Action and Therapeutics. 
Oleic Acid is only used in making the Oleates, which were introduced 
by Marshall, as substitutes for ointments, being cleaner, more elegant, and 
more penetrating, but decidedly more irritating if applied with friction. 
Their medicinal properties depend upon the bases employed, hence their 
actions and uses will be described under the corresponding basic heads. 
They should usually be diluted with an equal bulk of vaseline or olive oil 
before being rubbed into the skin, or they may produce a cutaneous erup- 
tion or even pustulation. As a rule, they should be lightly spread over 
the surface with the finger or a brush. As parasiticides, the Oleates of 
Copper and Mercury are most efficient, and in skin diseases generally 
these preparations are rapidly gaining favor. 



ACIDUM PHOSPHORICUM, Phosphoric Acid,— is a liquid 
composed of 85 per cent, of Orthophosphoric Acid, H 3 P0 4 , and 15 per 
cent, of water, and is obtained by oxidizing Phosphorus by Nitric Acid. 
It is strongly acid, odorless, colorless, and of sp. gr. 1.710 at 59 F. 

Preparations. 
Acidum Phosphoricum Dilutum, Diluted Phosphoric Acid, — has of Phosphoric Acid 
10 parts in 75 of Distilled Water, sp. gr. 1.057, and contains 10 per cent, of Orthophos- 
phoric Acid. Dose, ri^ v-xxx, in sufficient water. 



ACIDUM PICRICUM ACIDUM SULPHURICUM. 79 

Phosphates of Ammonium, Ferrum, and Sodium, Syrupus Ferri, Quininse et Strych- 
nine Phosphatum, and Acidum Hypophosphorosum Dilutum, are described under Phos- 
phorus. 

The action and uses of Phosphoric Acid are described with those of 
the other Mineral Acids under Acidum Hydrochloricum. It may be 
given in larger doses than the other acids without deranging digestion, 
and is therefore preferred in cases requiring acid treatment for a long 
period, as in diabetes, etc. It is considered of especial value in strumous 
affections, and it is thought to diminish the growth of osseous tumors, 
and to dissolve phosphatic deposits. As.it contains no free phosphorus, 
it cannot be used to obtain the effects of that drug. 



ACIDUM PICRICUM, Picric Acid, Carbazotic Acid, Trinitrophenol, C 6 H 3 - 
(N0 2 ) 3 (Unofficial), — is obtained by the action of Nitric Acid on Carbolic Acid, or 
many other substances. It has recently been introduced as a test for albumen and sugar 
in the urine. A saturated aqueous solution has been used locally in erysipelas with some 
advantage. Some of its salts (Picrates of Ammonium, Iron, etc.) have been tried thera- 
peutically, without any particular results. Powers as an antiperiodic and anthelmintic 
and against trichinse have been urged for it, but experience has not supported these 
claims. Dose, gr. v-xv per diem. 

Ammonium Picrate, in doses of gr. y% to gr. jss, in pill, four times daily, has been 

in over 10,000 cases with most effective results. 



ACIDUM SULPHURICUM, Sulphuric Acid,— is a strongly 
caustic and corrosive liquid, oily, inodorous, of a strong acid reaction, 
composed of not less than 92^ per cent, of absolute Sulphuric Acid 
(H 2 S0 4 ) and 7^ per cent, of water. It is obtained by the combustion 
of Sulphur and its oxidation by nitrous fumes. Its specific gravity should 
not be below 1.835, an d it is miscible in all proportions with water and 
alcohol, with evolution of heat. Occasionally used as a caustic. 

Preparations. 

Acidum Sulphuricum Dilutum, Diluted Sulphuric Acid, — has of the strong acid I 
part to 8^ of distilled water, and contains 10 per cent., by weight, of absolute sulphuric 
acid. Dose, rr\, v-xv, well diluted. 

Acidum Sulphuricum Aromaticum, Aromatic Sitlphuric Acid, Elixir of Vitriol, 
— is Sulphuric Acid 10 per cent, by volume, 20 per cent, by weight, diluted with Alcohol 
and flavored with Cinnamon and Ginger. It is not an acid, but rather an ether formed 
by reaction between the acid and the alcohol. Dose, \\ v-xv, well diluted. 

The action and uses of Sulphuric Acid generally are described with 
those of the other Mineral Acids under Acidum Hydrochloricum. Its 
chief use internally is in lead-poisoning, to form the insoluble sulphate, 
and as a remote astringent in diarrhoea, hemorrhoids, hemorrhages, 
night-sweats, and mucous discharges. In choleraic diarrhoea and lead 
poisoning it is generally administered in combination with Opium. The 
only hemorrhages in which it is efficient are those from mucous surfaces. 
It is exerted chiefly by the kidneys, part escaping by the bowels as 



1 



1 



80 ACIDUM SULPHUROSUM. 

sulphates, part also by the skin. Like the other mineral acids, it does not 
increase the acidity of the urine to any considerable extent. Its princi- 
pal actions are those of an astringent, an anhydrotic and a hemostatic. 



ACIDUM SULPHUROSUM, Sulphurous Acid— is a colorless 

liquid, of sulphurous taste and very acid reaction, composed of not less 
than 6.4 per cent., by weight, of Sulphurous Acid Gas (S0 2 ) and §3.6 per 
cent, of water. It is prepared by heating Sulphuric Acid with charcoal 
and dissolving the gas produced in distilled water. Dose, ftkv-^j, large- 
ly diluted with water. 

Preparations. 

Sodii Sulphis, Sodium Sulphite, Na 2 S0 3 .7H 2 0, — colorless, transparent, monoclinic 
prisms, efflorescent in dry air, of cooling, saline, and sulphurous taste, and neutral or 
feebly alkaline reaction ; soluble in 4 of water at 59 F., and in 0.9 of boiling water, 
very slighly soluble in alcohol. Dose, gr. v-xx. 

Sodii Bisulphis, Sodium Bistdphtte, NaHS0 3 , — opaque prismatic crystals, or a 
crystalline or granular powder, slowly oxidized in the air; of faint, sulphurous odor, a 
disagreeable taste, and an acid reaction; soluble in 4 of water and in 72 of alcohol 
at 59 F., in 2 of boiling water, and in 49 of boiling alcohol. By strong heat it is con- 
verted into sulphur and sulphate of sodium. Dose, gr. iij-x. 

Sodii Hyposulphis, Sodium Hyposulphite, Na 2 S 2 3 .5H 2 0, — large, colorless, mono- 
clinic prisms or plates, efflorescent in dry air, of cooling and bitter taste, and neutral or 
faintly alkaline reaction; soluble in 1.5 of water at 59 F., and in 0.5 of boiling water, 
which partly decomposes it ; insoluble in alcohol. Dose, gr. v-xx. 

Antagonists and Incompatibles. 
All oxidizing substances change the Sulphites into Sulphates, and the mineral acids 
decompose them. 

Physiological Action and Therapeutics. 

Sulphurous Acid has great affinity for oxygen, and is a powerful dis- 
infectant and deodorizer, and very destructive to all plant life. The gas 
inhaled is irritant to the glottis, and may produce dangerous inflamma- 
tion of the respiratory passages. 

Sulphurous Acid Gas'(Sulphurous Anhydride) is extensively used as a 
disinfectant, being the most powerful and convenient agent for this pur- 
pose. Sulphur is burned on a shovel or plate in the room to be fumi- 
gated, all outlets having been carefully closed. It is injurious to many 
fabrics. 

Sulphurous Acid is used locally in many throat affections as a spray or 
by a mop. In diphtheria, stomatitis, aphthae, ulcers of the tonsils, 
syphilitic and tuberculous laryngitis, chronic bronchitis, etc., it may be 
thus applied with great benefit. Morbid fermentation in the stomach 
with growth of penicillium and sarcinae is quickly stopped by 5 to 60- 
minim doses in water, or by the sulphites in 20-grain doses. In parasitic 
skin diseases and foul wounds these agents are extremely useful as local 
applications. 



ACIDUM TANNICUM. 8 I 

The Sulphites and Hyposulphites are partly decomposed by the 
acid of the stomach, sulphurous acid being given off, and the balance 
being converted into sulphates act as purgatives, and are absorbed, 
undergoing elimination as sulphates by the kidneys and bowels. They 
were formerly supposed to enter the blood and tissues as sulphites, and to 
arrest morbid processes of the zymotic character, but both these assump- 
tions have proven erroneous. The Sulphites were used in zymotic and 
septic fevers as internal antiseptics on theoretical grounds, but their sup- 
posed value has not been realized. 



ACIDUM TANNICUM, Tannic Acid, Gallotannic Acid, 
Digallic Acid, Tannin, HC 14 H 9 9 , — is a solid body in light-yellowish 
scales, of strongly astringent taste and acid reaction, obtained from 
powdered galls (see Galla), by exposure for three days in a damp at- 
mosphere, then macerating with ether, pressing, and drying the liquid 
portion. It is soluble in i of water, in 0.6 of alcohol, at 59 F., and in 
about 1 of glycerin with moderate heat ; very soluble in boiling water 
and in boiling alcohol, almost insoluble in ether, chloroform, benzol or 
benzin. Dose, gr. j-xx, in wafer, pill or capsule. 

Preparations. 

Unguentum Acidi Tannici, Ointment of Tannic Acid, — is a 20 per cent, ointment, 
made with Benzoinaied Lard. 

Trochisci Acidi Tannici, Troches of Tannic Acid, — each troche contains nearly 
one grain of Tannic Acid. 

Glyceritum Acidi Tannici, Glycerite of Tannic Acid, — strength 1 part in 4 of 
Glycerin. 

Suppositoria Acidi Tannici, Suppositories of Tannic Acid, (Unofficial), — have I 
part in 5 of Cacao Butter. 

Collodium Stypticum, Styptic Collodion, — has of Tannic Acid 20, Alcohol 5, Ether 
25, Collodion to make 100 parts. 

Vegetable Astringents contain some form of tannic acid, as Quercitannic Acid from 
Oak-bark, Rhatania-tannic Acid in Rhatany, etc. (For list, see page 71.) The of- 
ficial acid is Gallo-lannic Acid, being that produced from Galls. 

Antagonists and Incompatibles. 

Mineral acids, alkalies, persalts of iron, and salts of antimony, lead and silver, are 
chemically incompatible. Vegetable alkaloids and gelatin form insoluble precipitates 
with Tannic Acid. 

Physiological Action and Therapeutics. 
Tannic Acid is a powerful astringent. It precipitates pepsin and co- 
agulates albumen, impairs digestion, stops peristalsis, and causes constipa- 
tion. A part of that taken into the stomach unites with the pepsin and 
albumen, while a part is converted into Gallic ,and Pyrogallic Acids, 
and in this form is both absorbed and excreted. It is a crystalloidalbody, 
but combines with colloids, and is a valuable antidote in poisoning by the 
alkaloids and tartar emetic, with which it forms tannates which are 
6 



82 ACIDUM TARTARICUM— -ACONITUM. 

nearly insoluble. Its continued use disorders digestion, irritates the mu- 
cous membranes, and produces emaciation. Injected into the veins it 
forms emboli and thus may cause death, but by the stomach it is non- 
toxic. Some authorities hold that Tannic Acid is merely Gallic Acid 
Anhydride ; others believe that the difference between them is one of 
oxidation. Gallic Acid does not coagulate albumen or gelatin, while 
Tannic Acid does. 

Tannic Acid is a more powerful astringent than Gallic Acid, and hence 
is preferred for local use and for astringent effect on the intestinal canal. 
It is well employed in hemorrhoids and hemorrhages from the lower bowel, 
in hematemesis, epistaxis, rectal ulcers or fissures, catarrhs and chronic 
affections of the mucous membranes, endocervicitis, conjunctivitis, dysen- 
tery and diarrhoeas, eczema, impetigo and other forms of skin-disease, 
otorrhcea, bed-sores, prolapsus ani, and many other affections. 

Styptic Collodion is used to stanch the bleeding from an open wound, 
to unite and protect incised or lacerated wounds, and to cover and change 
the character of foul ulcers. 



ACIDUM TARTARICUM, Tartaric Acid, H 2 C 4 H 4 0g,— is a crystalline acid, pre- 
pared from Potassium Bitartrate (Acid Tartrate of Potassium, Cream of Tartar), by 
neutralizing a solution thereof with chalk and calcium chloride, then decomposing the 
calcium tartrate thus formed by sulphuric acid, evaporating and purifying. It occurs in 
colorless, transparent prisms, which are odorless, of acid taste and reaction, and soluble 
in 0.8 of water and in 2^ of alcohol at 59 F. Twenty grains exactly neutralize 27 of 
Potassium Bicarbonate, 22 of Sodium Bicarbonate, or 15^ of Ammonium Carbonate. 
Dose, gr. x-xxx. 

Preparations. 

Tartaric Acid is an ingredient of the Effervescing Powders (see under Potassium). 
Five Tartrates and one Bitartrate (see Index) are official, and are described, with their 
actions and uses, under the titles of their respective bases. For Potassium Bitartrate see 
under Potassium. The Alkaline Cupric Tartrate Volumetric (Fehling's) Solution is 
described in the Appendix. 

The actions and uses of Tartaric Acid are similar to those of the other Vegetable 
Acids, as described under Acidum Aceticum. It is chiefly employed in the preparation 
of effervescing refrigerant drinks and effervescing granulated salts. 



ACONITUM, Aconite, — is the tuber of Aconitutn Napellus, a 
perennial plant of the nat. ord. Ranunculacese (Monkshood), found in 
mountainous regions of Europe, Asia and N. America. This plant has 
deep-blue, helmet-shaped flowers, and leaves which have deeply-cut, 
wedge-shaped segments, exciting slowly when chewed a sensation of 
tingling in the tongue and lips. The root is conical and tapering, from 
2 to 3 inches long, dark-brown externally, whitish internally, having a 
thick bark enclosing a seven-rayed, star-shaped pith, odorless, taste 
sweetish at first, soon becoming acrid. A minute portion, cautiously 
chewed, causes prolonged tingling and numbness. Its active principle 
is the alkaloid Aconitine (see below), which it contains in the proportion 



ACONITUM. 83 

of .03 per cent. It also contains gum, sugar, Aconitic Acid, and several 
other principles, viz. — Aconine, Napelline, Pseudaconitine, Lyctonine, etc., 
concerning which there is much diversity of opinion. Dose, gr. j^-ij. 

Other aconite-roots are those of A. Cammarum, A.ferox, and the Chinese or Japan- 
ese Aconite, A. Chinense vel Japonicum. From the latter an alkaloid is obtained, 
named Japaconitine, which is even more poisonous than pseud-aconitine. The Indian 
variety (A. ferox) contains pseud-aconitine but does not yield aconitine. The former is 
considered to be more active than the latter, and Japaconitine more so than either the 
other two. 

Preparations. 

Extractum Aconiti, Extract of Aconite, — is at least four times as strong as the ex- 
tract official in the U. S. P., 1 870, which was prepared from the leaves, and is yet to be 
found in the shops. Dose, gr. Ye- 1 /^. 

Extractum Aconiti Fluidum, Fluid Extract of Aconite, — each drop represents 
nearly one grain of the powdered drug : an alcoholic preparation. Dose, lT\,^-ij. 

Tinctura Aconiti, Tincture of Aconite, — has of Aconite 35, Alcohol and Water to 
100. Is about 25 times stronger than the tincture of the leaf formerly official. Dose, 
ttlj£-iij. 

Tinctures of Aconite root vary greatly in strength. In Fleming's Tincture 79 parts 
of aconite are used in preparing 100 of the tincture, in that of the Br. P. 16, in the 
French 20, the German 10, while the Linimentum Aconiti (B. P.) is really a very strong 
tincture, of the strength of 1 to y z . Probably the best and safest preparation for ordi- 
nary use is a 10 per cent, tincture, of which the maximum single dose for an adult is 
stated in the P. Ger. at TT\, ix, and the maximum daily dose at TT^ xxxv. 

The best rule for the administration of aconite preparations is to give the minimum 
dose at intervals of 15 to 20 minutes, until the desired effect is produced. 

Unofficial Preparations. 

Aconitina, Aconitine, C 33 H 43 N0 12 , — a white, and usually amorphous solid, of alkaline 
reaction, soluble in 150 of cold and 50 of hot water; much more soluble in alcohol 
and ether. Is difficult to obtain of constant strength, some samples being all but inert, 
others extremely active. As obtained in the shops it is usually a mixture of several alka- 
loids. The Aconitijte Crystalisee of Duquesnel, which, according to Squibb, is a nitrate 
of aconitine, is considered to be the most active of those in the market. Dose, gr. ¥ l^— ^L. 

Oleatum Aconitinae, Oleate of Aconitine, — is a 2 per cent, solution in Oleic Acid, 
for external use. Duquesnel's crystals will not dissolve in Oleic Acid (Squibb). 

Napellina, Napelline, — is weaker than Aconitine, and has been used in doses of gr. 
%.~\' It has lately been studied by Laborde, who claims for it most valuable hypnotic 
properties, and proposes to use it as a substitute for opium and chloral. 

St. Jacob's Oil (a patent medicine), — is a weak Aconite Liniment, which also con- 
tains Ether, Alcohol, Turpentine, red coloring matter and water (Squibb). See Ap- 
pendix. 

Physiological Action. 
Aconite is a powerful depressant of the sensory nerve ends, the heart, 
the respiration and the spinal system. It is also antipyretic, diaphoretic 
and diuretic. It acts chiefly on the peripheral ends of the sensory nerves, 
but paralyzes both the motor and sensory nerves — the sensory being 
affected first and from the periphery inwards, while the motor nerves are 
affected from the centres outwards. It stimulates at first but soon relaxes 
the inhibitory apparatus of the heart, and paralyzes finally the vagus ends, 
the cardiac muscle and its contained ganglia, the respiratory centres, and 
the spinal cord in all its functions — sensory, reflex and motor ; but does 
not affect the cerebrum. 



i 



84 ACONITUM. 

The primary stimulation which the drug produces upon the vagus 
centre in the medulla slows the heart-rate at first ; but its depressant 
action upon the motor cardiac centres and the vagus end-organs in the 
heart, is soon manifested ; and finally the vagus centre shares in the 
increasing paralysis, which affects the vaso-motor centre as well as the 
cardiac nervous apparatus. The heart-rate becomes very rapid near the 
end, from paralysis of the vagus ends in its structure. 

Its taste is bitter, acrid and pungent. Soon after the ingestion of even 
a small quantity, a sensation of numbness and a persistent tingling are 
felt in the tongue and lips. Full medicinal doses cause a sense of con- 
striction in the fauces, irritation of the gastro-intestinal mucous membrane 
with increased secretion ; sometimes nausea and vomiting, and severe 
pains in the joints and muscles ; always more or less salivation, diaphoresis 
and diuresis ; reduced respiratory power, cardiac rate and force ; lowered 
arterial tension and temperature. 

A lethal dose produces great muscular weakness, dim sight, dilated 
(sometimes contracted) pupils ; shallow, irregular, and labored respiration, 
slow and weak pulse, cold surface, clammy sweat, great anxiety, numbness 
and tingling in the extremities, lowered body-temperature (2 to 3 ), 
abolished sensation, impaired reflexes and motility, and finally death from 
paralysis of the heart and respiration, with or without convulsions, con- 
sciousness being preserved until near the end, when C0 2 narcosis sets in. 
In two recorded cases, oedema of the entire body resulted from Aconite- 
poisoning by eating the leaves of the growing plant. 

Aconite is rapidly diffused and slowly excreted, the effects of a full 

medicinal dose continuing for three or four hours. Applied externally, 

it paralyzes the sensory nerves of the part, producing its characteristic 

numbness and tingling. 

Antagonists. 

Caffeine, Atropine, Morphine, Ether, Ammonia and Amyl Nitrite antagonize its 
effects on the heart and respiration. Digitalis counteracts its heart action and the relax- 
ation of cardiac inhibition. In Aconite poisoning, the stomach should be evacuated, 
warmth applied to the extremities, stimulants administered, artificial respiration if neces- 
sary, and the recumbent posture strictly maintained. Caffeine may be administered hypo- 
dermically and per orem. 

Therapeutics. 
Aconite antagonizes the fever process, and rightly used is therefore one 
of the most valuable drugs we possess. It has well been called the 
"therapeutic lancet," and is certainly responsible to a great extent for 
the disuse of venesection. Its power over the circulation, respiration and 
transpiration renders it of the greatest value in all affections characterized 
by high, resisting pulse, dry hot skin, and elevated body-temperature. It 
is especially useful in acute throat affections, the early stage of acute 
inflammations of the respiratory organs, catarrhal croup, acute pleuritis 
and peritonitis before the stage of effusion, simple and eruptive fevers, 



ADEPS. 85 

puerperal and surgical fevers, facial erysipelas, acute rheumatism, cardiac 
affections with overaction or hypertrophy and without valvular lesion, 
diarrhoea and dysentery from cold or exposure, menstrual suppression 
from chill, and neuralgia of the 5th (externally and internally), it having 
a very positive and selective influence on that nerve. It is also highly 
recommended in otitis, nervous palpitations, restlessness, and sick head- 
ache, as also in the acute stage of gonorrhoea. 

Aconite is best administered in small doses frequently repeated; from 
half a drop to a drop of the tincture every fifteen minutes in a teaspoon- 
ful of water, as a rule gives better results than do proportionately larger 
doses at longer intervals. 

Aconitine has been remarkably efficient in trigeminal neuralgia ; — so 
also has Napelline been in the same affection, and as an hypnotic it is 
well mentioned by several observers of authority. 

ADEPS, Lard, — is the prepared internal fat of the abdomen of Sz/s Scrofa (Pig), 
purified by washing, melting and straining. A soft, white, unctuous solid, of bland taste 
and neutral reaction, entirely soluble in ether, benzin, and bisulphide of carbon; com- 
posed of 38 per cent, of Stearin and Margarin, and 62 per cent, of Olein. Lard forms 
70 per cent, of Ceratum, and 80 per cent, of Unguentum, and enters into the composition 
of several of the official cerates. 

Fats are formed of the immediate principles, Stearin, Margarin and Olein, which are 
regarded as salts composed of stearic, margaric and oleic acids with a common base, 
glycerin ; also odorous and coloring principles. 

Preparations. 

Adeps Benzoinatus, Benzoinated Lard, — has 2 per cent, of Benzoin in powder, in- 
corporated by stirring. 

Oleum Adipis, Lard Oil, — is a fixed oil expressed from lard at a low temperature. 

The actions of the Oils and Fats are described under Morrhu^ Oleum. 

Lard is only used as an ingredient of ointments and cerates. Lard Oil is used in mak- 
ing the Unguentum Hydrargyri Nitratis, but has been proposed as an inferior substitute 
for Cod-liver oil in cases where the taste of the latter is particularly offensive. 

Adeps Lanse Hydrosus, Hydrous Wool-fat, Lanolin, — is the purified fat of the 
wool of sheep, mixed with not more than 30 per cent, of water. A yellowish-white, 
ointment-like mass, having a faint, peculiar odor; insoluble in water but miscible with 
twice its weight thereof. 

Under the name Lanolin this substance was in use for several years before it became 
official. It is a cholesterin fat, and a very old medicament, having been mentioned by 
Ovid, Herodotus, Pliny and Aristophanes ; yet the process for obtaining it from the suds 
from the washings of sheep's wool is patented in this country by Liebrich. It differs from 
all other fatty substances chiefly in resisting saponification and the action of water, having 
no tendency to become rancid; and readily passes through the integument, carrying with 
it any medicament with which it is charged. It is a perfectly neutral base, and therefore 
is not liable to decompose any ordinary substance. The difficulty about its use has been 
its very disagreeably sheepy smell, but recent samples seem in great measure to be devoid 
of this objectionable quality. It is particularly useful in chronic skin diseases where 
there is infiltration, and where a penetrative action is desired for medicaments locally 
applied. In a few cases of acute and subacute eczema it has proved irritating, but as a 
rule it is perfectly bland. Where a simple protective action is alone desired it is inferior 
to Lard, Vaseline or Cold Cream. 

Acidum Stearicum, Stearic Acid, — is an organic acid, usually obtained from the 
more solid fats, chiefly tallow. In its impure, commercial form, it occurs as a hard, 
white, glossy solid, odorless and tasteless, permanent in the air; insoluble in water, solu- 
ble in 45 of alcohol, also in ether. It is used as a substitute for wax, and is an ingredient 
of the Suppositoria Glycerini. 



1 



( 



86 .ETHER. 

iETHER, Ether, Ethyl Oxide (C 2 H 5 ) 2 0,— in its'absolute form is 
not official, the strongest preparation containing 4 per cent, of alcohol 
and some water. Considered as a generic term, an ether is analogous to 
a salt, as an alcohol is to a metallic hydrate. The particular ether 
officially so named is Ethyl Oxide, prepared from Ethyl Hydrate (Ethylic 
Alcohol) by a dehydrating agent with the aid of heat, and then purified 
by various processes. The agent used is Sulphuric Acid, hence this ether 
is improperly called " Sulphuric Ether," but the acid simply dehydrates 
the alcohol and remains in the retort, becoming constantly more diluted 
by the abstraction of water from the alcohol. Consequently H 2 is the 
difference between Alcohol and Ether. (C 2 H 6 0) 2 — H 2 = (C 2 H 5 ) 2 0. 
The official ethers are the two following, viz. — 

^ther, Ether, — is a volatile and inflammable liquid, composed of 
about 96 per cent, of absolute Ether, Ethyl Oxide, and about 4 percent, 
of Alcohol containing a little water. Sp. gr. 0.725 to 0.728 at 59 F. 
It is the preparation employed for anaesthetic use, and is generally though 
improperly called "Sulphuric Ether," a term which belongs to Ethyl 
Sulphate (C 4 H 10 SO 4 ). The dose of iEther for internal administration is 
n^x-3j, in syrup; hypodermically, for heart failure, n^xv-xxx. It is best 
prescribed as Spirit of Ether, which mixes readily with water. 

Water dissolves a tenth of its volume of Ether, and reciprocally Ether takes up about 
the same proportion of water. It is colorless, of a strong and characteristic odor, hot and 
pungent in taste. It evaporates speedily in the open air, with the production of con- 
siderable cold. When good, it evaporates from the hand, without leaving a disagreeable 
odor. It boils at about the temperature of the body (98.6 Fah.), and its vapor is very 
heavy and very inflammable. It dissolves Hydrargyrum Bichloride, Hydrargyrum 
Iodidum Rubrum, Iodine and Bromine freely ; Sulphur and Phosphorus sparingly. It is 
also a solvent of the fixed and volatile oils, many resins and balsams, caoutchouc, and 
most of the organic vegetable alkaloids. It does not dissolve Potash or Soda, in which 
respect it differs from Alcohol. 

./Ether Aceticus, Acetic Ether, Ethyl Acetate, C 2 H 5 C 2 H30, — is an 
inflammable liquid, transparent and colorless, of ethereal and acetous 
odor, soluble in alcohol, ether, chloroform, and in 8 of water. Sp. gr. 
0.893 t0 °-^95* It is a constituent of Sp. Odoratus andTr. Ferri Acetatis. 
Dose, \\ x-gj. 

Hydrobromic Ether, Ethyl Bromide, C 2 H 5 Br (Unofficial), — is not 
inflammable. Dose, internally and hypodermically, ttlx-^j. 

Hydriodic Ether, Ethyl Iodide, C 2 H 5 I (Unofficial), — is a colorless 
liquid, non-inflammable, and insoluble in water. Dose, inhaled, ttlxv. 

For the Chlorinated Ethers see under Chloroform. 

Preparations. 

Oleum /Ethereum, Ethereal Oil, — is a volatile liquid, consisting of equal volumes 
of heavy Oil of Wine and Ether. Used to prepare the Spt. Athens Comp. As it occurs 
in commerce is usually a worthless preparation. 

Spiritus ^Etheris, Spirit of Ether, — has of Ether 325 parts, Alcohol 675. Dose, 



iKTHER. 87 

Spiritus i*Etheris Compositus, Hoffm a nn's Anodyne, — contains Eiher 325, Alcohol 
650, Ethereal Oil 25 parts. Dose, TT^v-^ j. 

Spiritus Athens Nitrosi, Spirit of Nitrous Ether, Szveet Spirit of Nitre, — is an 
alcoholic solution of Ethyl Nitrite, C 2 H 5 N0 2 , containing 5 per cent, of the crude ether. 
It turns acid with age, and should not be kept long. It is a constituent of Mist. Glycyr- 
rhizse Co. (3 per cent.). Dose, ^ss-^ss. Its incompatibles are Potassium Iodide, 
Ferric Sulphate, Tr. Guaiaci, Tannic and Gallic Acids, and Antipyrin. 

Anaesthetic Mixtures. 

Nussbaum' s has — Ether 3 parts, Chloroform I, Alcohol I. 

Vienna General Hospital uses — Ether 9, Chloroform 30, Alcohol 9. 

The " Vienna Mixture" — Ether 3, Chloroform I. 

Medico-Chirurgical Society of London (1864) proposed — Ether 3, Chloroform 2, 
Alcohol 1. 

Physiological Action of Ether. 

Ether is anodyne, antispasmodic, diaphoretic and anthelmintic ; a 
cardiac and cerebral stimulant, an anaesthetic, and a narcotic poison. 
Given internally, it is one of the most powerful stimulants of the secre- 
tions, acting especially on the secretions of the stomach, salivary glands 
and pancreas. On the cerebrum and the motor and sensory nerves its 
action is similar to that of alcohol, but more prompt and less protracted. 
It is eliminated rapidly, chiefly by the lungs. Externally it is a powerful 
refrigerant and local anaesthetic ; also rubefacient when rubbed into the 
skin. 

Inhaled Ether produces at first faucial irritation, a sense of strangula- 
tion and cough ; then a stage of excitement (cerebral intoxication), in 
which the face is flushed and the respiration and pulse are accelerated. A 
tetanic convulsive stage generally follows, the face being cyanosed, the 
muscles rigid, and the respiration stertorous. This soon subsides, and 
complete insensibility is established, the muscles being then relaxed, the 
reflexes abolished, and the cerebral functions suspended, the lower centres 
in the medulla carrying on the processes of respiration and circulation. 
If the inhalation be continued, these also become paralyzed, death 
usually resulting from slow paralysis of respiration, the heart pulsating 
long after breathing has ceased. If the inhalation be discontinued before 
the lower centres are affected, the patient gradually emerges from the 
condition of insensibility, and, as the narcosis subsides, vomiting is usually 
experienced. 

Dr. Brunton found that in a hot climate Ether will decompose within a few hours, and 
hence, during his investigations for the Hyderabad Chloroform Committee, he found it 
impossible to obtain pure ether. This may account for the preference for Chloroform as 
an anaesthetic which is so universal in the Southern States. 

Ether Compared with Chloroform. 
Ether is less irritant than Chloroform to the mucous membranes when 
swallowed, but its vapor is more irritant to the air-passages. It is more 
of a general stimulant, and less depressant to the heart and circulation. 



i 



l 



8$ JETHER. 

It does not clot the blood. Its vapor is very inflammable, less pleasant to 
inhale, slower in action, has a longer stage of excitement, and a less 
profound narcosis, and causes a greater degree of vomiting. It is much 
less dangerous than Chloroform, death from the inhalation of Ether 
occurring slowly and usually by paralysis of respiration — from Chloro- 
form, it is almost always sudden. Ether has undoubtedly caused a 
number of deaths, besides several which occurred some hours after the 
anaesthesia. 

Modes of Dying from Anesthetics. 

(i.) From sudden paralysis of the cardiac ganglia, early in the inhalation, by reflex 
action proceeding from some peripheral injury before complete anaesthesia is produced. 
Thus, in the extraction of teeth, a small quantity of Chloroform having been administered, 
the heart is enfeebled, and the action of the cerebral hemispheres suspended, but not 
those of the basal or medullary ganglia. If at this stage the 5th nerve be irritated, by 
the intimate relation of its nucleus with that of the pneumogastric reflex inhibition may 
be transmitted over the latter, arresting the cardiac ganglia. The stage of incomplete 
anaesthesia is always a dangerous one in which to perform any operation around the 
distribution of the 5th nerve. 

(2.) In the stage of rigidity, from tetanic fixation of the respiratory muscles, the blood 
backing up on the venous side, and arresting the heart's action, respiration ceasing before 
the cardiac action is stopped. 

(3.) In the stage of complete relaxation, by paralysis of respiration; or by paralysis of 
the tongue, causing obstructed respiration. 

(4.) In the same stage, by paralysis of the motor ganglia of the heart. 

(5.) From depression of the functions by chloroform narcosis, and from shock, — and 
may occur in the anaesthetic state, or afterwards. 

Contraindications for Anaesthesia are — fatty degeneration or dila- 
tation of the heart, renal and pulmonary disease, enlarged tonsils, cere- 
bral tumor, and chronic alcoholism — particularly the first and last named. 

Dangerous Symptoms should be met by withdrawing the vapor and 
inverting the patient head downwards, drawing the tongue forwards, and 
applying a cold douche to the face and chest. Atropine hypodermically 
is an agent of great value in combating the cardiac failure, — artificial 
respiration and faradization of the respiratory muscles if breathing ceases. 
A??iyl Nitrite by inhalation, or Ammonia hypodermically. Heat to the 
body and limbs. 

Pental, Tri-methyl-ethylene, C 5 H ]0 (Unofficial), — is a colorless liquid, highly inflam- 
mable, insoluble in water, but miscible in all proportions with alcohol, ether and chloro- 
form. Sp. gr. 0.678. It is obtained by heating amylene hydrate in the presence of acids. 

Pental is an efficient anaesthetic, equal to Nitrous Oxide in its rapidity of action and 
safety, but superior thereto in its more prolonged action and its having no unpleasant 
after-effects. Under it there is seldom any stage of exhilaration, and consciousness is 
sufficiently retained to enable response to commands, even when insensibility to pain is 
reached. It does not lose its effect by repeated inhalations. Compared with Chloroform, 
it acts more promptly, and has no evil after-effects ; with Ethyl Bromide, it is somewhat 
slower in action but more lasting in effect, and can be prolonged as may be necessary ; 
with Nitrous Oxide, it can be continued for a longer time, is more safe, and free from 
after-effects of unpleasant character. 

A comparison of these agents in respect to their safety has been made by Dr. Richard- 
son, who considers Methylic Ether to be the safest of all, and the others as follows : 

Safe are— Ethyl Bromide, Ethyl Chloride, Ether, Ethene (defiant gas), Ethene Chlo- 



.ETHER. 89 

ride, Methyl Bromide, Methyl Chloride, Methyl Ether, Methene Chloride, Methane 
(marsh gas), Nitrous Oxide. 

Of doubtful value are — Amylene, Amyl Chloride, Butyl Chloride, Benzene (benzol), 
Carbon Bisulphide, Carbon Dioxide, Carbon Tetrachloride, Methyl Alcohol, Methylal, 
Spirits of Turpentine. 

Dangerous are — Amyl Hydride, Butyl Hydride, Carbon Monoxide, Ethyl Hydride. 
Chloroform and Ethene Dichloride are considered useful, but requiring care. 

Physiological Action of Other Ethers. 

Hydriodic Ether is an antispasmodic and a general stimulant ; also 
an anaesthetic if inhaled for a sufficiently long time. Its use as a medici- 
nal agent is chiefly to bring the system rapidly under the influence of 
iodine. It increases appetite, stimulates the action of the heart, gives 
vivacity to the general feelings and activity to the intellect. 

Hydrobromic Ether has a not unpleasant odor, produces but little 
irritation of the air-passages, has very brief stages of excitement and 
rigidity, and but a short stage of insensibility, with prompt awakening 
and but little of the mental confusion and excitement consequent on the 
use of the other anaesthetics. It is not inflammable, acts quickly, and is 
a good local anaesthetic. Its actions in other respects correspond with 
those of Ether. 

Nitrous Ether is a mild diaphoretic, a diffusible stimulant, a carmin- 
ative, and an efficient diuretic. On the blood it acts similarly to Amyl 
Nitrite, diminishing oxygenation, relaxing the peripheral vessels, accel- 
erating the heart's action, and thus lowering arterial tension. Relaxing 
the renal and cutaneous vessels, it is diuretic and diaphoretic. 

Acetic Ether has a pleasant odor and taste, forming agreeable combi- 
nations with other carminatives as a stimulant and antispasmodic. 

Therapeutics. 

When diluted with alcohol Ether mixes readily with water, and may be 
administered internally with advantage in indigestion of fats, and to aid 
the digestion of Cod-liver Oil. It is also given in hysteria to relieve the 
paroxysm and flatulence, and in hepatic colic from calculi, Ether with 
Turpentine (Durande's solvent remedy), which acts only as an anodyne 
and antispasmodic, is considered by some as of great value. 

Subcutaneously Ether is used in the algid stage of cholera, sudden car- 
diac depression, neuralgia, and in the adynamia of hemorrhage, pneu- 
monia and the eruptive fevers. 

Local anaesthesia by the Ether-spray affords great relief in neuralgia of 
superficial nerves, lumbago, chorea, and spinal irritation. In minor sur- 
gical operations it is a valuable method. 

As an Ancesthetic the vapor of Ether is less prompt than that of 
Chloroform, but is equally efficient and much safer. It should be inhaled 
in as concentrated a form as possible, and will then produce insensibility 



90 AGARICUS ALBUS. 

in from 5 to 10 minutes. If a light be in the room it should be high 
above the patient. A grate-fire or gas-stove in the vicinity is very dan- 
gerous. [Compare Chloroform.] Besides its surgical uses ether-anaesthesia 
is employed in neuralgia, cancer, tetanus, chorea, colic, delirium, puer- 
peral mania and convulsions, infantile convulsions, hystero-epilepsy, epi- 
leptic seizures, laryngismus stridulus, whooping-cough, and asthma. The 
unpleasant after-effects may be greatly modified if not entirely prevented 
by the previous administration of Morphine (gr. -1— 1) and Atropine 
(gr. Y20) subcutaneously. 

Hydrobromic Ether had a short period of popularity as an anaesthetic, 
but fell into disrepute after a few cases of death under its influence, which 
were probably not due to the agent used (Levis' and Sims' cases). Its 
action is less prolonged than that of Ether, but it has many advantages, 
requiring only 3J to gij, rapidly given, and being uninflammable. Its 
inhalation has been of especial value in hysteria, epilepsy, chorea and 
other spasmodic disorders; and it has been employed subcutaneously in 
place of Ether in the treatment of such spasmodic affections as whooping- 
cough, chorea, etc. 

The Compound Spirit of Ether (Hoffmann's Anodyne) is an admir- 
able agent in gastralgia, colic, flatulence, syncope, etc., also in the vari- 
ous manifestations of the hysterical paroxysm. In combination with 
the camphorated tincture of Opium it is often remarkably efficient in 
checking the diarrhoea of hot weather. 

Spirit of Nitrous Ether is used as a diaphoretic, a diuretic and a 
carminative ; also in expectorant mixtures, as an antipyretic in febrile 
affections, and to relieve pain in angina pectoris, dysmenorrhcea and 
asthma. When its diuretic effect is desired it should be administered 
in iced water, and the patient should be lightly covered: but when its 
diaphoretic action is required, it should be preceded by a hot drink, and 
the patient should be well covered. 

Hydriodic Ether may be obtained in glass capsules containing five 
minims each, and is used by inhalation in chronic pulmonary disorders, car- 
diac dyspnoea, spasmodic affections of the bronchi and larynx, asthma, and 
in catarrhal laryngitis with dyspnoea. It is not employed as an anaesthetic. 



AGARICUS ALBUS, White or Purging Agaric (Unofficial),— is the fungus 
Polyporus officinalis, which grows on the European larch. It occurs in large, white, 
spongy pieces; and contains Agaricic or Laricic Acid, also from 40 to 70 per cent, of 
resins. The term Agaricin was formerly applied to the impure Agaricic Acid containing 
about 3 per cent, of Agaricol, which is physiologically inert. 

The taste of Purging Agaric is first sweetish, then becoming very acrid and bitter. 
The powder inhaled causes violent sneezing, and taken internally in full doses it produces 
watery stools. Small doses check diarrhoea and dysentery, and diminish the secretions 
of the bronchi and mammae. 

Agaricus Albus was formerly employed as a drastic purgative, in doses of gr. xxx to 
3J. It has lately been used, with much success, in 15-grain doses of the powder, or 3 



AGARICUS CHIRURGORUM AGARICUS MUSCAR1US. . 9 1 

grains of the alcoholic extract, to check the night-sweats of phthisis. Agaricic Acid 
has proved very valuable in checking persistent sweating from any cause, especially that 
occurring after influenza. The dose is gr. ^ to j '• an( l it should not be given hypoder- 
mically. 



AGARICUS CHIRURGORUM, Surgeon's Agaric (Unofficial),— is the interior 
portion of the fungus Polyporus fomentarins, which grows on the trunks of beeches, 
birches, and oaks in Europe. It is prepared for use by boiling in weak lye and beating 
with mallets, and then occurs in light, thin, yellowish-brown pieces, soft and pliable, 
without odor or taste. It is almost pure cellulose. It was formerly used as a mechanical 
hemostatic, and for the purpose of moxa. When soaked in a strong solution of Potas- 
sium Nitrate or Potassium Chlorate and dried, it is very inflammable, and is then called 
Spunk. 

AGARICUS MUSCARIUS, Amanita Muscaria, Fly-Agaric 
(Unofficial), — is a poisonous mushroom, of disagreeable odor and burn- 
ing, acrid taste, used in infusion with milk for poisoning flies, and by the 
Tartars as an intoxicant. It contains an actively toxic alkaloid, Musca- 
rine, C 5 H 13 N0 2 , of syrupy consistence, odorless and tasteless, soluble in 
water and alcohol, and readily dissolved out by water and dilute acetic 
acid, so that a doubtful mushroom may be easily rendered innocuous. 
It .may also be produced synthetically, but it is doubtful wjiether the 
article so prepared is as active as the natural product. It has been made 
from Choline by Schmiedeberg. 

Preparations. 

Muscarina, Muscarine (Unofficial). — Dose, gr. i-gr. ij. It maybe used hypoder- 
mically in watery solution. 

Muscarinae Nitras, Nitrate of Muscarine (Unofficial), — may be used hypodermi- 
cally, in doses of from gr. T L to gr. f . 

Physiological Action. 

Muscarine is a powerful respiratory and cardiac depressant, paralyzing 
the respiratory centre and arresting the heart in diastole by paralyzing 
its motor ganglia while stimulating its inhibitory apparatus. It lowers 
the arterial tension, produces profound salivation, lachrymation and 
sweating, contracts the pulmonary vessels, causing intense dyspnoea, and 
increases the intestinal, hepatic and pancreatic secretions, but markedly 
diminishes the renal. It disturbs the gastro-intestinal tract, causing 
tetanic intestinal contractions, severe colic, vomiting and purging. It 
produces spasm of the accommodation, marked myosis and contraction 
of the pupil when given internally, but dilates the pupil widely when 
locally applied. [Gelsemium does so also.] Under its action the body 
temperature is decidedly reduced, and the excretion of waste-products is 
lessened. It is eliminated unchanged by the kidneys. 

Agaricus acts as an intoxicant to the cerebrum, producing more vertigo 
and delirium than Alcohol, followed by profound sopor with lowered re- 
flexes, perhaps coma and death. 



92 AILANTHUS — ALCOHOL. 

Antagonists. 

Atropine exactly opposes Muscarine, and vice versa ; no example of physiological 
antagonism being so complete in all particulars. When a frog's heart is arrested by the 
topical action of a minute quantity of Muscarine, the application of a little Atropine 
will immediately paralyze the inhibition and restore the pulsations. An equally prompt 
antagonism runs through their entire spheres of action. Digitalin is to some extent 
antagonistic ; so also is Eserine. 

Therapeutics. 
Muscarine has been as yet little used in medicine, but it will probably 
prove to be a valuable drug. It has been long used, with marked benefit, 
in the night-sweats of phthisis. A tincture of Agaricus has been found 
beneficial in ataxic typhus, chorea, and chilblains. Muscarine promises 
to be of great value in inflammations characterized by copious exudation, 
especially eye-inflammations, catarrhal jaundice, recent hemorrhoids, 
acute bronchitis, pulmonary hemorrhage, incipient pulmonary congestion, 
diabetes of both forms, and in constipation due to intestinal torpor and 
deficient secretion, accompanied by a torpid liver and difficult digestion 
of fats. In the latter affection it should be given in small doses, gr. -gLj, 
thrice daily. 



AILANTHUS, Tree of Heaven (Unofficial), — is the bark of Ailanthus glandu- 
losa, a well-known shade tree, of the nat. ord. Simarubacese, indigenous to China, but 
cultivated elsewhere. It contains an oleo-resin and a volatile oil, on which its properties 
probably depend. Dose, gr. x-gj. 

Preparations. 
Extractum Ailanthus Fluidum, Fluid Extract of Ailanthus (Unofficial), — Dose, 

Tinctura Ailanthus, Tincture of Ailanthus (Unofficial), — Dose, Tr^ x-^ij. 

Ailanthus is a decided nauseant, and a drastic purgative, causing also vertigo, weak- 
ness, cold sweats, dull headache, pains in the back, numbness and tingling in the limbs. 
It paralyzes the cerebrum and spinal cord of animals, impairment of motility beginning 
in their hind extremities. The cardiac action, at first increased, soon slows, the pulse 
becoming small and weak, and the respiration depressed, death occurring from paralysis 
of respiration. It is a good taeniafuge. 

Ailanthus is used against tapeworm, a decoction of the fresh bark ( gj to ^iv), or the 
oleo-resin in drachm doses, being very efficient. It has also been well employed in 
malignant scarlatina, with dark and partial eruption, insensibility, delirium and other 
cerebral symptoms. 



ALCOHOL, Alcohol, Ethyl Alcohol, Ethyl Hydrate, C 2 H 5 OH. 
The official alcohol is Ethyl Alcohol, which is represented in the phar- 
macopoeia by the several preparations named Brandy, Whiskey, and 
Wine, as also under the following four forms, viz. — 

Alcohol Absolutum, Absolute Alcohol, C 2 H 5 OH, — is Ethyl Alcohol, 
containing not more than i per cent, by weight of Water. A transparent, 
inflammable, colorless, mobile and volatile liquid, very hygroscopic, of 
characteristic, agreeable odor, and burning taste. Sp. gr. not higher than 
0.797 at 59 F., or 0.789 at 77 F. Used to manufacture Chloroform. 

Alcohol, — a liquid composed of about 91 per cent, by weight, or 94 



ALCOHOL. 93 

per cent, by volume, of Ethyl Alcohol, C 2 H 5 OH, and about 9 per cent, 
by weight, of Water. A transparent, inflammable, colorless, mobile and 
volatile liquid, of agreeable odor and burning taste. Sp. gr. 0.820 at 59 
F., or 0.812 at 77 F. Miscible with water in all proportions and with- 
out any trace of cloudiness ; also miscible with ether or chloroform. 
Obtained by the distillation of fermented saccharine fluids. Used in pre- 
paring all the tinctures and spirits, also in some of the liniments, liquors 
and mixtures. 

Alcohol Deodoratum, Deodorized Alcohol, — a liquid composed of 
about 92}^ per cent., by weight, or 95.1 per cent, by volume, of Ethyl 
Alcohol, and about 7^ per cent., by weight, of Water. Sp. gr. about 
0.816 at 59 F. 

Alcohol Dilutum, Diluted Alcohol, — a liquid composed of about 41 
per cent., by weight, or about 48.6 per cent., by volume, of absolute 
Ethyl Alcohol, and about 59 per cent, of Water. It is prepared by mix- 
ing together equal volumes of Alcohol and Distilled Water, or 410 parts 
by weight of the former and 500 of the latter. Sp. gr. about 0.936 at 
59° F. 

An Alcohol is a volatile organic compound, which contains no N, has a great affinity 
for water, and reacts with acids, forming therewith H 2 and ethers. Alcohols are there- 
fore analogous to the metallic hydrates, as are Ethers to salts. Methyl Alcohol is 
obtained by the destructive distillation of wood, Phenyl Alcohol (Phenol) by that of 
coal-tar, and the fermented Alcohols (Ethyl, Amyl, etc.) from any vegetable substance 
containing sugar, (or starch and the ferment Diastase, which converts the starch into 
sugar), by fermentation through the agency of the yeast-plant, which splits the sugar into 
Alcohol and C0 2 . The product contains much water, and is then distilled in order to 
separate the alcohol, which passes over first, with a certain amount of water, the greater 
part of the latter being left behind. In this country Alcohol is so produced from grain 
(chiefly barley), and is termed "High Wine," being disposed of by the distillers to 
certain wholesale liquor dealers, many of whom proceed to " rectify" it by mixing and 
blending it with water, essential oils of corn, rye, etc., ethers, burnt sugar, and occasion- 
ally small quantities of genuine whiskey, brandy, etc. The product is then labeled " Old 
Tom Gin," " Old Crow Whiskey," etc., according to the requirements of the retail 
dealers. True Whiskey is distilled from the mash of fermented grain (corn, wheat, and 
rye, or a mixture of all three), and should be not less than two years old, to be official; 
Brandy from the fermented juice of fresh grapes, and should be not less than four years 
old. Wines are the product of the fermented juice of grapes, without distillation. 

Alcohol may be produced synthetically by shaking Olefiant Gas (C 2 H 4 ) with strong 
Sulphuric Acid, then diluting and distilling. Absolute Ethyl Alcohol, which is only 
used for chemical testing and fo» the manufacture of Chloroform, is obtained by shaking 
Rectified Spirit (Alcohol) with Potassium Carbonate, decanting and distilling with slaked 
lime. 

Alcohol very slowly oxidized forms Aldehyde (C 2 H 4 0); if less slowly Acetic Acid 
(C 2 H 4 2 ) ; if quickly, as in burning, C0 2 and H 2 0, which are in all cases the ultimate 
products of its continued oxidation. 

Principal Unofficial Alcohols. 

Methyl Alcohol, Methyl Hydrate, CH 3 OH, Wood-spirit,— also called 

Carbinol, Methol, Hydroxymethane. A non-fermented alcohol, obtained 

from the destructive distillation of wood. Ordinarily it contains many 

impurities, which give it a very disagreeable odor, and mixed with ethyl 



94 ALCOHOL. 

alcohol it renders the latter so disagreeable as to be unfit for drinking. 
Such a mixture is sold, under the name Methylated Spirit, for use as a 
solvent in the arts, as a combustible in lamps, etc. 

Amyl Alcohol, Amyl Hydrate, C 5 H n OH, Potato-spirit, Fusel Oil. — 
A fermented alcohol obtained from the potato, also occurring in the crude 
spirit produced by the fermentation of saccharine solutions with yeast, 
and separated by the excessive distillation thereof, passing over after the 
ethyl alcohol. Is oxidized into Valerianic Acid. From it is prepared 
Amyl Nitrite, by distilling with nitric and sulphuric acids and copper 
wire. It is an oily liquid, of penetrating and oppressive odor and burn- 
ing taste : sparingly soluble in water, but soluble in all proportions in 
alcohol, ether and essential oils. 

Preparations. 

Spiritus Frumenti, Whiskey, — obtained from the distillation of the mash of fer- 
mented grain; rye, wheat or corn (U. S.), barley (Scotch), and at least two years old. 
Sp. gr. 0.917 to 0.930. Has an alcoholic strength of 44 to 50 per cent, by weight; also 
Ethers developed by the action of acetic and butyric acids on the alcohol, and traces of 
Amyl Alcohol (fusel-oil) even in the best. 

Spiritus Vini Gallici, Brandy, — obtained from the distillation of the fermented juice 
of grapes, and at least four years old. Sp. gr. 0.925 to 0.941. Has an alcoholic strength 
of 39 to 47 per cent, by weight, and CEnanthic and other Ethers developed by age. Pale 
Brandy is colored by the cask, the dark has caramel to color it. Is often prepared artifi- 
cially by adding to high wines Acetic or Nitric Ether, Caramel, and Logwood or Catechu 
for astringency. 

Vinum Album, White Wine, — should contain from 10 to 14 per cent, by weight of 
absolute alcohol, and is made by fermenting the unmodified juice of the grape, freed from 
seeds, stems and skins. California Riesling, Ohio Catawba, etc. 

Vinum Rubrum, Red Wine, — should contain from 10 to 14 per cent, by weight of 
absolute alcohol, and is made by fermenting the juice of colored grapes in presence of 
their skins. Native Claret, Burgundy, etc. 

Unofficial Alcoholic Preparations. 

Rectified Spirit, sp. gr. 0.835, — has 85 per cent, by weight of absolute alcohol, and 
no fusel oil. Is often spoken of as "56 over proof," meaning that to reduce 100 volumes 
of it to the strength of proof spirit, requires 56 volumes of water. 

Proof Spirit, sp. gr. 0.920, — contains 49 per cent, by weight of absolute alcohol, with 
a peculiar oil and other foreign matters. 

Rum, — is obtained from the distillation of fermented molasses, and has about 42 per 
cent, by weight of alcohol. 

Gin, — has about the same alcoholic strength as rum, and approaches very nearly to the 
official Spiritus Juniperi Compositus. It is usually distilled from rye or barley, and flavored, 
in Holland, with juniper berries and hops, in England, often with oil of turpentine, 
various cheap aromatics, acetate of lead, sulphate of zinc, cayenne pepper, etc. Pure gin 
is slightly diuretic, from the oil of juniper contained in it. 

Spiritus Odoratus, Perfumed Spirit, Cologne-zvater, — prepared by adding to 800 
parts of Alcohol, Water 158, Acetic Ether 2, Oil of Bergamot 16, Oil of Lemon 8, Oil 
of Rosemary 8, Oil of Lavender Flowers 4, and Oil of Orange Flowers 4 parts. A per- 
fume or ingredient of lotions. 

Vinum Aromaticum, Aromatic Wine, — consists of Stronger White Wine 94 per 
cent., with Lavender, Origanum, Peppermint, Rosemary, Sage and Wormwood, of each 
I per cent. Was official in the U. S. P. 1880. 

Vinum Portense, Port Wine, — is not a natural wine, spirit being added during the 
process of manufacture, and the alcoholic strength raised to 30 or 40 per cent. 

Vinum Xericum, Sherry Wine, — a dry, spirituous white wine, generally made to 
order by the dealers, and having from 20 to 35 per cent, of alcohol. 



ALCOHOL. 



95 



Sparkling Wines, as Champagne, Hock, Catawba, — are more or less sweet, and 
charged with carbonic acid, being bottled before fermentation is completed and the grape 
sugar all converted into alcohol. They contain 8 to io per cent, of absolute alcohol. 

Sweet Wines, as Burgundy, Tokay, Muscatel, Malaga, Angelica, Madeira, etc., — 
are of low alcoholic strength, 6 to 7 per cent, unless fortified. 

Light Red Wines, as Claret, Red Rhine, Concord, — have 5 to 7 per cent, alcohol, 
tannic acid, grape coloring matter, etc. 

Dry Acid Wines, as Rhine and Moselle wines, California Hock, Ohio, and Kelley- 
Island Catawba. — in these fermentation is complete, and the alcoholic strength from 5 to 
7 per cent. 

Beer, Ale and Porter,— are fermented liquors, made from malted grain, with hops 
and other bitters added. Beer is made by slow fermentation, the yeast sinking; Ale by 
rapid fermentation, the yeast floating. Their alcoholic strength is from 2 to 3 per cent, in 
beer, to 4 to 6 per cent, in ale and porter, — and they also contain malt extract, carbonic 
acid, lactic acid, various aromatics, potassium and sodium salts, etc. 

Kumyss, — is obtained by the fermentation of milk, that of the mare being used in 
Tartary, where it is largely employed as a food. It contains from I to 3 per cent, of 
alcohol, sugar, lactic acid, casein, fat, salts, carbonic acid and ethers. (See under its 
own title.) 

Physiological Action of Alcohols. 
The Alcohols of the series to which the above-mentioned belong are 
all narcotic poisons when taken in sufficiently large doses; and have the 
general effect of paralyzing the nerve-centres in the inverse order of their 
development. Their symptoms may be divided into stages, viz. — (1) 
Stimulant, (2) Narcotic and Anodyne, (3) Anaesthetic, (4) Paralytic; 
therein closely following the action of the volatile anaesthetics derived 
from them, though wanting in the profound degree of anaesthesia which 
the latter produce. Ethyl Alcohol, the effects of which are detailed 
below, has the most typical action, and in poisoning by it all the stages 
follow each other in regular order. In poisoning by Methyl Alcohol the 
excitement is greater, the subsequent stages succeed each other more 
rapidly, and if the dose be insufficient to cause death, the effects pass off 
more quickly. They all lower the body-temperature. 

The post-mortem appearances, after acute poisoning by the alcohols, show changes in 
the blood, stomach, intestines, liver, lungs and kidneys ; some of which are probably due 
to the asphyxiation resulting from the paralysis of respiration. The Blood is dark and 
clotted in the heart. The Stomach and Intestines are congested and softened, especially 
so if the ingested alcohol has been undiluted. The Liver is very much congested, soft 
and friable. The Spleen is gorged with blood and softened. The Lungs are congested 
and show small extravasations of blood, and in the Kidneys hemorrhages are also found. 

Physiological Action of Ethyl Alcohol. 
Externally applied, Alcohol is a powerful antiseptic and disinfectant, 
also refrigerant, astringent, anhidrotic, rubefacient, and slightly anaes- 
thetic. Applied to the exposed skin it quickly evaporates, cooling the 
surface, temporarily contracting the superficial vessels, and checking the 
secretion of the sweat-glands. If its evaporation is prevented, as by 
covering with a watch-glass or a piece of rubber, or if the alcohol is 
rubbed in, it absorbs water from the tissue. and hardens it. It also 
coagulates the albumen of the part, but the coagulum is soon redissolved 



g6 ALCOHOL. 

by the fluids of the tissues. It then dilates the vessels of the derma, pro- 
ducing a sensation of warmth and a rubefacient effect upon the skin. 

Upon the mucous membrane of the mouth and pharynx similar effects 
are produced by the same application. If the alcohol is concentrated, a 
burning sensation is felt immediately ; also an increased flow of saliva 
and quickened pulse, due to reflex action. Then follows a slight local 
anaesthesia of the part, and if the alcohol be held there for some time, 
the mucous membrane becomes whitish and opaque, from coagulation of 
the albumen, abstraction of water from the tissue and congestion of its 
vessels. This soon disappears, as resolution of the albumen occurs. 

Internally, in moderate quantity and single dose, Alcohol acts briefly 
as a cerebral, cardiac and general stimulant ; in large doses as an intoxi- 
cant and deliriant, and finally as a narcotic poison and paralyzant of the 
nerve-centres. It is somewhat antipyretic, also diuretic and antispas- 
modic, and is hypnotic in many cases. 

A single dose of a strong alcoholic preparation, for example an ounce 
of neat brandy, introduced into the stomach, immediately produces im- 
portant and valuable reflex effects. The cardiac rate is quickened, and 
its force is increased ; the vessels of the entire body are dilated, especially 
those of the skin ; the blood-pressure is raised, and a sense of glowing 
heat is produced. These reflex effects are well seen in the prompt resto- 
ration of a fainting person by the administration of a single dram of 
whiskey or brandy. By the same measure the nausea, paleness and other 
unpleasant symptoms produced by tobacco may be instantly counter- 
acted. 

Internally, in small quantity diluted, Alcohol dilates the gastric vessels, 
reddening the mucous membrane of the stomach, produces a sense of 
warmth and comfort, stimulates the gastric glands to increased production 
of gastric juice, and increases the activity of the gastric movements. 
Taken moderately, immediately before or during meals, it thus promotes 
the appetite and assists digestion ; lessens the elimination of waste-pro- 
ducts (urea and C0 2 ), causes a subjective sensation of heat, and slightly 
raises the body temperature. It briefly stimulates the heart, prolonging 
its systole and reducing the length of the diastole, and increases the 
functional activity of all the organs. The effects of large doses are very 
injurious ; the pepsin of the gastric juice is precipitated thereby, the 
gastric and hepatic vessels are congested, the walls of the stomach are 
inflamed, and the gastric glands and hepatic cells are over-stimulated to 
the production of pathological secretions. If the ingestion is continued, 
even in moderate quantities frequently repeated, chronic gastritis ensues, 
gastric mucus is poured out in large amount, the gastric glands soon 
atrophy, and the permanent dyspepsia of drunkards is set up, with morn- 
ing vomiting of glairy mucus. The further effects of large doses are the 



ALCOHOL. 97 

total arrest of digestion, the production of intoxication, perhaps hallu- 
cinations and delirium, also great incoordination of thought and motion, 
depressed sensibility, depression of the heart and respiration, lowered 
arterial tension and body-temperature, abolished reflexes, stupor, and, if 
the dose be sufficient, coma and death. 

Upon the Blood Alcohol acts to first increase and then diminish the 
amoeboid movements of the white corpuscles, and so affects the red cor- 
puscles as to prevent the oxyhemoglobin from readily parting with its 
oxygen. It consequently diminishes the oxidation of the tissues, and may 
lead to imperfect combustion of fat, which then accumulates. The result 
is obesity in many persons who habitually consume large quantities of 
alcoholic beverages, especially if these contain much saccharine material. 

Upon the Heart and Circulation the first effects of Alcohol are those 
of slight and brief stimulation by reflex action. After its absorption the 
same effects are exhibited in a more marked degree. The pulse becomes 
fuller, the action of the heart is quickened and its force increased, due to 
stimulation of its accelerator nerves. The vaso-motor system is inhibited, 
causing the dilatation of all the vessels of the body, especially those of 
the periphery, and producing a sense of increased body-heat. The blood- 
pressure is raised, the great increase of cardiac action overcoming the 
results of the vascular dilatation. The mental and bodily functions are 
all stimulated for a time, the person feels better for the dram, his muscular 
power seems to be increased, more urine is passed, and perspiration is 
freer. But these effects are very transitory, and after a brief period of 
stimulation reaction sets in, and the entire organism is depressed to a 
lower point than where it was before the ingestion of the alcoholic stimu- 
lant. Large doses do not stimulate the heart at all, but immediately 
depress it, both by reflex action and by direct paralysis after their absorp- 
tion. A toxic dose may paralyze the heart almost immediately by reflex 
action, but usually, after a very brief period of excitement, it produces 
insensibility, stertorous breathing, dilated or contracted pupils, complete 
muscular resolution, and death by paralysis of the heart and respiration. 
The action of alcohol upon the heart exemplifies two therapeutic laws : 
(i) That stimulation is necessarily followed by depression, and (2) that 
drugs which in moderate doses excite a function are very apt in large doses 
to paralyze it. 

On the Skin and Kidneys Alcohol is mildly diaphoretic and diuretic, 
acting partly by its vascular dilatation, partly by stimulation of glandu- 
lar activity. On the Intestines it has a slightly astringent effect at first, 
but in those who use it habitually to excess the bowels are always very 
loose, and the evacuations watery. 

Upon the Nervous System Alcohol has specific and selective action. By a 
moderate dose this entire system is stimulated, chiefly as a result of increased 



gS ALCOHOL. 

blood supply due to the vascular dilatation and cardiac elevation. Reac- 
tion, however, soon occurs, and if the dose be very large, the period 
of exaltation quickly passes into one of profound cerebral depression, 
but this is usually preceded by marked incoordination of thought and of 
muscular movement, shown by incoherency of language, difficult speech, 
and staggering gait. The reflex activity of the spinal centres is abolished 
next, the urine and faeces are discharged involuntarily; the depression 
extends to the respiratory centre, breathing becomes difficult and the face 
cyanosed ; profound coma supervenes, respiration and the heart are para- 
lyzed, and the patient dies. 

The reflex depression occurs early in the case, and accounts for the 
impunity with which a drunken man will often bear an injury which 
would cause death by shock to a sober one. 

The action of Alcohol upon the nervous system illustrates well, in the order of its 
events, the physiological fact that stimulation is followed usually by depression; as well 
as the law that drugs which affect the functions progressively exhibit their earliest powers 
upon those functions which are highest in development (being those latest acquired by 
the individual and last to appear in the species), and influence next the next lower, until 
finally the lowest, namely those of respiration and circulation. The primary stimula- 
tion and subsequent depression of function proceeds therefore, in a descending scale from 
the highest or least firmly fixed and latest acquired function, to the lowest or most firmly 
fixed one. Thus, by Alcohol, the intellect is affected very early and the judgment abol- 
ished very soon, even though the imagination, the emotions and the power of speech 
remain stimulated. Soon these follow the same course, imagination is abolished, the 
patient loses command over his emotions, cries and laughs immoderately and without 
reason; next loses control over his organs of speech, talking incoherently and thickly, 
and then can only make a noise. At the same time other delicate and lately developed 
movements, as those required for writing, feeding, etc., are incoordinately performed and 
soon paralyzed. General muscular movements, being less highly and earlier developed, 
are next to become implicated, being first incoordinated, and soon abolished. The paraly- 
sis of reflex action follows, though lowered earlier in the case, then that of respiration 
and finally that of the heart. 

The Antipyretic action of Alcohol is partly due to its power of lessening 
oxidation, but chiefly to the dilatation which even moderate doses pro- 
duce in the vessels of the surface. This dilatation subjects the warm blood 
from the interior of the body to the cooling influence of the atmosphere, 
as also to that due to evaporation from the skin ; and if kept up by 
repeated drams in a freezing temperature will soon so chill down the 
blood as to kill the subject. 

Under ordinary conditions the contraction of the cutaneous vessels, in a person ex- 
posed to cold, prevents the warm blood from approaching the surface in any great quan- 
tity and becoming cooled ; but this mechanism is temporarily paralyzed by every dose of 
alcohol, admitting the hot blood to circulate freely over the surface, and to be rapidly 
cooled down until the patient may be absolutely frozen to death as a result of repeatedly 
taking " something to keep him warm." This fact is well known to Arctic travelers and 
to the lumbermen of the northern forests, who have been taught by bitter experience to 
let alcohol severely alone when exposed to severe cold. 

Delirium Tre?nens occurs after an alcoholic debauch, usually in cases 
where the stomach is so deranged as to prevent the ingestion or assimila- 



ALCOHOL. 99 

tionoffood. So long as the toper can eat and digest his food he is 
practically not liable to this affection. It generally begins in from two 
to four days after the patient has lost his appetite and commenced to 
reject or vomit his food ; and is marked by great restlessness, obstinate 
insomnia, a peculiar tremor of the tongue and limbs ; also by delusions 
connected with the sense of sight, the patient imagining that he sees 
animals (dogs, rats, snakes, beetles, etc.) around him. The delirium is 
constant and active, may become violent and pass into mania, or the 
patient may die suddenly while in this state, without any warning symp- 
toms. In several cases observed by the writer the delirium appeared four 
and five days after the last alcoholic dose was taken, though the patient 
was eating, sleeping, and working during the interval, apparently conva- 
lescent. Under treatment, and especially if sleep is brought on, the 
delirium usually subsides gradually, and the patient recovers. 

Chronic Alcoholism is the result of the ingestion for a considerable 
length of time of an excessive quantity of alcohol, even though perhaps 
never sufficient to cause acute intoxication. One of the earliest symptoms 
usually observed is the vomiting of watery fluid or glairy mucus in the 
morning after rising. The bowels are generally loose, and the evacuations 
watery. The skin has a greasy look and a satiny feel ; and the capillaries 
thereof on the face may become permanently dilated, giving to the 
cheeks a characteristic, dusky-red hue, and a flaming red color to the 
nose. In old drunkards, the latter organ often becomes covered on its 
tip with dusky-red tubercular enlargements, making it a very unsightly 
appendage. The stomach and liver are in a condition of chronic conges- 
tion, the food is not digested, and often to a great extent abandoned, the 
patient, in fact, living upon alcohol. Eructations of gas and flatulence 
are constant and distressing ; the body is usually puffed and bloated, the 
eyes bleary, red and watery. [One of the most graphic descriptions of 
the drunkard's personal appearance is that by Trollope, in " Orley Farm," 
Chapter 57.] 

After a time the connective tissue of the liver increases (hyperplasia), 
its parenchymatous structure atrophies or undergoes fatty degeneration, 
the organ contracts (cirrhosis), the portal circulation is impaired, the 
veins of the abdominal integument become prominent, and soon ascites 
ushers in the final stage. Cirrhosis of the kidneys may accompany that 
of the liver. The general impairment of function extends early to the 
nervous system, the mental powers are dulled, the temper becomes 
irritable, and tremor appears in the tongue, lips and hands. As a result 
of the prolonged use of alcohol very serious pathological changes take 
place throughout the organism. It exerts its essential and most injurious 
influence on the vital organs by its presence in the circulation, being 
thus brought into direct contact with the cellular tissues of the vital 



IOO ALCOHOL. 

organs. It sets up hyperplasia of the connective tissue, resulting in 
sclerosis, especially in the stomach, brain, liver and kidneys ; produces 
fatty degeneration (steatosis) of the blood, the arterial walls and the 
parenchyma of the various organs, depresses the brain, the heart and 
the arterial tension. Chronic disease of the heart, the arteries, and the 
mucous lining of the stomach and intestines, gout, diabetes, Bright's 
disease of the kidneys, paralysis, ataxia, peripheral neuritis, epilepsy, 
amaurosis, and insanity may result from the continued use and abuse of 
alcohol. The malt liquors (beer, ale, etc.) are less prone than the spirits 
to affect the brain, but are even more apt to set up fatty degeneration 
of the heart and liver. The heart is very liable to undergo gradual 
hypertrophy, partly by reason of the constant whipping up it receives 
from every dram of alcohol taken, and partly as a result of renal cirrhosis. 
Several of the largest hearts ever seen by the writer at autopsies, some of 
which were veritable instances of cor bovinum, occurred in subjects of 
chronic alcoholism associated with employment involving exposure and 
great anxiety, as in masters of steamships, superintendents of mines, etc. 
Impurities in Alcohol increase greatly its toxic action ; so that inferior 
brandy from a public liquor shop has a lethal action nearly one-half 
greater than that of pure ethyl alcohol. (Dujardin-Beaumetz.) 

Alcoholic Coma may be easily confounded with that of apoplexy, opium narcosis, con- 
cussion of the brain, acute pneumonia, uraemia and epilepsy, the differential diagnosis 
being almost impossible to make with accuracy when the coma is deep. The pupils 
afford no trustworthy indication, as they may be either dilated or contracted in alcoholism. 
They are often unequally contracted in apoplexy, and in apoplexy of the pons varolii 
they may be equally and minutely contracted, as in opium-poisoning. The difficulty of 
diagnosis is increased by the common practice of giving a dram of whiskey or brandy as 
a reviver, so that a stranger found insensible on the street and brought to a hospital, may 
smell of alcohol without having been a subject of alcoholism. When no accurate history 
of the case can be obtained the diagnosis is so difficult as to be all but impossible in 
many cases. 

Alcohol is rapidly diffused throughout the organism, which oxidizes a 
portion of it, about an ounce and a half for the adult in 24 hours, the 
oxidation yielding force, which is utilized as nervous, muscular, and gland- 
ular power. A larger quantity is probably poisonous, as it sets up struc- 
tural changes in the various organs, and lowers the power of resistance to 
morbific influences. It renders its victims particularly liable to phthisis, 
and has frequently caused directly an intractable form of that disease, 
pulmonary sclerosis. It makes patients bad subjects for withstanding 
any severe illness, especially pneumonia, or to successfully undergo severe 
surgical operations. 

The portion not oxidized is excreted unchanged by the lungs, the 
skin and the kidneys, but does not appear in any quantity in the urine 
unless very large amounts have been ingested. The very young and the 
very old bear more alcohol relatively than the adult. It has been proven 






ALCOHOL. IOI 

to exist normally in the human organism, and within the limit above 
stated it is undoubtedly a food, as is shown by the fact of its retention 
and combustion in the body, supplying the place of other foods, so that 
the quantity of food which without it would be insufficient, with its aid 
becomes sufficient to maintain the body-weight. 

Treatment of Acute Alcoholic Poisoning. 

If a very large dose has been taken recently, the stomach should be evacuated of what 
is unabsorbed. Then Ammonia may be given by inhalation cautiously, warmth applied 
to the extremities, cold affusion to the head, faradism of the muscles of respiration. 
Milk, mucilaginous drinks, black coffee, are useful afterwards. Lupnlin as a substitute 
stimulant, or Capsicum in 20 to 30 grain doses. Chloral, in 30 grain dose, repeated in 
two hours, to secure sleep, is very efficient, or 30 grs. each of Chloral and Potassium 
Bromide, for the same purpose. Chloral is said by teachers to be dangerous in old 
alcoholic cases, but the daily experience of physicians of inebriate asylums does not cor- 
roborate this statement. Nutritious, digestible diet in liquid form and small quantity 
frequently repeated, is an essential feature of the treatment. Ammoniimi Chloride, g ss 
in }4 pi nt °f water at one draught, is said to have a marvellous power in generally 
straightening up a drunken subject, restoring the faculties, and antagonizing stupor. 

Treatment of Delirium Tremens. 

Two principal objects are aimed at, — (i) to support the strength by nutritive diet, (2) 
to overcome the obstinate and exhausting insomnia and restlessness. For the latter pur- 
pose the mixture of Chloral and Potassium Bromide above mentioned is by far the most 
efficient agent, and the dose (gr. xxx of each) may be repeated every two hours until 
sleep is secured. Digitalis has been administered in large doses to quiet the delirium, and 
successfully in some cases, but this is a very dangerous treatment. (Brunton.) Opium 
or Morphine may be used in cases which show signs of exhaustion, but should be con- 
fined to such alone. Its general employment in this affection is decidedly injurious. 
Bismuth, with Magnesia and Hydrocyanic Acid, for the vomiting. Nutrient Enemata 
may be required, if the patient is unable to retain food. No Alcohol should be given. 

Treatment of Chronic Alcoholism. 

The continued ingestion of alcohol in excessive quantities is not a disease, as sentimen- 
talists would have us believe, but is simply a vicious drug-habit, and may be overcome, 
like any other drug-habit, by the exercise of the subject's will-power alone in abstaining 
therefrom. The effort to gradually reduce the amount consumed simply prolongs the 
agony and is much less efficient than the total and immediate withdrawal thereof en- 
tirely. This should be carried out in an inebriate asylum in most cases. Strychnine is 
a specific remedy for alcoholism, and the basis of all the so-called "cures" which are ex- 
tensively advertised under the gold-extracting title of " Chloride of Gold Cures." Ten 
to twelve minims of a solution of Strychnine Nitrate, gr. iij in jx of distilled water, 
should be injected hypodermically 3 or 4 times a day for two weeks, and less often for two 
weeks more, gradually reducing the dose and frequency of administration. 

Therapeutics of Alcohol. 
The external and local use of alcohol in medicine includes many appli- 
cations of its antiseptic, astringent, refrigerant and rubefacient qualities. 
Diluted, in the proportion of four parts to one of water, it makes an 
excellent lotion for bruises, sprains, and other slight injuries, where it is 
desired to cool the part and check impending inflammation. A per- 
fumed spirit, as Cologne Water, is commonly used as a lotion to the fore- 
head for the relief of headaches. Alcohol does good service as an appli- 
cation to prevent bedsores and cracked nipples, as it hardens the inflamed 



1 



1 



102 ALCOHOL. 

skin by abstracting water therefrom and coagulating the albumen tempo- 
rarily. Diluted alcohol is applied on the surface of the body in fevers, 
to cool the skin and check excessive sweating. Alcoholic liniments 
(Lin. Camphorae, etc.,) are rubbed into the cutaneous tissue for their 
rubefacient effect, to aid the absorption of inflammatory products and to 
relieve pain, in chronic rheumatism, lumbago, myalgia, etc. As a gargle 
or spray, diluted alcohol is one of the very best local agents in tonsillitis, 
pharyngitis, and other inflammatory affections of the throat, especially 
diphtheria, in which disease it fulfils several important purposes, acting as 
an efficient local antiseptic, astringent and anaesthetic. Among miners, 
hunters, frontiermen and others, lotions of whiskey or brandy are in 
common use as applications to wounds and sores, and they could not find 
a more efficient agent for the purpose, when conjoined with thorough 
cleanliness of the lesions. 

Internally, in small quantities taken just before or during a meal, alco- 
hol is an efficient aid to digestion, especially in the aged and feeble, or 
persons who are greatly exhausted by overwork. In the atonic indigestion 
of nervous and depressed subjects and in cholera infantum, good brandy 
is universally found to be beneficial. Care must be taken, however, not 
to exceed the amount which agrees with the case, for large quantities 
precipitate pepsin, paralyze the gastric secretions, and set up a subacute 
gastritis, which will become a chronic one if the indulgence is persisted 
in, with eventual atrophy of the gastric glands. 

In the form of a sparkling wine, as champagne, or as brandy and soda- 
water, alcohol may control vomiting from many causes, especially that of 
yellow fever and sea-sickness. A single full dose of strong whiskey or 
brandy is often a very efficient combatant of fainting or of collapse, by 
its prompt reflex stimulation of the circulation. Diarrhoea of simple 
form may be checked by a dram of good brandy, acting as a tonic 
astringent to the intestines. An attack of acute coryza, or a cold from 
exposure beginning with a chill, may frequently be aborted by a full dose 
of spirits in hot water taken just before going to bed, for the purpose of 
relaxing the peripheral vessels and thus promoting diaphoresis and restor- 
ing the disturbed balance of the circulation. In anaemia and chlorosis 
good red wines are almost indispensable, also in convalescence from 
acute diseases, sudden and profuse hemorrhages, and many other morbid 
conditions. In phthisis alcohol does good service if it promotes assimila- 
tion and assists digestion, shown by increase of the body-weight during 
its employment. It is invaluable in poisoning by cardiac depressants and 
snake-venom, and in cardiac failure from any cause. 

In many fevers, Alcohol is often very serviceable, but may do harm if 
used therein without discrimination. Its powers of lessening oxidation, 
of being itself oxidized in the body and acting as a food, of reducing 



ALLIUM. 103 

body-temperature and promoting perspiration and sleep, are all indica- 
tions for its beneficial employment in most febrile conditions; while its 
stimulant action on the heart may be available in such diseases as typhoid 
fever, lobar pneumonia, etc., to tide that organ over a brief period of 
depression or a condition of impending collapse. Furthermore, for some 
unexplained reason, it often slows the pulse in fever, and when it does so 
its moderate use will be of general benefit to the patient. The danger is 
that if continuously given in such affections it may fail to make the 
required impression when an emergency calling for it occurs. The best 
rule to observe for its administration in typhoid, diphtheria, pneumonia 
and other fevers is to withhold it until the first sound of the heart becomes 
feeble and dull, and then to use it boldly but not excessively. Many 
authorities urge its continuous administration in diphtheria, probably 
from a belief in its antiseptic action on the poison in the blood, similar 
to that which it undoubtedly exercises against the venom of the rattle- 
snake. It is an absolute necessity in the treatment of acute lobar pneu- 
monia, if the patient has been accustomed to its daily use as a beverage ; 
but in other subjects of this disease it is best given at the crisis only, to 
tide the patient over a brief period of extreme danger. 

The use of alcoholic beverages in moderate quantity by healthy 
persons is violently condemned by extreme total abstinence advocates, 
who make use of garbled quotations from medical authorities to support 
their arguments. Physicians generally agree with the position of Mr. 
Lawson Tait, who has recently declared that he is " fully persuaded after 
thirty years of life, as hard in work and as full of responsibility as well 
could be, that the moderate use of alcohol is a necessity in our modern 
life." 

Dr. Robert Farquharson sums up the case for moderate drinking as 
follows: "All stimulant is unnecessary for the young and for people 
living perfectly healthy lives. But, under the stress and struggle of 
modern civilization, few of us beyond middle age are placed under 
normal physiological conditions, and a little alcohol helps us to round 
the corners, and to plane away the asperities of existence. In turns it 
may be a stimulant, or a sedative, or a tonic, or a digestive, or an actual 
food ; and unless we run on into excess, no physical damage can possibly 
be done to our tissues. The argument in its favor, when wisely and 
prudently used, seems complete. It does us good, and can do us no 
harm." 



ALLIUM, Garlic, — is the bulb of Allium sativum, a plant of the nat. ord. Liliaceae, 
indigenous to Asia, but cultivated in Europe and America. It is sub-globular and com- 
pound, consisting of eight bulblets, covered by dry, membranous scales. Its odor is 
pungent and disagreeable and its taste warm and acrid. It contains a Volatile Oil, which 
consists mainly of the Sulphide of Allyl (C 3 H 5 ) 2 S, on which its qualities depend. Allied 
species are Allium Cepa, the Onion, and Allium Porrum, the Leek. 



104 ALNUS ALOE. 

c 

Syrupus Allii, Syrup of Garlic, — contains 20 per cent, of Garlic, Sugar and Dilute 
Acetic Acid. Dose, gj-iv, according to age. 

Garlic, Leeks and Onions are stimulant to the digestion and to the nervous system, and 
are supposed to have a special influence upon the bronchial secretion. Garlic is also thought 
to be emmenagogue and anthelmintic. It promotes diaphoresis and diuresis, and acts as 
a tonic and carminative. Many persons use it as a condiment. Large doses will often 
produce gastric irritation, flatulence, hemorrhoids, headache and fever. In domestic 
practice it is frequently employed as an external application in the cutaneous eruptions of 
children, and as a poultice or liniment in infantile disorders of many kinds. Internally 
it is of real benefit in feeble digestion and flatulence, chronic catarrhal affections of 
children, in nervous and spasmodic coughs, and in nervous vomiting. 



ALNUS, Alder-Bark (Unofficial), — is the bark of Alnus serrulata, the common 
American Alder, a small tree of the nat. ord. Betulaceae. It has similar properties to 
those of A. glutinosa, the European Alder, and A. tircana, the Tag Alder, and contains 
a tannic acid, an oil, and a resin. The bark and leaves are astringent and bitter, and are 
chiefly used as gargles for the throat, as local applications to wounds and ulcers, and to 
restrain the secretion of milk. Dose of the powdered bark gr. x, in decoction or infusion, 
several times a day. The Tag Alder is highly recommended as a hemostatic. 



ALOE, Aloes, — is official in the two following named varieties, also 
as the Purified Aloes preparation, and the neutral principle, Aloin. 

Aloe Barbadensis, Barbadoes Aloes, — is the inspissated juice of the 
leaves of Aloe vera, a plant of the nat. ord. Liliacese. Occurs in opaque, 
hard, orange-brown masses, of saffron-like odor and bitter taste. 

Aloe Socotrina, Socolrine Aloes, — the inspissated juice of the leaves 
of Aloe Perryi, a plant of the nat. ord. Liliacese, inhabiting the island of 
Socotra and the eastern coast of Africa near the southern shore of the 
Red Sea, which has orange-colored flowers and resembles in appearance 
the American aloe or century-plant {Agave americand). It occurs in soft 
masses, hard exteriorly, of a yellowish-brown color, fragrant odor and 
bitter taste, soluble in alcohol and in boiling water, and containing a 
peculiar volatile oil, a resin and Soaloin, C 15 H 16 7 , a variety of the prin- 
ciple Aloin, which is common to all varieties of aloes, — also Aloetic and 
Chrysammic Acids. Dose, gr. j-v. 

Another variety is Aloe Capensis, Cape or Natal Aloes, from Aloe 
ferox. 

Aloinum, Aloin, — a neutral principle obtained from several varieties 
of Aloes, chiefly the above-named, which yield respectively Barbaloin, 
and Soaloin. These are soluble in 60 of water, 20 to 30 of alcohol, and 
in 380 to 470 of ether. Soaloin is soluble in 9 parts of acetic ether. 
Dose, gr. ss-ij. 

Preparations. 

Aloe Purificata, Purified Aloes, — prepared from Socotrine Aloes by melting and 
mixing with -^th of Alcohol, straining and evaporating. The product is in irregular, 
dull-brown, brittle pieces, almost entirely soluble in alcohol. From it are prepared the 
following preparations. Dose, gr. j-v. 

Extractum Aloes, Extract of Aloes, — prepared by mixing I part of Socotrine Aloes 
with 10 parts of Boiling Distilled- Water, standing 12 hours, decanting, straining and 
evaporating. Dose, gr. ss-v. 



ALTHAEA. 105 

Tinctura Aloes, Tincture of Aloes, — has of Aloes 10, Glycyrrhiza, 20 Diluted Alco- 
hol to 100 parts. Dose, gss-ij. 

Tinctura Aloes et Myrrhae, Tincture of Aloes and Myrrh, — Aloes 10, Myrrh 10, 
Glycyrrhiza 10, Alcohol and Water to ico parts. Dose, 3 ss-ij . 

Pilulae Aloes, Pills of Aloes, — each has of Aloes, gr. ij with the same quantity of Soap. 

Pilulae Aloes et Asafetidae, Pills of Aloes and Asafetida, — each contains gr. 1 l / z of 
each ingredient. 

Pilulae Aloes et Ferri, Pills of Aloes and Iron, — each pill contains gr. j each of 
Aloes, Sulphate of Iron and Aromatic Powder, with Confection of Rose. 

Pilulae Aloes et Mastiches, Pills of Aloes and Mastic, Lady Webster's Pill, — each 
has of Aloes gr. ij, Mastic gr. ss, Red Rose gr. ss. 

Pilulae Aloes et Myrrhae, Pills of Aloes and Myrrh, — each contains of Aloes gr. ij, 
Myrrh gr. j. Aromatic Powder gr. ss, mixed with Syrup. 

Pulvis Aloes et Canellae, Powder of Aloes and Canella (Unofficial), — contains the 
powdered bark of Canella alba. Dose, gr. v-xx. 

Aloes is also a constituent of Pilulae Rhei Compositae and Tinctura Benzoini Composita 
— (which see, per Index). 

Physiological Action and Therapeutics. 

Aloes is a tonic-astringent and resin-bearing purgative, an emmena- 
gogue and an anthelmintic against the thread-worm. As a cathartic it 
acts chiefly on the lower half of the large intestine, in doses of gr. j-iv 
producing in about 10 hours copious soft evacuations with some griping 
pain. This effect is produced whether the drug be taken internally or 
absorbed from an exposed surface, so that it probably diffuses into the 
blood and is eliminated by the mucous membrane of the colon. It is a 
stomachic tonic in small doses, a stimulant of the hepatic functions, and 
an excitant of the pelvic circulation. It may cause abortion in the female 
and priapism in the male, and is said to have frequently produced hemor- 
rhoids, which if existing it will certainly aggravate. Given to nursing 
mothers it imparts a purgative quality to their milk. 

Aloes is chiefly used in combination with Iron, Myrrh, Nux-vomica, 
etc., for amenorrhoea and chronic constipation with atonic dyspepsia and 
hypochondriasis. It is curative in certain forms of hemorrhoids, espec- 
ially those occurring after delivery and where the condition is not one of 
active pelvic congestion. It is also used internally and as an injection 
in gonorrhoea, and for simple atonic jaundice. It must be avoided in 
irritable rectum, hemorrhoids of active form, menorrhagia and pregnancy, 
unless given in small doses and with care. The Pil. Aloes et Ferri is 
perhaps the most generally useful agent in the anaemia, amenorrhoea and 
constipation of girls at the period of puberty. 



ALTHiEA, Marsh-Mallow, — is the root of Allhaa officinalis, a European plant 
of the nat. ord. Malvaceae, occurring in dry cylindrical pieces, of white color, without 
pith, of faintly aromatic odor and sweetish mucilaginous taste. It contains about 35 per 
cent, each of vegetable mucus and starch, with 2 per cent, of Asparagin, also pectous 
matter, sugar, fixed oil, but no tannin. It is a constituent of Massa Hydrargyri and Pil- 
ulae Phosphori, and is much used as an excipient in extemporaneous pharmacy. Dose, 
indefinite. 

Syrupus Althaeas, Syrttp of Althcea, — has of Althaea 5 per cent., and should be 
freshly made. Dose, indefinite. 



106 ALUMEN. 

Physiological Action and Therapeutics. 

ALTH/EA is one of the best mucilaginous drugs, but has no active medicinal properties. 
It is used in Europe to make pectoral teas and syrups, and is extensively employed as a 
mucilaginous demulcent. The powdered root makes a good emollient poultice. In the 
German Pharmacopoeia a Compound Althaea Tea is official, which under the common 
name, "German Breast Tea." is a popular demulcent drink in bronchial affections, coughs, 
colds, etc. 

ASPARAGIN is an organic principle, occurring in large rhombic crystals, and found in 
many other plants, as in the shoots of asparagus, vetches, potatoes, liquorice, the sweet 
almond, the root of the locust, etc. It is considered a derivative of Succinic Acid, and 
has diuretic properties, besides being sedative to the circulation. It may be used in as- 
cites, especially in children, in the anasarca of Bright's disease, and in gout. Dose, gr. 
ij-iij, in water. 



ALUMEN, Alum, Potassiui?i Alum, — is Aluminum and Potassium 
Sulphate, Al 2 K 2 (S0 4 ) 4 -f- 24.H 2 0, which, when the 24 molecules of water 
are driven off, becomes Alumen Exsiccatum, Dried Alum, A1 2 K 2 - 
(S0 4 ) 4 . Alum occurs in large, octahedral crystals, or cubes, of sweetish 
astringent taste and acid reaction. It is soluble in 9 parts of water at 59 
F., and in 0.3 part of boiling water, but is insoluble in alcohol. The 
Ammonia-alum (Alumini et Ammonii Sulphas) was formerly official, and 
is still sold and dispensed as "Alum." Dose, gr. x-xx, — as an emetic 5j 
for a child. 

Preparation. 

Alumen Exsiccatum, Dried Alum, — is a white, granular powder, slowly soluble in 
20 parts of water at 59 F., and quickly soluble in 0.7 of boiling water. Dose, gr. x-xx. 

Alum is an astringent, coagulating albumen and stimulating muscular 
contraction. At first it excites the flow of saliva and then markedly 
diminishes it. It coagulates pepsin and arrests digestion, stops peristalsis, 
and usually causes constipation, though sometimes inducing diarrhoea. 
Although coagulating albumen, even in weak solution, it enters the blood, 
constricts the capillaries, arrests secretions, especially those of mucous 
surfaces, and stops capillary hemorrhage. 

In teaspoonful doses Alum is an efficient and non-depressant emetic. 
In large doses it is a gastro-intestinal irritant, %)$/% of dried Alum having 
caused the death of an adult in 8 hours. 

Alum is used locally as an astringent in chronic catarrhs, leucorrhoea, 
gonorrhoea, hemorrhoids, bed-sores, ulcers, relaxed throat, colliquative 
sweats, catarrhal ophthalmia and granular lids. The dried powder is 
escharotic, destroying granulations and warty growths, and is used by 
insufflation in chronic nasal catarrh. 

Internally it is beneficial in gastric catarrh, gastralgia, enteralgia, pas- 
sive hemorrhages, lead colic and constipation. As an emetic it is em- 
ployed in croup, and it is a good antidote in lead-poisoning. 

Alum is best administered alone, as it forms precipitates with a large 
number of drugs. 



ALUMINUM AMMONIACUM AMMONIUM. I Of 

ALUMINUM. — This metal is not official, though of its salts two are, besides Alum. 
They are — 

Alumini Hydras, Aluminum Hydrate, Hydraied Alumina, Al 2 (OH) 6 , — is a white, 
light, amorphous, tasteless powder, insoluble in water or alcohol, but soluble in strong 
alkaline or acid solutions. Dose, gr. iij-xx in powder or mixture. 

Alumini Sulphas, Aluminum Sulphate, A1 2 (S0 4 ) 3 -\- i6H 2 0, — is a white crystalline 
powder, soluble in 1.2 of water at 59 F., almost insoluble in alcohol. Used locally. 

Physiological Action and Therapeutics. 

The Hydrate is a feebly astringent and desiccant powder, occasionally used in 
inflammatory skin affections as a local application, and internally in diarrhoea. 

The Sulphate is antiseptic and astringent. It has been used internally in diarrhoeas, 
but is chiefly employed in a 5 per cent, solution locally to ulcers, or in stronger solution 
(!jiij ad |jvj) in foul discharges from mucous surfaces. A saturated solution is a mild 
caustic, and may be used daily as a local application to enlarged tonsils, nasal polypi, 
ulceration of the os uteri, and various chronic enlargements. The Benzoinated Solution 
of Alumina is an unofficial preparation used for the same purposes. 



AMMONIACUM, Ammoniac, — is a gum-resin, obtained from Dorema Ammo- 
niacum, a Persian plant of the nat. ord. Umbelliferae, occurring in yellowish-brown tears 
of peculiar odor, and bitter, acrid and nauseous taste. When triturated with water it 
readily yields a milk-white emulsion, and contains a Volatile Oil, which differs from that 
of Asafoetida, in that it is neither sulphuretted nor phosphoretted. It also contains resin, 
gum, gluten, etc. Dose, gr. x-xxx. 

Emulsum Ammoniaci, Emulsion of Ammoniac, — an emulsion with water of 4 per 
cent, strength, the resin being suspended by the contained gum. Dose, ,^ss-j. 

Emplastrum Ammoniaci cum Hydrargyro, Ammoniac Plaster zvith Mercury. — 
Ammoniac 72, Mercury 18, Oleate of Mercury 8 per cent., and contains also Lead-plaster, 
and Dilute Acetic Acid. 

Ammoniac is a stimulating expectorant and a laxative, and has a mildly irritant action 
on the skin. Its actions are similar to those of Asafoetida, but much less powerful. It 
is not much used, but may be employed with benefit in chronic bronchial affections, 
especially of the aged, the mixture with Ammonium Chloride or Carbonate facilitating 
expectoration and lessening wheezing. It is also recommended in asthma, and in 
glandular enlargements and indolent swellings the plaster is employed as a stimulating 
alterative and resolvent. 



AMMONIUM, NH i5 — is a hypothetical compound radical, which 
does not exist in the free state, but which in combination with acids forms 
salts which closely resemble those of the elements Potassium and Sodium. 
Many of its salts are official, as well as the aqueous solutions of the gas 
Ammonia, NH 3 , which is produced during the putrefaction of all organ- 
isms, and of many organic nitrogenous compounds existing in the air and 
in the soil in the free state. The chief commercial source of Ammonium 
salts is the ammoniacal liquor from gas-works and bones. 

Preparations of Ammonia. 

Aqua Ammonise, Ammonia Water, — is an aqueous solution of Ammonia, contain- 
ing 10 per cent, by weight of the gas. It is a colorless liquid of pungent odor, acrid 
taste and strongly alkaline reaction. Sp. gr. 0.960 at 59 F. Dose, TTLv-^ss, well 
diluted. 

Aqua Ammonise Fortior, Stronger Ammonia Water, — contains 28 per "cent, by 
weight of the gas. Sp. gr. 0.901 at 59 F. 

Spiritus Ammoniae, Spirit of Ammonia, — is a 10 per cent, solution of the gas in 
alcohol. Sp. gr. about 0.810. Dose, Hbx-3J, diluted. 



108 AMMONIUM. 

Spiritus Ammoniae Aromaticus, Aromatic Spirit of Ammonia, — contains Am- 
monium Carbonate, Aqua Ammoniae, Oils of Lemon, Lavender, and Nutmeg, Alcohol 
and Water. Used in the Tinct. Guaiaci Ammoniata and the Tinct. Valerianae Ammo- 
niata. Dose, ^ss-ij. 

Linimentum Ammoniae, Ammonia Liniment, — has of Aqua Ammoniae 35 parts, 
Cotton-seed Oil 60, Alcohol 5 parts. 

Ammonium Salts and their Preparations. 

Liquor Ammonii Acetatis, Solution of Ammonium Acetate, Spirit of Mindererus, — 
is prepared by neutralizing Dilute Acetic Acid with Carbonate of Ammonium, and con- 
tains about 7 per cent, of the Acetate. It should be freshly made. Used in Liquor 
Ferri et Ammonii Acetatis. Dose, ^j-,^j. 

Ammonii Benzoas, Ammonium Benzoate, NH 4 C 7 H 5 2 , — in minute four-sided, lami- 
nar crystals, soluble in 5 of water and 28 of alcohol at 59 F. Dose, gr. v-xv. 

Ammonii Bromidum, Ammoniu?n Bro?nide, NtLJBr, — in prismatic crystals or as a 
granular salt, soluble in \y 2 of water and 30 of alcohol at 59 F. Dose, gr. x-^ss, 
well diluted. 

Ammonii Carbonas, Ammonium Carbonate, NH 4 HC0 3 .NH 4 NFf 2 C0 2 , — occurs in 
white masses consisting of both the bicarbonate and carbonate, which on exposure to 
air becomes a white powder (acid carbonate). Soluble in 5 parts of water at 59 F. 
Dose, gr. v— x. 

Ammonii Chloridum, Ammonium Chloride, Sal-a?m?ioniac, HN 4 Cl, — a white, 
crystalline powder, of saline taste, and slightly acid reaction; soluble in 3 of water and 
very sparingly in alcohol. Dose, gr. j-xx. 

Trochisci Ammonii Chloridi, Troches of Ammonium Chloride, — each contains \ x / z 
grains of the chloride. 

Ammonii Iodidum, Ammonium Iodide, NHJ, — a deliquescent, granular, white salt, 
soluble in 1 of water and 9 of alcohol at 59 F. Dose, gr. ij-x. 

Ammonii Nitras, Ammonium Nitrate, NH 4 N0 3 , — in colorless crystals or fused 
masses, soluble in 0.5 of water and 20 of alcohol at 59 F. Only used to prepare Nitrous 
Oxide Gas by heating to 365 F., for anaesthesia. 

Ammonii Valerianas, Ammonium Valerianate, NH 4 C.H 9 2 , — in white, quadrangu- 
lar plates, deliquescent; very soluble in water and alcohol. Dose, gr. j-v. 

Raspail's " Eau Sedative" (Unofficial), — consists of Aqua Ammoniae 25 ij, Sodii 
Chloridum 3 ij, Spiritus Vini Camphorat. Jjiij,Aqua ^xxxij. For local use. 



Physiological Action. 
The gas Ammonia is intensely alkaline and irritant to mucous mem- 
branes; inhaled producing spasmodic cough and a sense of suffocation. 
Its prolonged inhalation will induce violent inflammation of the air- 
passages and oedema of the glottis. It stimulates the nasal branch of the 
fifth nerve, exciting the vaso-motor centre by reflex action, and thus rais- 
ing the arterial tension. Applied to the skin and allowed to evaporate, 
it has a slight rubefacient effect, but if evaporation be prevented it pene- 
trates the epidermis, and has a powerfully vesicant action. The Aqua, 
swallowed undiluted, may cause death quickly by suffocation from the 
action of its vapor upon the air-passages ; if not, it may excite gastro- 
enteritis accompanied by coma, differing in the latter respect from 
potassium or sodium poisoning. After absorption it stimulates both the 
respiration and the circulation by direct action on their respective nerve- 
centres. Ammonia exists normally in the circulation, where it keeps the 
fibrin in solution and thus maintains the fluidity of the blood. It in- 
creases the glycogenic function of the liver, and is converted finally into 



AMMONIUM. IO9 

urea. It is a powerful irritant to muscular tissue, causing tetanic contrac- 
tion and subsequent rigor mortis when directly applied. 

Ammonium Salts all stimulate and finally paralyze the spinal cord, 
motor nerves and muscles, in animals, but the order and intensity of the 
action vary with the salts employed, some having a predominating influ- 
ence on the cord, others on the motor nerves. In general they may be 
said to form a series, of which the members at one end stimulate the cord, 
and those at the other paralyze both the cord and the motor nerves. At 
the stimulant end are Ammonia and the Chloride ; at the paralyzant end 
the Iodide; the Bromide, Phosphate and Sulphate lying between (Brun- 
ton). In medicinal doses they act on man as stimulating expectorants, in 
large quantity they injure the structure of the red blood-corpuscles, and 
if long continued they produce rapid emaciation by impairing digestion 
and increasing tissue-waste. 

The Chloride has decided cholagogue powers, increases the excretion 
of urea, in 20-grain doses is purgative, and is considered to have a select- 
ive action upon the gastric mucous membrane. The Carbonate is a 
powerful and very diffusible stimulant ; when administered internally in 
moderate doses it is probably decomposed by the HC1 of the gastric 
juice, nascent ammonia being set free and absorbed. It stimulates the 
respiratory centre, acts as a stimulating expectorant, and in very small 
doses stimulates the secretion of the gastric juice. It is also emetic, and 
has been supposed to prevent iodism when administered conjointly with 
Iodide of Potassium. The Solution of the Acetate is an active dia- 
phoretic if the body be warm, or a diuretic if it be cool. In wineglassful 
doses it will counteract many of the immediate effects of alcohol. The 
Phosphate is diuretic, and is believed to decompose the insoluble Sodi- 
um Urate in the blood, converting it into the soluble salts Ammonium 
Urate and Sodium Phosphate, and thus promoting its elimination. The 
Benzoateis also diuretic, and like Benzoic Acid passes out of the system 
in the urine as Hippuric Acid. It stimulates the liver, and acidifies the 
urine where there is phosphatic tendency thereof. The Nitrate and 
Sulphate are only used for the preparation of other .salts, while the 
Iodide, Bromide and Valerianate correspond in action to that of their 
titular bases, and are described under their respective titles, Iodum, 
Bromum and Valeriana. 

Antagonists to A?nmonia. 
When inhaled, give HC1 vapors by inhalation to form the chloride; if taken in solu- 
tion, give Vegetable Acids, and demulcents to protect the mucous surfaces. Its physio- 
logical antagonists are the cardiac sedatives, Aconite, Digitalis, Veratrum, etc. 

Therapeutics. 
The strong solution of Ammonia may be used as a rubefacient and 
vesicant, and its vapor, by cautious inhalation, in syncope and the results 



IIO AMMONIUM. 

of shock. Locally, it is a good application to bites of the less venom 
ous reptiles and to the stings of insects. The Carbonate is used inter- 
nally in the eruptive fevers, delirium tremens, continued fevers, pneu- 
monia, etc., where much depression exists; as a stimulating expectorant 
in chronic bronchitis, in the broncho-pneumonia of children, and in 
cardiac asthma. It is highly recommended in scarlet fever in doses of 3 
to 5 grains every one, two or three hours, all acid drinks or fruits being 
prohibited while it is being administered. With ten-minim doses of tinc- 
ture of capsicum in an ounce of some bitter infusion it is exceedingly 
efficient, in 5-10-grain doses, for the sinking sensations and craving for 
stimulants experienced by subjects of alcoholism. It may be used as an 
emetic in bronchitis, when the tubes are choked with mucus and the cir- 
culation of the patient is weak. It may also be employed by inhalation, 
and administered internally, for similar purposes as Liquor Ammonise. 

In dose of 5 grains, administered hypodermically in the vicinity of wounds caused by 
poisoned arrows, the Carbonate was repeatedly used by Dr. Parke, Stanley's surgeon in 
Africa, with entire success in saving life when so employed immediately after injury. 
Those so wounded at too great a distance to receive this treatment invariably died within 
a short period of time. 

The Chloride has high repute in catarrh of the stomach, with anorexia, 
bad taste in the mouth, flatulence, coated tongue, etc., in short, the 
symptoms of so-called " biliousness; " also, in chronic congestion of the 
liver, jaundice from catarrh of the bile-ducts, nervous and sick headaches, 
myalgia, amenorrhcea, muscular rheumatism and neuralgia. In the latter 
affection it should be given in 30-grain doses several times a day. It is 
also efficient in bronchial catarrh without fever, and in chronic bronchitis 
when the secretion is scanty and tough. It is remarkably efficient in 
straightening up a victim of acute alcoholism ; administered to one on 
the verge of delirium tremens, in dose of x / 2 drachm in half a pint of 
water, swallowed at one draught, it is said to restore the patient's facul- 
ties so quickly as to astonish those who have never seen it so employed. 
Locally, in solution, it has been well employed in inflammatory swell- 
ings, as sprains, inflamed joints, orchitis, etc., as a lotion; also, to allay 
itching in prurigo, to remove ecchymoses and glandular enlargements. 
Eau Sedative is often a good local application in headaches. 

The Solution of the Acetate is especially beneficial in the exanthe- 
mata, influenza, coryza, anomalous febrile conditions of children, acidity 
and vomiting ; also, in erysipelas when there is feeble circulation, cyan- 
osis and delirium. It is frequently combined with Spirit of Nitrous Ether, 
as a diuretic and diaphoretic in febrile affections. The Phosphate is 
particularly applicable to gout and lithaemia, and is a very efficient chola- 
gogue. The Benzoate is useful in cystitis with alkaline urine and phos- 
phatic deposits, as it acidulates the urine, at the same time stimulating 
and disinfecting the mucous coat of the bladder. 



AMYGDALA. I I I 

Aqua Ammonite has been administered by intra-venous injection, with 
efficacy and safety, in sudden or threatened thrombosis, cardiac paralysis 
from Chloroform, and in poisoning by Hydrocyanic Acid and other car- 
diac depressants. In the same manner, it has been employed, but unsuc- 
cessfully, in poisoning by the bite of venomous reptiles. Ten drops of 
the strong Liquor are diluted with three parts of water, and carefully in- 
jected into a vein, all air being rigorously excluded from entrance there- 
into. 

The therapeutics of the Iodide, Bromide and Valerianate are enume- 
rated under the titles Iodum, Bromum and Valeriana respectively. 



AMYGDALA, Almond. — The seeds of two varieties of Prunus 
Amygdalus (nat. ord. Rosacese), namely Amygdala amara and Amygdala 
dulcis, are official, together with several preparations, some prepared from 
one variety, some from another, while one is from either and one from 
both. An important point is the reaction between Amygdalin and 
Emulsin in the presence of water producing Hydrocyanic Acid (see ante, 
page 74). Amygdalin, C 20 H 27 NO n , is a crystalline glucoside, existing in 
Amygdala amara but not in Amygdala dulcis ; while the ferment Emulsin 
is common to both varieties. 

Amygdala Amara, Bitter Almond, — is the seed of Prunus Amygdalus, 
var. a??iara, a. tree of the nat. ord. Rosacese, indigenous to Western 
Asia, but cultivated in many other parts of the world. The seed is lanceo- 
late in shape, brownish in color, about an inch long, having a white, oily 
embryo of bitter taste, which, when triturated with water, emits an odor 
of Hydrocyanic Acid. Cultivated chiefly in Spain and the Balearic Islands. 

Amygdala Dulcis, Sweet Almond, — is the seed of Prunus Amygdalus, 
var. dulcis, a tree of the nat. ord. Rosacese. The bitter and sweet almond 
trees are identical botanically, and the fruits and seeds of the two varie- 
ties resemble each other closely, only differing in taste and the presence 
of Amygdalin (see above). The sweet almond is largely cultivated about 
Malaga and in California. 

Preparations. 

Aqua Amygdalae Amarae, Bitter Almond Water, — is a weak solution of the Oil of 
Bitter Almond in Distilled Water (1 to 1000). Is only a flavored water. Dose in- 
definite. 

Oleum Amygdalae Amarae, Oil of Bitter Almond, — is a volatile oil, of peculiar and 
aromatic odor, bitter, burning taste, and neutral reaction; soluble in 300 of water, but 
freely in alcohol and ether. Dose TT\, }(-], in mixture. 

This essential oil, one of the products of the reaction between Amygdalin and Emul- 
sin (see ante, p. 74), contains a varying quantity of Hydrocyanic Acid (3 to 14 per cent.), 
which may be removed by distillation with caustic potash. Nitrobenzol, or " Oil of Mir- 
bane," closely resembles the oil of bitter almond, and like it is used for flavoring. It 
contains no Hydrocyanic Acid, but is a dangerous poison, producing toxic effects when 
inhaled, even in small doses. 



I 



112 AMYL NITRIS. 

Spiritus Amygdalae Amarae, Spirit of Bitter Almond, Essence of Bitter Almond, 
— has of the Oil I, dissolved in Alcohol 80, and Water added to 100 volumes. Dose, 
to be regulated by the quantity of alcohol desired. 

Syrupus Amygdalae, Syrup of Almond, — has of Bitter Almond 4 per cent., of Sweet 
Almond 14. Dose indefinite. 

Emulsum Amygdalae, Emulsion of Almond, — made of Sweet Almond 6 per cent., 
with Acacia, Sugar and Water. A demulcent drink, used as a vehicle for cough mix- 
tures. Dose, ^ij-gss. 

Oleum Amygdalae Expressum, Expressed Oil of Almond, — is the fixed oil which is 
expressed from either Bitter or Sweet Almond. Used in Unguentum Aquse Rosae, and 
as a bland local application in skin affections. 

Physiological Action and Therapeutics. 

The bitter and sweet varieties of the species Primus Amygdalus differ 
in action only through the agency of the principle Amygdalin contained 
in the former. The Sweet Almond is demulcent and nutritive, while the 
fixed oil expressed from either variety is a bland application, having the 
same action as Olive Oil. The action of the Bitter Almond and its oil is 
due to the Hydrocyanic Acid contained in them (see ante, p. 74). 

The Expressed Oil of Almond is demulcent, and in doses of ^j-ij a 
mild laxative. It is used externally for excoriations, chapped hands, and 
inflammatory skin affections, and is applied to the ear in earache. The 
cake remaining after the expression of the fixed oil from the sweet almond 
is ground into flour, and used in the form of biscuits for diabetics as a 
substitute for bread, as it contains no starch. 

The Oil of Bitter Almond is used as a flavoring agent, and may be 
employed locally or internally in lieu of Hydrocyanic Acid. The Syrup 
is somewhat sedative, but is generally used as a demulcent or for flavoring 
purposes. The Emulsion is used in catarrhal affections and as a vehicle 
for cough-mixtures. The poisonous character of the Bitter Almond and 
its essential oil (Oleum Amygdalae Amarge) should be kept in mind. 

AMYL NITRIS, Amyl Nitrite, — is a liquid containing about 80 
per cent, of Amyl Nitrite, C 5 H n N0 2 , together with variable quantities of 
undetermined compounds. It occurs as a clear, yellowish liquid, of 
ethereal and fruity odor, aromatic taste, and neutral or slightly acid 
reaction, extremely volatile, insoluble in water but freely soluble in 
alcohol, ether, chloroform and benzin. It is produced by the action of 
Nitric or Nitrous Acid upon Amylic Alcohol, and when impure may have 
Nitric or Hydrocyanic Acid in it. Dose internally t\%-) dissolved in 
alcohol, — by inhalation rrrij-v; but larger doses are probably safe. 

Analogous Compounds. 

Glonoinum, Glonoin, Nitroglycerin, Trinitrin, Glyceryl Trinitrate, C 3 H 5 (N0 3 ) 3 , — 
is a clear, oily liquid, insoluble in water, but soluble in alcohol, ether, oils, etc., produced 
by the action of Nitric and Sulphuric acids upon Glycerin. It is a dangerous explosive, 
and should not be kept in stronger solution than 1 per cent. Dose, TT\, 2^0" t0 lo or more » 
according to susceptibility. Official in the Spirit. 



AMYL NITRIS. II3 

Spiritus Glonoini, Spirit of Glonoin, Spirit of Nitroglycerin, — is a I per cent, solu- 
tion in alcohol. Dose, TT\, ^-x. The strong tincture sold by the homoeopathic pharma- 
ceutists and official in their American Pharmacopoeia is a 10 per cent, solution, or ten 
times the strength of the above. It is an extremely dangerous preparation, both as an 
explosive and as a medicine. (See American Homoeopathic Pharmacopoeia, 2d ed., 
Boericke & Tafel, 1883, page 235.) 

Tabellse Nitroglycerini (B. P.), Tablets of Nitroglycerin, — are tablets of chocolate, 
each containing gr. yi^ of pure Nitroglycerin. Dose, j-ij. 

Sodii Nitris, Sodium Nitrite, NaN0 2 , and Potassium Nitris, Potassium Nitrite, 
(the latter unofficial), — are used as substitutes for Amyl Nitrite and Nitroglycerin. The 
former is a white, crystalline powder, deliquescent in the air, in which it gradually oxidizes 
to sodium nitrate; has a mild, saline taste, but no odor; very soluble in water, slightly 
in alcohol. Dose, gr. ss-v, according to individual susceptibility. 

Ethyli Nitris, Ethyl Nitrite, C 2 H 5 N0 2 , — constitutes about 5 per cent, of Spiritus 
^Etheris Nitrosi. (See page 87, ante.) 

Physiological Action. 

Amyl Nitrite and the other Nitrites agree closely in their general 
action, producing great vascular dilatation by paralyzing either the sym- 
pathetic system, the vaso-motor centre or the muscular coat of the arteri- 
oles, — which, is yet undecided. They cause tumultuous action of the heart 
by relaxing its inhibition; — lowered respiration, from paralysis of the re- 
spiratory muscles and impairment of the ozonizing function of the blood ; 
— diminution of sensation, motility, and reflexes ; — a sense of heat, but 
lowered body-temperature; also throbbing pain in the head, beating 
carotids, quickened pulse, flushed face and vertigo. 

The effect of an ordinary inhalation of Amyl Nitrite on man is very 
transitory, excepting the headache, which may last several hours. Of all 
the nitrites it is the most prompt but least enduring in action, and is best 
administered by inhalation. It causes sugar to appear in the urine and 
increases the quantity of urine voided. Mixed with blood it forms 
methaemoglobin, which is not so readily deoxidized as haemoglobin, and 
under its influence the blood in the body becomes of a dark chocolate 
color both in the arteries and in the veins. 

Nitroglycerin acts similarly, but less promptly, and its action is more 
enduring. Its headache is of intensely frontal character, and persists for 
hours after the other effects have passed off. It is more suitable for inter- 
nal administration. 

Sodium Nitrite is also slower in action than Amyl Nitrite, and does 
not cause so much throbbing headache as Nitroglycerin. It may be 
given in solution with water. 

The action of all these agents is probably due to the Nitrous Acid 

contained in them. 

Antagonists. 

Ergot, Belladonna, Strychnine, Brucine, Digitalis, Picrotoxin, and all other agents 
which increase the functional activity of the spinal cord and sympathetic are antagon- 
istic, though by reason of their slower rate of diffusion the antagonism- may not be always 
available. Stimulants, artificial respiration, the alternate cold and hot douche, with cold 
to the head, and Ergotin or Atropine subcutaneously, are the best means to be used in 
cases of poisoning by the Nitrites. 
8 



114 AMYLUM. 

Therapeutics. 

The inhalation of Amyl Nitrite is a useful palliative in angina pectoris, 
epilepsy, tetanus, and many of the respiratory neuroses, as spasmodic 
asthma, whooping-cough, laryngismus stridulus, etc. It is also indicated 
in migraine of the pale-face form, and in the cold stage of intermittents 
and pernicious remittents, to prevent internal congestion, — also in convul- 
sions of various kinds, including the. puerperal. It has been sometimes 
used in threatened death from chloroform anaesthesia, and in poisoning 
by strychnine. 

Nitroglycerin is employed with benefit in neuralgic dysmenorrhcea, 
and sea-sickness ; also in chronic interstitial nephritis, by redistributing 
to* the kidneys their-blood-supply cut off by degeneration of the renal 
ganglionic centres. It promptly relieves hiccough, also migraine of spas- 
modic character, and has afforded immediate relief in neuralgia of the 
fifth and in sciatica. Its administration in angina pectoris, though not 
producing such prompt results as that of Amyl Nitrite, gives excellent 
and much more lasting effects. It is useful in the weak heart of the aged, 
or that from fatty degeneration, or when, as in Bright's disease, the 
arterial tension is above normal; also in irritable and overacting heart, 
which it relieves by lowering arterial tension. 

Sodium Nitrite has been successfully employed in angina pectoris, 
hemicrania, and in asthma of purely bronchial and neurotic origin. It 
has also proved decidedly beneficial in the abnormally high arterial ten- 
sion of chronic desquamative nephritis, especially when complicated with 
a weakened and dilated heart. 



AMYLUM, Starch, C 6 H 10 O 5 ,— is the fecula of the seed of Zea Mays, 
Maize or Indian Corn, a plant of the nat. ord. Graminaceae. Though 
corn starch is the official kind, any other might be properly used, as the 
starch occurring in wheat, barley, oats, arrow-root, sago and tapioca, all 
of which foods were official in the U. S. P. of 1870. The last three are 
entirely composed of starch; wheat contains about 70 per cent., and 
rice 90 per cent. 

Starch is a carbohydrate, and occurs in distinct grains, forming irregular angular 
masses, white, inodorous, and tasteless, easily pulverized, of neutral reaction, and insol- 
uble in alcohol, ether or cold water. Under the microscope the granules are seen to be 
lenticular in form and concentrically striated. When boiled with water it yields a 
whitish jelly of bluish tinge, which when cool gives a deep blue color with test-solution 
of iodine, the color disappearing on warming and returning on cooling. 

By boiling with dilute mineral acids Starch is converted into Glucose, 
Dextrin being formed as an intermediate product. Hot concentrated 
nitric acid converts it into Oxalic Acid, but cold fuming nitric acid dis- 
solves it, forming an explosive compound. Diastase, ptyalin and pan- 



ANISUM ANTHEMIS. I I 5 

creatin convert it into Glucose. [For Glycogen, Dextrin, Cellulose 

and other allied substances see the article Saccharum in the following 

pages.] 

Glyceritum Amyli, Glycerite of Starch, — has of Starch 10 parts, Water 10, Gly- 
cerin 80, triturated and heated to a transparent jelly. Used as a vehicle for external 
applications. 

Starch, though a nutritive of the first order, may be regarded as inert 
medicinally. It serves as a protective and absorbent if dusted over the 
skin, as a vehicle for enemata, and as an antidote in iodine-poisoning. 
Mixed with glue it makes an excellent stiff bandage for surgical purposes. 



ANISUM, Anise, — is the fruit of Pimpinclla Anisum, a European plant of the nat. 
ord. Umbelliferse. It occurs in ovate bodies, */£ inch long, hairy, of grayish color, aro- 
matic odor, and sweet, spicy taste, resembling conium fruit in appearance. Dose, gr. x-xx. 

Preparations. 

Oleum Anisi, Oil of Anise •, — is a volatile oil distilled from Anise, and represents the 
medicinal qualities of the plant. It congeals at 50 to 59 F., is soluble in an equal part 
of alcohol, and is an ingredient of Tinctura Opii Camphorata, Trochisci Glycyrrhizae et 
Opii, and of the two following preparations. Dose, rr\J-v. 

Aqua Anisi, Anise Water, — has in 500 parts 1 of Oil of Anise triturated with Calcium 
Phosphate, and mixed with distilled water. Dose, indefinite. 

Spiritus Anisi, Spirit of Anise, — is a 10 per cent, solution of the oil in alcohol. 
Dose, 3j-ij. 

The Volatile Oil is the active constituent of Anise. It has a slightly stimulant action 
on the heart and the digestive organs, and liquefies the bronchial secretion, being probably 
in part excreted by the bronchial mucous membrane. It is a favorite flavoring ingredient 
of cough-mixtures, and relieves slight intestinal colic and flatulence in children. In full 
doses it has weak narcotic power. 



ANTHEMIS, Chamomile, — the flower heads of Anlhemisnobilis, a European per- 
ennial of the nat. ord. Compositae, collected from cultivated plants. Chamomile-flowers 
are sub-globular, about 3^ inch broad, having numerous white, three-toothed florets on a 
conical, solid receptacle, a strong but agreeable odor, and an aromatic, bitter taste; and 
contain a volatile oil, a camphor and a bitter principle, but no alkaloid. There are no 
official preparations. An infusion (giv to Oj) may be given in doses of ^j-ij. 

Oleum Anthemidis, Chamo?tiile Oil (Unofficial), — the volatile oil, is of a dark blue 
or green color, and is composed of various ethers, the Angelates and Valerianates of 
Butyl predominating. Dose, ttljj-x, on sugar. 

Physiological Action and Therapeutics. 

Chamomile is a stomachic tonic. It improves the appetite and aids digestion by increas- 
ing the vascularity of the gastric mucous membrane. In large doses the warm infusion 
is emetic, and perhaps diaphoretic, though the latter action is chiefly due to the hot water. 
The oil is remarkably efficient in reducing reflex excitability in frogs, even after its excita- 
tion by Strychnine or Brucine. 

Chamomile is popular in domestic practice. An infusion is used by nurses for many 
infantile complaints, and externally as a fomentation torelieve pain, as in colic, etc. The 
oil is very efficient in reflex cough, pulmonary catarrh, acute dyspepsia, diarrhoea of chil- 
dren, spasmodic asthma, whooping-cough, colic, and the spasmodic and pseudo-neuralgic 
affections of hysterical women. It should prove extremely useful in poisoning by Strych- 
nine, from its power over reflex excitability. 

The Chamomile of the homoeopaths is the Matricaria Chamo7nilla, or German Cham- 
omile, official in the U. S. Pharmacopoeia as "Matricaria," which see. 



f 



Il6 ANTIMONIUM. 

ANTIMONIUM, Antimony, Sb.— Metallic Antimony is not 
official, nor is it used in medicine. It is represented, however, by the 
following official salts and preparations, viz. : 

Compounds of Antimony and their Preparations. 

Antimonii et Potassii Tartras, Antimony and Potassium Tartrate, Tartar Emetic, 
2KSbOC 4 H 4 6 .H 2 0, — small white crystals or a granular powder of sweet, disagreeable 
metallic taste, soluble in 17 of water at 59 F., and in 3 of boiling water, insoluble in 
alcohol. Dose, gr. jg—j, but after tolerance is established as high as gr. ij may be given. 
Is an ingredient of the two following, viz. : 

Vinum Antimonii, Wine of Antimony, — has of Tartar Emetic 4, Boiling Distilled 
Water 65, Alcohol 150, White Wine to 1000. Contains about 2 grains of Tartar Emetic 
to the % , and is an ingredient of Mistura Glycyrrhizae Composita. Dose, rr\, v-xv, as a 
febrifuge and expectorant. 

Syrupus Scillae Compositus, Compound Syrup of Squill, Cox's Hive Mixture, Hive 
Syrup, (See under Scilla), — contains about 1 grain of Tartar Emetic to the ^, with 
Squill, Senega, etc. Dose, rt^j-^j, cautiously in children. 

Antimonii Oxidum, Antimony Oxide, Sb 2 3 , — a heavy, gray powder, insoluble in 
water or alcohol, but readily and wholly soluble in Hydrochloric or Tartaric Acid solu- 
tions. Dose, gr. j-iij. It constitutes j/jd of — 

Pulvis Antimonialis, Antimonial {or fames') Powder, — consists of the Oxide of 
Antimony 33 parts, with 67 of Calcium Phosphate. Dose, gr. iij-viij, every 3 hours as a 
diaphoretic, larger doses for emetic and cathartic effects. 

Antimonii Sulphidum, Antimony Sulphide, Sb 2 S 3 , — is the native sulphide, purified 
by fusion, and as nearly free from Arsenic as possible ; steel-gray masses, or a black, 
lustreless powder, insoluble in water or alcohol. Dose, gr. %-]. 

Antimonii Sulphidum Purificatum, Sb 2 S 3 , — is purified by maceration in Aq. 
Ammoniae, washing and drying. Dose, gr. %.-}. 

Antimonium Sulphuratum, Sulphurated Antimony, Kermes Mineral, — is chiefly 
Sb 2 S 3 , with a very small amount of Sb 2 3 . A reddish- brown, odorless and tasteless 
powder, insoluble in water or alcohol. Is a constituent of Pil. Antimonii Compositae. 
Dose, gr. j-v. 

Pilulae Antimonii Compositae, Plummets Pills, — each pill containing about gr. ^ 
each of Calomel and Sulphurated Antimony, with Guaiac and Castor Oil. 

Physiological Action. 
Tartar Emetic in its action represents the other official antimonial 
preparations, being a cardiac, arterial and general depressant, a proto- 
plasmic poison, a systemic and local emetic, a specific gastro-intestinal 
irritant, an expectorant and a diaphoretic. Like Aconite, Arsenic, Hy- 
drocyanic Acid and Potassium, it is destructive to protoplasm, destroying 
function in all nitrogenous tissue, and paralyzing the spinal cord, the motor 
nerves, the muscles and the sensory nerve terminations. It is especially 
depressant to the heart-muscle and the cardiac motor ganglia; it combines 
with the red blood-corpuscles, lessening their oxidizing power, lowering 
the blood-pressure and reducing the body-temperature. Its taste is styp- 
tic and one of its earliest effects is the production of constriction of the 
fauces. It promotes waste and rapid excretion of waste-products, carbonic 
acid and urea being especially increased. Being eliminated by all the 
excretory organs, including the skin, it excites follicular inflammation at 
the points of elimination ; resulting in an eruption which is papular at 
first, then becomes vesicular, and finally pustular, the pustules being urn- 
bilicated, like those of variola. This same eruption is also produced by 



ANTIMONIUM. 117 

the application of the drug to the skin with friction. Aphthous ulcera- 
tions, extending from the mouth to the stomach, with salivation and 
painful deglutition, may also result from its continued use. 

In small doses Tartar Emetic stimulates secretion in the bronchial and 
salivary glands, the stomach, intestinal canal, liver and pancreas. In 
larger doses it excites nausea, vomiting and purging, with evacuations 
like the "rice-water discharges" of cholera, and great prostration of the 
vital powers. Toxic doses produce similar symptoms, besides epigastric 
pain, cyanosis, delirium, cramps, motor and sensory paralysis, suppression 
of urine and collapse, — much the same phenomena as observed in Asiatic 
cholera. 

The Sulphide occurs native, and is the source from which the other 
compounds are prepared. It seems to be inert medicinally. Sulphurated 
Antimony owes its efficacy to the small quantity of the Oxide contained 
in it, and as this is variable, the action of the preparation is uncertain. 
The Oxide has a similar action to that of Tartar Emetic, but being in- 
soluble in water, it is of much less certain activity. 

Antidotes and Antagonists. 
Tannic Acid, or any substance containing it, is the antidote, forming the insoluble tan- 
nate. Opium, Alcohol, Ether, and other antispasmodics are physiological antagonists. 
Demulcent drinks should be freely administered to protect the mucous membranes. Al- 
kalies and Salts of Lead decompose Tartar Emetic. 

Therapeutics. 
Tartar Emetic was formerly much employed as an antiphlogistic on 
account of its power to cut short acute inflammations of sthenic type, 
and its use was very much abused, so that it has now gone out of fashion 
as a remedy. The contra-stimulant treatment of pneumonia and other 
inflammatory diseases by large doses of this salt after tolerance was estab- 
lished, is only worthy of reference as an historical fact. The same may 
be said of its external use as a counter-irritant as well as of its employment 
as an emetic, in both of which capacities it is too severe, while its emesis is 
too tardy in action to be of any value in poisoning. It is, however, a very 
efficient agent in many grave affections, if used in small doses (gr. -g^—j-g-); 
being highly efficacious in acute inflammatory affections of the respi- 
ratory tract, especially pneumonia, broncho-pneumonia, acute oedema of 
the lungs, feverish and catarrhal colds, bronchitis, laryngitis and tonsil- 
litis. In many respects it acts like Aconite in these and kindred affections, 
producing copious diaphoresis, slowing the pulse and allaying restlessness. 
It is considered a good remedy in puerperal peritonitis, mammitis and 
orchitis, in lumbago and other muscular rheumatisms, also in photophobia 
and in gastric indigestion after beer-drinking. In still smaller doses 
(gr. j^-Q hourly) it is particularly efficient in catarrhal inflammations of 
the respiratory mucous membrane in children, accompanied by rattling 



( 



I I 8 ANTIPYRINUM. 

breathing and much mucus, which is expelled with difficulty. Such cases 
often simulate asthma, the attacks being marked by cough, wheezing, and 
difficult respiration, with sibilant rales in the chest, and usually follow on 
severe colds or on measles. The Compound Syrup of Squill is commonly 
used as an expectorant and nauseant in the treatment of bronchitis and 
croup. The quantity of Tartar Emetic in it (gr. j to the g) should be 
remembered in administering it to children. (See Scilla.) 

The Oxide is chiefly employed in the form of James' Powder (Pulvis 
Antimonialis) for its mild diaphoretic qualities. The Sulphide is not 
used in medicine. Sulphurated Antimony is very uncertain in action 
and is but little used. The Compound Pill of Antimony (Plummer's 
Pill) was devised to obtain mercurial results without writing Hydrargyrum 
on a prescription. 

ANTIPYRINUM, Antipyrin, Dimethyl-phenyl-pyrazolon, Phena : 
zone, C 20 H 18 N 4 O 2 (Unofficial), — is a synthetical base, which forms salts 
analogous to those of Ammonium. It is a product of the destructive 
distillation of Coal-tar (compare Chinolinum), prepared by a patented 
and complicated process. It may also be obtained synthetically by heat- 
ing Methyl-oxy-chinicin with Phenyl-hydracin, and collecting the pow- 
der. It occurs as a grayish or reddish-white crystalline powder, which 
combines with acids to form salts, is somewhat bitter, and soluble in one- 
half its weight of hot water, and in its own weight of cold water ; but is 
still more so if the water is acidulated with dilute nitro-hydrochloric acid. 
It is less soluble in alcohol, chloroform or ether, gives an intensely red 
color with Ferric Chloride, a beautiful green with Nitrous Acid, and a 
yellow color with Nitric Acid, which deepens to crimson on warming. 
It is not irritant to either the stomach or the tissues, and may be admin- 
istered hypodermically. 

Dose and Administration. 

The full antipyretic dose for an adult was at first stated at 30 grains hourly for three 
hours, or 90 grains for the antipyretic effect. For children, gr. j for each year of age as 
a dose, to be repeated twice, or thrice, with the same intervals between each dose. That 
such dosage was far too great, soon became evident from the many reports of alarming 
symptoms of collapse resulting in numerous instances ; and the tendency has lately been 
towards a decreased dose at shorter intervals, which should be lengthened as soon as the 
drug-effects begin to be manifested. An average adult dose is now placed at 10 grains, 
for children % grain per year of age between 2 and 5, ^ grain per year from 5 to 10 ; 
not exceeding 5 grains at a dose for any child under 15 years of age. 

Antipyrin has but little flavor, is not unpleasant, and is therefore readily taken by chil- 
dren, in which respect it is greatly superior to Quinine. It may be administered in com- 
pressed tablets, each having from 1 to 5 grains ; — or in Aromatic Elixir, — say gr. lxxx in 
5 iv, of which solution each % contains gr. ijss. If vomiting result, the same dose 
may be dissolved in half its weight of hot water, and injected hypodermically while 
warm. 

Antagonists and Incompatibles. 
Antipyrin may be decomposed when brought into contact with Nitrous compounds, a 
new and poisonous substance being supposed to be formed, of uncertain composition, but 



ANT1PYRINUM. I 1 9 

resembling the Anilin greens. The mixture of this drug with Spiritus Etheris Nitrosi is, 
therefore, highly dangerous, if this supposed reaction is at all likely to occur. 

It is more or less decomposed or thrown out of solution by a large number of chemical 
compounds and other preparations, of which the following are the most important, viz. : — 

Acid, Hydrocyanic, Dilute. . Arsenic and Mercury, Solution of the 

Acid, Tannic. Iodides of. 

Butyl. chloral. Hydrate. Mercuric Chloride. 

Chloral Hydrate. Naphthol (3 (solid). 

Cinchona, Decoction. Nitrites in solution (acid). 

Cinchona, Fluid Extract. Sodium Bicarbonate. 

Catechu, Infusion (cone). Sodium Salicylate (solid). 

Ferrum, Sulphate. Tinctures containing Tannin, Iron, or 

Ferric Salts in Solution. Quinine. 

Hamamelis, Tincture. Rose, Infusion. 

Iodine, Tincture. Uva Ursi, Infusion. 

Antipyrin and Phenyl -urethan liquefy when rubbed together. 

Derivatives and Allied Compounds. 

Salipyrin, Antipyrin Salicylate, (Unofficial), — is formed by combining Salicylic Acid 
57.7, and Antipyrin 42.3 parts; and is the only salt of the base which has any thera- 
peutic importance. Described under Salix. 

Hypnal, (Unofficial), — is a combination of Antipyrin and Chloral, heated together, 
which is credited with hypnotic and analgesic power. Described under Chloral. 

Physiological Action. 
Antipyrin is a powerful antipyretic, a local anaesthetic, and a general 
analgesic, — and also possesses diaphoretic, mydriatic, antiseptic, disinfec- 
tant, hemostatic and slightly hypnotic powers. After the ingestion of a 
full medicinal dose (gr. xx-xxx), there is a stimulant stage of short dura- 
tion, in which the heart's action is increased, and a subjective sense of 
heat is experienced, with flushing of the face. This is soon followed by 
profuse sweating, coldness of the surface, slowed pulse, considerable de- 
pression, and if fever be present by lowered temperature ; the latter coin- 
ing on within half an hour after taking the drug and its degree being in 
direct ratio to the quantity administered, as also its continuance, — the 
former being usually from 3 to 5 degrees, and the latter from 1 to 10 
hours, a fair average being about 2 hours. In one case a fall of 12 F. 
was observed. 

When given with Kairin, the mixture of the two drugs has been found to produce a 
much greater fall of temperature, with longer continuance down, than that produced by 
an equal quantity of either drug given alone. 

After the antipyretic effect of the dose has passed off, the temperature 
(in fever) commences to rise again, — the onset being usually preceded by 
a chill, which is of slight degree when compared with the severe rigors 
and dangerous depression occurring under the action of Kairin, Chino- 
lin, and other members of the group. 

In health the administration of a full dose gives rise to slight nausea, 
singing in the ears, and a reduction of the body temperature of scarcely 



120 ANTIPYRINUM. 

any extent, about ■^ u ° F. It slightly raises the arterial tension and blood- 
pressure; — sometimes (but seldom) induces vomiting, also a peculiar 
eruption on the skin ; — and may cause such a degree of depression as 
to amount to collapse. It has no effect upon the respiration, but acts as 
a sedative upon the cerebrum, leaving behind a somewhat depressant in- 
fluence on the brain. It dilates the pupils and is eliminated by the kid- 
neys, appearing in the urine some three hours after its ingestion. The 
profuse sweating which it causes may be prevented by giving in advance 
a small dose of Atropine or Agaricine. 

In toxic dose its principal influence is exerted upon the blood, altering 
the shape of the red corpuscles, separating the hematin, and causing de- 
composition of that fluid. 

As an Antipyretic, Antipyrin, like Alcohol, acts by a double mode of 
operation, — (i) by diminishing oxidation, and (2) by promoting heat- 
loss. The latter is attained by dilating the cutaneous .vessels, allowing 
free radiation from the surface, and by the refrigerant action due to 
evaporation of the sweat. 

As an Analgesic, Antipyrin has a very considerable degree of power, 
in common with all the Chinolin derivatives ; but its property in this re- 
spect is found to act almost entirely upon pain due to manifestations of 
the rheumatic diathesis. In general anodyne action, it is not to be com- 
pared with the derivatives of Opium. Its hemostatic power is claimed 
to be superior to that of Ergotine. 

Therapeutics. 

One of the most popular of the modern antipyretics, Antipyrin deserves 
high rank in professional esteem, being one of the most certain and most 
powerful depressants of temperature, though somewhat dangerous, and 
devoid of any other influence upon the course of any febrile disorder. 
Its principal applications are as follows, viz. : — 

In hyperpyrexia from any cause it is efficient. In acute rheumatism, 
it has held a high place as a remedy, for some time. In typhoid fever 
and other febrile conditions, wherein hyperpyrexia occurs, as phthisis, 
erysipelas, pleuritis, pneumonia, surgical fever, etc. In neuralgise, neu- 
ritis, and other painful affections, especially when of rheumatic origin, — 
as lumbago, sciatica, hemicrania, supra-orbital neuralgia, etc., in which 
10-grain doses are generally sufficient, and may be given hypodermically. 
In painful affections of hysterical persons ; — pain from cerebral tumors 
and from cardiac diseases, — also painful menstruation ; — all of which are 
often relieved by it. In acute paroxysms of gout, a dose of 10 grains 
every two hours, preceded by a commencing dose of 25 grains, promptly 
relieved the pain and shortened the duration of the attack in one very 
thoroughly observed and carefully reported case. In chronic gout, very 






APIOLUM — APOCYNUM. 121 

remarkable results are reported from the use of this agent, indicating a 
specific action thereon of curative character. 

It has seemed to render efficient service in dysmenorrhoea, carbuncle, 
and cerebro-spinal meningitis; and affords valuable aid in the pyrexia of 
intermittents, in which stage the slow action of Quinine prevents its 
availability for immediate relief. 

It has rendered signal service in the diarrhoea of children, given in 
doses of gr. ss to gr. jss ; also in the urticaria-like eruptions of children 
its action when administered internally has been so promptly efficient as 
to indicate for it a direct influence upon the vascular nerves. As a 
symptomatic remedy against itching it is equally efficient in nervous 
pruritus, true prurigo, urticaria, erythema, pemphigus vulgaris, and lichen 
ruber. As an antigalactagogue 4-grain doses every two hours have proven 
highly efficacious. It is successfully employed against whooping-cough, 
chorea, bronchial asthma, and sea-sickness. 

For the purpose of relieving pain, the conjoint administration of Anti- 
pyrin and Morphine is said to be much more efficient than the use of 
either agent alone. 

APIOLUM, Apiol, (Unofficial), — is a non-volatile, oily liquid, of green color, acid 
reaction and pungent taste, soluble in alcohol, ether, chloroform, and in glacial acetic acid. 
It is extracted from the fruit of Petroselinum sativum (Parsley), a biennial plant of the nat. 
ord. Umbelliferae, which also contains a gelatinous substance named Apiin, and a Volatile 
Oil which is by some considered to be the true emmenagogue principle of the plant. 
Apiol is probably a mixture of several substances, and as found in commerce is often an 
impure oleoresin. Dose, rr^ ii j— x in capsule two or three times a day; as an emmena- 
gogue, rri, xv in one daily dose. 

A camphor, also named Apiol, C 12 H u 4 , is obtained from the same source, and occurs 
in white needles, of a feeble parsley odor, insoluble in water, but freely soluble in alcohol 
or ether. Dose, gr. xv as an antiperiodic, gr. v-x against dysmenorrhoea. 

Physiological Action and Therapeutics. 

In small doses (ttr, iij— v) Apiol is carminative, diuretic, diaphoretic, expectorant and 
stimulant to the circulation. In full doses (ttlxv) it is decidedly emmenagogue and 
feebly antiperiodic, producing headache, tinnitus aurium, intoxication, giddiness, etc., its 
action generally resembling that of Quinine. Large doses (ttl, xxx- 3 j) are decidedly 
narcotic. 

It has had some reputation in intermittents and in malarial neuralgise, but is most fre- 
quently employed in amenorrhoea and dysmenorrhoea, being of especial advantage in the 
amenorrhcea of anaemia, also when the menstrual discharge is fetid. It is becoming 
fashionable as a supposed abortifacient, but is useless for this purpose, and if freely used 
may produce decided narcotism, especially if the preparation employed should happen to 
be an active one. 

The capsules of Apiol put up in France and sold in this country over the counters of 
drug-stores to any applicant are generally inert ; hence cases of poisoning by this drug 
are seldom observed. They are, however, an important source of revenue to the retailers, 
as, being " imported " preparations, they command a high price, which is readily paid by 
gullible women who wish to "bring around their courses." 



APOCYNUM, Canadian Hemp, — is the root of Apocynum cannabinum, an 
indigenous perennial plant of the nat. ord. Apocynacese, and is inodorous, but of bitter, 
disagreeable taste. It contains a peculiar active principle, Apocynin, also tannic and 



4 

122 APOMORPHINA AQUA. 

gallic acids, resin, wax, caoutchouc, etc. Dose of the powdered root, gr. v-xxx. A de- 
coction ( !|ss to the pint) may be given in doses of ^j-ij thrice daily. 

Extractum Apocyni Fluidum, Fluid Exti-act of 'Apocynum, — Dose, rr\,v-xxx. 

Apocynum is powerfully emetic and cathartic in full doses, also diaphoretic, expecto- 
rant and sometimes actively diuretic. It lowers the pulse-rate, produces much nausea, 
and induces drowsiness. It should not be confounded with the Indian or American 
Hemps (Cannabis sativa), which have entirely different qualities. 

The only condition in which Apocynum has proven of much value is dropsy, especially 
the anasarca of Bright's disease and ascites, in which 15-grain doses are indicated. The 
active principle, Apocynm, is a good expectorant, in doses of gr. ^ to gr. y 2 . 



APOMORPHINA, Apomorphine, — is an artificial alkaloid, pre- 
pared from Morphine or Codeine by the action of strong acids or zinc 
chloride. The Hydrochlorate (C lt H 17 N0 2 HCl) is official, and occurs in 
minute, colorless crystals, odorless, of bitter taste, and neutral or faintly 
acid reaction ; soluble in about 45 of water and in the same quantity of 
alcohol [at 59 F., almost insoluble in ether or chloroform; decomposed 
by boiling water or boiling alcohol. 

Dose, gr. ■£§ to ^ hypodermically, gr. T ^ to ^ by the mouth. For young children, gr. 
-J^ to gL should not be exceeded. Solutions should be fresh when used, and as they 
alter rapidly by keeping, should have a few drops of hydrochloric acid added to them, to 
prevent decomposition. 

Physiological Action and Therapeutics. 

Apomorphine is a systemic emetic, acting directly on the vomiting 
centre, and is the quickest, most certain and least irritating of all emetics, 
acting in from five to twenty minutes with but moderate nausea. In large 
dose it is very depressant to the heart (gr. ^ having caused death in a 
weak adult by cardiac failure), and produces paralysis of the motor and 
sensory nerves, delirium, convulsions, and depression of respiratory 
power. Small doses (gr. -^) are expectorant. 

The Hydrochlorate is the preparation usually employed, and the only 
official one. It is the best emetic to use in many cases of poisoning, 
particularly when swallowing is difficult, but is useless in narcotic poison- 
ing after narcosis has blunte ( d the vagus centre. It is a very desirable 
agent in any case where time is of great importance. 

As an expectorant it is highly recommended but has not yet been much 
used. In catarrhs the -gL- of a grain every 3 hours will prove of great 
advantage, but it must be used with caution, especially in young chil- 
dren, who bear this remedy very badly. 

In hacking coughs without expectoration it has proven a very efficient 
agent, given in minute doses, gr. Jg- to ■£$ in the 24 hours. 

AQUA, Water, H 2 0, — is natural water, in its purest attainable 
state ; a colorless limpid liquid, devoid of odor or taste, and of neutral 



AQUA. 123 

reaction. Besides entering into the composition of most of the official 
extracts, fluid extracts, and many other pharmaceutical preparations, from 
it are prepared the 17 official Waters (Aquse), and also the following: — 

Aqua Destillata, Distilled Water, H 2 0, — 1000 parts of water are distilled, the first 
100 parts obtained being thrown away, 800 parts are preserved. It is as near chemically 
pure water as can be obtained. 

Aqua Carbonata, Carbonated Water, Soda-water, (Unofficial), — is water highly 
charged with carbonic acid gas, C0 2 , the excess of gas being dissolved in the water by 
pressure, and escaping in bubbles when the pressure is taken off. It was official in the 
U. S. P., 1870, under the title Aqua Acidi Carbonici, the formula requiring that the wa- 
ter be charged with five times its volume of gas, for which a pressure of five atmospheres 
is required. The materials usually employed by soda-water manufacturers for producing 
the gas, are either Sodium Bicarbonate or Marble-dust, and Sulphuric Acid. 

Nomenclature of Water. 

Aqua Fluvialis, River- water. Aqua Destillata, Distilled Water. 

Aqua Pluvialis, Rain-water. Aqua Bulliens, Boiling Water. 

Aqua Fontana, Spring or Well-water. Aqua Fervens, Hot Water. 

Aqua Marina, Sea-water. Aqua Communis, Common Water. 

Aqua Carbonata, Carbonated Water, Balneum Maris, Warm-water Bath. 

Soda Water. Balneum Vaporis, Vapor Bath. 

Mineral Waters. 
Natural Water differs from Distilled in containing saline and other con- 
stituents in varying proportions, — from common water (Aq. Communis), 
in which they are so small in quantity as not to alter the taste, color, etc., 
up to the Sea-water, having 33/3 per cent., and that of the Dead Sea with 
26^ per cent. Spring waters, impregnated with foreign substances so as 
to have a decided taste and a marked action on the human system, are 
called Mineral Waters, which may be subdivided into various groups, 
according to their prevailing constituents, as Carbonated, Alkaline, Saline, 
Sulphuretted, Silicious, etc. Full analyses of all the principal mineral 
waters of Europe and America are given in the United States Dispensatory, 
but a few of the most prominent will be mentioned here. 

Carbonated Mineral Waters. 

Selters, Nassau, Germany, , . . 30<:ubic inches ] 

Apollinaris. Nuenahr, Prussia, 47 " of C0 2 

Old Sweet Spring, West Virginia, , , . . . 1 1 " to the pint. 

Sweet Chalybeate Spring, Virginia, .... 13 " J 

These waters are cold, contain generally Carbonates of Calcium, Magnesium and 
Sodium (in some, Iron), which are held in solution by the excess of Carbonic Acid, also 
Chlorides of Sodium and Potassium, Sulphates, Phosphates, etc. 

Alkaline Mineral Waters. 

Ems, Germany. Perry Spring, Ills. 

Salzbrunn, Germany. St. Louis Spring, Mich. 

Gleickenberg, Austria. Buffalo Lithia Spring, Va. 

Vichy, France. Hot Spring, Va. 

Vals, France. Warm Spring, Va. 

Bladon Spring, Ala. Berkeley Spring, Va. 

Congress Spring, Cal. Bethesda Spring, Wis. 

Seltzer Spring, Cal. Gettysburg Spring, Pa. 



124 AQUA. 

These waters are generally cold, those of Vichy and Ems being warm. They contain 
a considerable amount of Sodium Carbonate, also Sodium Chloride and Sulphate, and 
various other Chlorides, Carbonates and Sulphates, with Carbonic Acid gas in varying 
quantity. Vichy and Vals waters depend for their efficacy almost wholly on the quantity 
of Sodium Carbonate contained in them, which is for Vichy from 26 to 50 grains and for 
Vals about 60 grains to the pint. 

Saline Mineral Waters. 
Friedrichshall, Germany. Cheltenham, England. 

Hunyadi Janos, Hungary. Kissengen, Bavaria. 

Baden-Baden, Germany. Reichenhall, Bavaria. 

Wiesbaden, Germany. Adelheidsquelle, Bavaria. 

Carlsbad, Bohemia. Kreutznach, Prussia. 

Pullna, Bohemia. Saratoga Springs, N. Y. 

Seidlitz, Bohemia. Ballston, N. Y. 

Marienbad, Bohemia. Hot Springs, Arkansas. 

St. Catherine's, Ontario, Canada. 

These waters are of more complex composition, the various waters of Saratoga contain- 
ing more than thirty constituent salts. Those usually present are the Sulphates and 
Carbonates of Sodium, Calcium, Magnesium, etc. {Magnesian waters) ; Chlorides of 
Sodium, Potassium and Lithium {Chlorinated waters) ; Ferrous salts {Chalybeate waters), 
with Iodine, Bromine, Manganese salts, and Phosphates in some few. Carbonic Acid 
gas is present in all. Most of them are purgative, some are considered alterative, and 
many are warm (loo°-i6o°). 

The most powerful member of the saline group is Hunyadi Janos, which contains about 
150 grains each of Magnesium and Sodium Sulphates to the pint, and is, therefore, effec- 
tively purgative. Nearly as strong is Pullna water, with 124 grains of Sodium Sulphate 
and 93 grains of Magnesium Sulphate to the pint. Friedrichshall is less powerful, but 
perhaps a better aperient water in doses of 6 to 10 fluid ounces. Marienbad contains no 
Magnesium Sulphate, but has 36 grains of Sodium Sulphate, 9 of Sodium Carbonate, 1 1 
of Sodium Chloride, and a small quantity of Ferrous Carbonate to the pint; in transpor- 
tation, however, it loses its Carbonic Acid and deposits the Iron. It is not aperient in 
ordinary doses. Carlsbad water contains 20 grains of Sodium Sulphate and 9 each of 
Sodium Carbonate and Chloride to the pint. The so-called " Carlsbad Salt " is simply 
Sodium Sulphate with a trace of the Carbonate. Hartnack gives the following formula 
for its artificial preparation: Sodium Sulphate 100 parts, Sodium Bicarb. 80, Sodium Chlo- 
ride 40 ; a dessertspoonful in water as a mild saline purgative. These waters are imported 
into, and made in the United States in large quantities, and may be ordered through any 
druggist. 

Sulphurous Mineral Waters. 

Aix-la-Chapelle, Prussia. Blue Lick Spring, Ky. 

Bareges, S. France. Sharon Spring, N. Y. 

Eux-Bonnes, S. France. Yellow Sulphur Spring, Va. 

Llandrindod, Wales. t White Sulphur Spring, W. Va. 

Harrowgate, England. Salt Lake Warm Springs, Utah. 

These waters all contain Sulphuretted Hydrogen gas, also Carbonic Acid gas and Car- 
bonates, Chlorides and Sulphates of Sodium, Potassium, Magnesium and Calcium ; some- 
times Carbonate and Oxide of Iron, Iodide and Bromide of Sodium. 

Silicious Mineral Waters. 
Hot Springs, Iceland. Geysers of Yellowstone Park. 

The constituents of these waters are chiefly alkaline Silicates. 

Physiological Action of Water. 
Water is an essential constituent of all the tissues of the body, form- 
ing from 0.2 per cent, of the enamel of the teeth to 77 per cent, of the 
ligaments. In the liquids of the organism it is contained in the propor- 



AQUA. 125 

tions of 78 per cent, of the blood to 93 of the urine, and 99 of the tears. 
In moderate quantity it is necessary to digestion, but in large amount it 
weakens digestion by diluting the gastric juice. Ice-cold water, if freely 
used, suspends the action of the pepsin, depresses the nerves of the stom- 
ach, and lowers its blood supply. The free use of water internally pro- 
duces increased cutaneous and renal excretion, and promotes the elimina- 
tion of some of the products of tissue-change, as urea, phosphoric acid, 
etc. In some subjects it favors the deposition of fat. 

Cold Water applied externally, as by a bath (4o°-6o° F.), abstracts 
a portion of the body-heat, lowering the surface temperature and depress- 
ing the cutaneous nerves, producing spasmodic breathing and a quick- 
ened pulse. If the temperature of the water is not too low and the bodily 
vigor is good, reaction soon occurs, and the general effect is tonic to the 
-muscular power, circulation and respiration. If this does not take place 
a secondary chill occurs, and serious depression may result. 

Warm Water (95°-ioo° F.) applied to the surface of the body, as 
by baths of water or steam, packing, etc., acts in the opposite manner at 
first, increasing the circulation in the skin, the rapidity of the pulse and 
respiration and the body temperature. Rapid tissue-change occurs, the 
waste products being eliminated chiefly by the skin and the pulmonary 
mucous membrane. If long-continued, precordial oppression, giddiness 
and muscular debility are experienced. 

Hot Water (iio°-ti2° F.) at first dilates the vessels of the part to 
which it is applied, and soon afterwards contracts them. It is a valuable 
means of relieving congestion and inflammation, and is a most effective 
hemostatic when the bleeding is from small vessels or of capillary charac- 
ter. Whether generally or locally applied it is one of the most reliable 
means of relieving spasm. 

Hot Vapor applied to the surface accelerates the circulation and pro- 
duces profuse sweating. Its general action is similar to that of warm 
water. 

Mineral Waters taken internally act chiefly by virtue of the water,, 
partly in accordance with the effects of their various constituents. As 
baths, their action is doubtless entirely due to their temperature. 

Pathogenic Microbes of several diseases, notably those of cholera and typhoid fever, 
are conveyed to the human system in drinking water contaminated therewith. But these 
organisms are destroyed by a temperature of 144° F. in the absence of their spores, while 
a temperature of 2 1 2° F. , that of boiling water, maintained for five minutes, destroys the 
spores of all pathogenetic organisms which have been tested (Sternberg). This fact is of 
the highest practical importance, as it shows that no germs of disease need ever gain en- 
trance to our bodies through our drinking water, if we will only boil it. Many years ago 
an English physician's report was quoted in Braithwaite's Retrospect, in reference to the 
immunity of the Chinese from typhoid fever, though, he said that in Pekin there was no 
system of sewerage, but that all excreta was thrown on the ground to find its way into the 
watercourses by which the city was supplied, to soak into wells, etc. Yet, the author 
said, that contrary to all experience elsewhere, typhoid fever was unknown in Pekin. 
The reason is to be found in the fact that the Chinese boil all the water they drink. 



126 AQUA. 

Those who know them best say that they never drink cold water, but always tea, i. e., 
boiled water. Something there must be to account for their remarkable health under 
otherwise adverse hygienic surroundings. 

Therapeutics of Water. 

Cold Water or Ice has many external applications of value in the 
treatment of disease. As a wet pack it is used in tonsillitis, diphtheria 
and croup. Cold baths are the most effective antipyretic in the high tem- 
perature of fevers, and the cold wet pack is used for the same purpose. 
Ice or cold water is applied to the head in acute cerebral congestion, and 
to the spine in chorea, etc. \ also locally in hemorrhoids, bubo, orchitis, 
and to the uterus in post-partum hemorrhage. Cold affusion to the body 
is employed as a preventive of spasmodic croup, as well as to lessen the 
tendency to taking cold. 

Hot Water externally as fomentations, hot wet pack, baths, etc., is 
most effective in reducing local congestion and setting up resolution of 
local inflammation. Hot fomentations to the renal region are useful in 
functional inactivity of the kidneys. The hot spinal douche is. used in 
affections of the spinal cord and meninges, and in the backache of women. 
The hot wet pack is highly esteemed in inflammation of the chest organs, 
and hot injections for chronic inflammation of the uterus. Hot water 
dressings for wounds are strongly favored by many high surgical author- 
ities. Vapor and Turkish baths are used as diaphoretics in advanced 
kidney disease, in acute and chronic rheumatism, mineral poisoning, and 
syphilis. Warm baths, with cold applications to the head, are esteemed 
of value in infantile convulsions and chorea. 

Internally, water is chiefly of value as a diuretic, and if hot as a dia- 
phoretic. A glass of cold water before breakfast daily is often an effective 
means of overcoming constipation, while the drinking of hot water an 
hour before each meal has been of great value to many dyspeptics. The 
value of the popular teas in chronic diseases is almost entirely due to the 
diluent, diuretic and diaphoretic actions of the hot water used. 

Carbonated Water, or " Soda-water," as it is popularly called, is employed as a 
grateful beverage in hot weather, being flavored with various syrups. It is also an agent 
of great value for febrile cases, as it allays thirst, lessens nausea, and promotes the secre- 
tion of urine. It forms an excellent vehicle for the administration of the saline cathar- 
tics, especially Magnesium Sulphate, and of the various carbonates. It is one of the 
numerous agents which have been found efficacious in the vomiting of pregnancy. 

Therapeutics of the Mineral Waters. 
An undue value is placed by the laity and interested proprietors on the 
medicinal value of mineral waters, causing the various localities of the 
best advertised springs to become resorts for invalids and idlers from every 
civilized country. The benefit derived is in most instances due to the 
change of climate and scene, freedom from home cares and business 



ARGENTUM. \2J 

worry, regularity of life and diet, drinking of water in quantity, and in 
many cases the substitution of water for alcoholic beverages. In order 
to get the worth of their money, people will gladly submit to rigid 
hygienic and dietetic restrictions at a watering-place which they would 
totally ignore under treatment at home. The same may be said of the 
treatment at the so-called "hydropathic" or "water-cure" establish- 
ments. As a rule, those springs will prove of most value which are 
furthest removed from the patient's residence, for "distance lends en- 
chantment" in these matters as well as in many others. Invalids whose 
homes are in the vicinity of some wonder-working spring will not usually 
derive much benefit from its water, but will by that of another spring, 
similar in constituents, but located several hundred miles away. 

The principal affections in which mineral waters are esteemed most 
highly are the following : dyspepsia, cirrhosis of the liver, gout, rheu- 
matism, lithiasis, diabetes of hepatic origin, constipation, strumous dis- 
orders, obesity, plethora of the pelvic organs, hypochondriasis, skin dis- 
eases, especially those dependent on gastric derangement, phthisis, con- 
stitutional syphilis, metallic poisoning, etc., in all of which the influences 
above mentioned are especially efficacious, and are no doubt the chief 
factors in producing any benefit which maybe attainable. Aperient and 
purgative waters are useful in many cases where a prejudice exists against 
purgative medicine, but none against the same agents in a natural water. 
The strong saline-aperient waters, as Carlsbad, Hunyadi, Friedrichshall, 
etc., have considerable repute in the treatment of the uric-acid diathesis 
and calculous affections, and the waters of St. Catherine's Wells are 
credited with decided influence upon local and chronic rheumatism. 

The special therapeutics of mineral waters are to be found in this volume under the 
heads of their principal constituents, as Sodium Chloride, Sodium Sulphate, Magnesium 
Sulphate, etc., also in the therapeutical part of the book. 



ARGENTUM, Silver, Ag, — is represented by the following four 
official salts, viz.: — 

Silver Compounds and their Preparations. 

Argenti Nitras, Silver Nitrate, AgN0 3 , — occurs in colorless rhombic crystals, of 
bitter caustic taste and neutral reaction, soluble in 0.6 of water and 26 of alcohol at 59 
F. Is best given in pill or distilled water; never with tannin or a vegetable extract, lest 
an explosive compound result. Dose, gr. ye-%, — if watched, up to gr. j may be given. 
When melted with 4 per cent, of Hydrochloric Acid, it makes — 

Argenti Nitras Fusus, Moulded Silver Nitrate, Lunar Caustic, — for local use 
as a mild caustic and astringent. Argenti Nitras Dilutus, Diluted Silver Nitrate, 
Mitigated Caustic, — is the same salt melted with twice its weight of Potassium Nitrate. 
Is used locally by ophthalmologists. 

Argenti Cyanidum, Silver Cyanide, AgCN, — has no medicinal use except for the 
extemporaneous preparation of Hydrocyanic Acid. (See ante, page 74.) 

Argenti Iodidum, Silver Iodide, Agl, — a greenish yellow powder insoluble in water 
or alcohol. Is used instead of the nitrate internally, as it is supposed not to discolor the 
skin. Dose, gr. %-) in pill. 



128 ARGENTUM. 

Argenti Oxidum, Silver Oxide, Ag 2 0, — a brownish black powder, nearly insoluble 
in water and insoluble in alcohol. It should not be triturated with readily oxidizable or 
combustible substances, and should not be brought into contact with ammonia. Dose, gr. 
y z -\) in pill. Is not dangerous. 

All the silver salts should be protected from light in dark amber-colored vials. 

Physiological Action. 

Silver Nitrate is a powerful astringent and a limited escharotic. 
Applied to the skin or mucous membrane it combines with the albumen 
of the tissue, excites superficial inflammation, which is soon followed by 
an altered condition of the part, and stains the same black under the 
influence of light. The stains may be removed by washing with a strong 
solution of Potassium Cyanide. Given internally in small doses it 
increases secretion, stimulates the heart, promotes nutrition, and acts as a 
nerve tonic. Its continued use produces symptoms which are collectively 
termed Argyrta, and are as follows : gastro-intestinal catarrh, tissue 
waste, uraemia, albuminuria, fatty degeneration of the heart, liver and 
kidneys, hemorrhages, fluidity of the blood, a slate-colored line along the 
margin of the gums, and a similar discoloration of the skin and mucous 
membranes, with centric impairment of the nervous system producing 
paralysis on a large scale, loss of coordination power, convulsions, and 
finally death by paralysis of respiration. Large doses produce violent 
gastro-enteritis, also ulcer of the stomach from thrombosis of its veins, 
and destruction of the gastro-intestinal mucous membrane. 

The Iodide and Oxide are sometimes used to produce the same con- 
stitutional effects, they being supposed not to discolor the skin, but this 
has been found to be fallacious. The oxide is much the least irritant of 
the silver salts. 

Antagonists and Incompatibles. 

Common Salt freely used is the antidote, precipitating the silver as the insoluble chlo- 
ride and acting as an emetic. The Nitrate is exceedingly sensitive to organic material 
and light, which decompose it readily. Incompatibles are all the soluble Chlorides 
(hence it should be used in distilled water), most of the Mineral Acids and their salts, 
Alkalies and their Carbonates, Lime-water and astringent infusions. 

A course of silver medication should be regulated by suspending the remedy after 5 or 
6 weeks' use, and then promoting elimination by purgatives, diuretics and baths. To 
prevent the general discoloration Potassium Iodide should be given conjointly with the 
silver, and baths of Sodium Hyposulphite used frequently. 

Therapeutics. 
Locally the Nitrate is much used as a stimulant application, an astrin- 
gent, a caustic, an alterative and an antiphlogistic. To ulcers and in 
throat affections the solid stick may be used, but solutions of various 
strengths, from gr. j to gr. xl to the %, are much better. The mildest so- 
lutions are employed in conjunctivitis (never over the cornea), the stronger 
in throat and mouth affections, and the strongest in lupus, erysipelas and 
other skin diseases. A solution in Nitrous Ether (gr. xl to the J) is said 



ARNICA. 129 

to abort superficial inflammations if applied early to the neighboring in- 
tegument, and in erysipelas a solution of gr. xx to the 3 is often used 
over the inflamed surface and beyond, after careful washing and drying, 
in the hope of preventing the extension of the disease, which it will not 
do. The mucous membrane of the conjunctiva, fauces, larynx, urethra, 
bladder, uterus, vagina and rectum, have all been subjected to the local 
action of this salt. 

Internally the silver salts are used in dyspepsia with vomiting of yeasty 
fluid, chronic gastritis and gastric ulcer, dysentery of chronic type, espe- 
cially if rectal ulcer (the Nitrate internally and by enema), the diarrhoea 
of phthisis and typhoid fever (Nitrate with Opium), chronic spinal inflam- 
mations causing locomotor ataxia or paraplegia, and epilepsy ; in the 
latter affection the Nitrate having occasionally given good results. 

The Oxide has been used internally for gastric neuralgia, irritative 
dyspepsia, pyrosis, gastric and pulmonary hemorrhages, and menorrhagia. 
The Iodide is employed to obtain the constitutional effects of silver, but 
has no advantages over the other preparations. 

ARNICA, — is the plant Arnica Montana or Leopard's Bane, a peren- 
nial of the nat. ord. Compositae, indigenous to the mountains of Northern 
Europe and Siberia, and said to have been also found in the mountains 
about the headwaters of the Missouri and Columbia rivers. It has large 
orange-yellow flowers, and a small, curved rhizome with several rootlets. 
Both the flowers and the roots are official. Its most important constituent 
is Trimethylamine, C 3 H 9 N, an ammoniacal alkaloidal principle, which is 
probably the active ingredient. It also contains Arnicin, Inulin, Capro- 
nic and Caprylic Acids, tannin, mucilage, resins, and two essential oils, 
one of which exists in the flowers, the other in the root. 

Arnicse Flores, Arnica Flowers, — the flower-heads of Arnica Mon- 
tana, large, yellow, having 14 to 16 strap-shaped florets in the ray, twice 
as long as the disk, which consists of numerous tubular florets. The odor 
is feebly aromatic, the taste bitter and acrid. Used in Tincture and 
Infusion. 

Arnicse Radix, Arnica Root, — the rhizome and rootlets of Arnica 
Montana, is about 2 inches long and ^ to ^ inch thick, externally brown 
and rough from leaf-scars, internally whitish, with a thick bark contain- 
ing a circle of resin-cells and a large, spongy pith. Odor somewhat aro- 
matic, taste pungent, aromatic and bitter. Resembles Valerian, which is 
distinguished by its smell ; Serpentaria, which has many contorted root- 
lets ; and VeratruM Viride, which has thicker rootlets. Dose, gr. v-xx. 

Preparations of the Flowers. 

Tinctura Arnicse Florum, Tincture of Arnica Flotvers, — 20 per cent. Dose, 
TT\, v-xxx. 



I3O ARNICA. 

Infusum Arnicae, Infusion of Arnica (Unofficial), — Arnica flowers 20, to 100 paits 
of water, is thought by many observers to be the best form for local use, as it does not 
excite dermatitis, probably from containing none of the Volatile Oil, nor the insoluble 
principle Arnicin. 

Preparations of the Root. 

Extractum Arnicae Radicis, Extract of Arnica Root, — Dose, gr. j-iij. 

Extractum Arnicae Radicis Fluidum, Fluid Extract of Arnica Root, — Dose, 
rr^ v-xx. 

Tinctura Arnicae Radicis, Tincture of Arnica Root, — 10 per cent. Dose, n^v-xxx. 

Emplastrum Arnicae, Arnica Plaster, — contains Extract of Arnica Root 2>Z parts to 
67 of Lead Plaster. 

Derivative. 

Trimethylamina, Trimethylamine, C 3 H 9 N (Unofficial), — is a thin, colorless, strongly 
alkaline liquid, boiling at 50 F., and at ordinary temperatures is a colorless, inflammable 
gas. The Hydrochlorate is the most stable salt, crystallizing in white or colorless prisms, 
nearly odorless, of pungent taste, very deliquescent, and freely soluble in water and in 
alcohol. Dose, gr. ij-iij in syrup every 2 hours. 

Trimethylamine has been obtained from Arnica flowers and those of several other 
plants, from Ergot, Hops, Codeine, Cod-liver Oil, and decomposing albuminous sub- 
stances, such as human urine, herring-pickle, and the residue left in making sugar from 
beets. It is sometimes incorrectly named Propylamine, a term also applied to an impure 
trimethylamine, but in reality an allied and isomeric compound. 

Physiological Action. 
Arnica is irritant, stimulant, depressant, antipyretic, diuretic and vul- 
nerary. It irritates the gastro-intestinal tract, and in some persons the 
local use of an alcoholic preparation of the flowers will excite erysipela- 
tous inflammation of the skin, though those of the root have not been 
observed to do so. In small doses internally it increases the action of the 
heart, raises the arterial tension and stimulates the action of the skin and 
the kidneys. Large doses produce a transient excitement, followed by 
depression of the circulation, respiration, and nerve-centres ; headache, 
unconsciousness, and even convulsions being induced, the body-tempera- 
ture lowered, the pupils dilated, and muscular paresis produced. A toxic 
dose paralyzes the nervous systems of animal and organic life, causing 
collapse and death. 

Therapeutics. 

Arnica is a popular remedy with those who patronize the so-called 
homoeopathic school of practice, but like many other agents which the 
homceopathists claim to have given to medicine, it is a remedy much 
older than homoeopathy, and was investigated originally by regular physi- 
cians, notably by Van der Kolk in the sphere of mental affections. 

Externally, the tincture in water has a popular reputation in sprains, 
bruises, etc., though an infusion is better for local use. Ecchymoses are 
rapidly dispersed by its administration internally as well as externally ; 
and, in internal bruises from shocks or concussions, its internal use has 
proven very efficacious. The aqueous preparation locally promotes the 
rapid union of cut surfaces. 



ARSENUM. I 3 £ 

Internally, besides its value as noted above, Arnica is undoubtedly 
employed in typhus and typhoid fevers as an efficient stimulant and 
antipyretic ; also in delirium tremens, rheumatism and rheumatic gout, 
hemorrhages, epistaxis, haemoptysis, amaurosis, concussion of the brain, 
chronic dysentery, and paralysis of the .bladder, it has rendered good 
service. 

In idiopathic mania, after the first excitement has diminished, Arnica, 
in aqueous preparation internally, has given great satisfaction. It has 
often checked an exhausting diarrhoea after many other remedies have 
failed. 

Trimethylamine is an active escharotic and a gastro-intestinal irritant. It lowers the 
rate and force of the heart, decreases the body-temperature, and diminishes (though 
sometimes increases) the excretion of urea. The Hydrochlorate is a powerful antipyretic 
in doses of gr. ij every 3 hours. It has been found useful in acute rheumatism and gout, 
relieving pain, reducing temperature, and diminishing the frequency of the pulse. In 
chronic rheumatism, as a liniment (1 to 3 of Glycerin), it is said to give relief equal to 
that produced by any anodyne. It has also been used with benefit in chorea, moderat- 
ing the spasmodic movements when not suspending them entirely. 



ARSENUM, Arsenic, As. — The metal Arsenic is not used in 
medicine, but is represented by one of its Oxides, a salt of another Oxide, 
and the Iodide, which are official; together with four preparations of 
these compounds, or of their salts, viz. : — 

Arsenic Compounds and their Preparations. 

Acidum Arsenosum, Arsenous Acid, Arsenic Trioxide, White Arsenic, As 2 3 , — 
is a heavy, white solid, occurring as an opaque powder, or in semi-transparent masses 
having usually a striated appearance, soluble in 30 to 80 of water at 59 F., the solubility 
varying with its physical condition, also soluble in 15 of boiling water, in alkalies and 
their carbonates, hydrochloric acid and in glycerin. It is volatilized at 424.4 F., with- 
out melting, and when thrown on ignited charcoal it emits an alliaceous odor. Arsenous 
Acid is obtained by roasting native arsenides, and condensing the fumes in a long hori- 
zontal chimney. Dose, gr. ^ to -^. 

Liquor Acidi Arsenosi, Solution of Arsenous Acid, — is a I per cent, solution in 
HC1 and Distilled Water. Dose, rtyj-viij, thrice daily in water after meals. 

Liquor Potassii Arsenitis, Solution of Potassium Arsenite, Fowler's Solution, — is 
a 1 per cent, solution, prepared by boiling together Arsenous Acid 1, Potassium Bicar- 
bonate 2, Comp. Tincture of Lavender 3, and Distilled Water to 100. Dose, nVj-viij, 
in water thrice daily after meals. 

Sodii Arsenas, Sodium Arsenate, Na 2 HAs0 4 -f- 7H 2 0, — is a salt of the second 
oxide, Arsenic Acid, As 2 5 . Occurs in colorless prismatic crystals, of feebly alkaline 
taste and a faintly alkaline reaction, soluble in 4 of water at 59 F., very soluble in 
boiling water, hardly soluble in alcohol. Dose, gr. j-^-j ; of the dried salt, gr. aj-yV 

Liquor Sodii Arsenatis, Solution of Sodium Arsenate, Pearson's Solution, — is a I 
per cent, solution of the dried Arsenate in Distilled Water. Dose, TTLij-xv, in water 
after meals. 

Arseni Iodidum, Arsenic Iodide, Asl 3 , — occurs in glossy, orange-red crystalline 
masses or scales, gradually losing iodine by exposure to the air, soluble in 7 of water and 
in 30 of alcohol at 59° F. ; is gradually decomposed by boiling water and t>y boiling alco- 
hol, and is completely volatilized by heat. Dose, gr. -^-\. 

Liquor Arseni et Hydrargyri Iodidi, Solution of Arsenic and Mercuric Iodide, 
Donovan's Solution, — has Arsenic Iodide and Mercuric Iodide, of each I part in loo of 
Distilled Water. Dose, n\ij-viij, in water after meals. 



132 ARSENUM. 

Unofficial Arsenic Compounds. 

Cupri Arsenis, Cupric Arsenile, — occurs in the various cupro-arsenical pigments used 
for wall-paper coloring and as insect-poison, viz. — Scheele's green, Mineral green, Paris 
green, etc. Is highly poisonous. Dose, gr. T ^ daily, in divided doses. 

Liquor Arseni Bromidi, Solution of Arsenic Bromide, Clemens'' Sohition, — so named 
by Dr. Clemens, who described it as a chemical union of Arsenic and Bromine, but the 
action of Bromine on Arsenous Acid results in the formation of Arsenic Acid and Hydro- 
bromic Acid, and the preparation is rather a Liquor Potassii Arsenatis et Bromidi. It 
contains Arsenic equal to 1 per cent, of Arsenous Acid. Dose, rt\J-v, thrice daily in 
water after meals. 

Liquor Arseni et Auri Bromidi, Solution of Arsenic and Gold Bromide, — contains 
gr. gL of each salt in tt\x. It is known by the trade-name "Arsenauro" ', and is highly 
recommended by Dr. Barclay in the scleroses, diabetes, epilepsy, etc. Dose, Tl\v-xv, in 
water, after each meal. 

Physiological Action. 

Arsenous Acid, when applied to the skin denuded of its epidermis, acts 
as a painful escharotic, producing violent inflammation and resulting in 
a slough which forms a barrier to its absorption. If applied in dilute 
solution over a large surface, it will be absorbed, and may produce the 
systemic effects to be described. 

In small doses it is a stomachic and general tonic, promoting the appe- 
tite and digestion, increasing the cardiac action, the respiratory power, 
and the intestinal secretions, — stimulating peristalsis, exalting mental 
activity and the sexual appetite, and producing a fair skin and a rotund 
form. When tolerance of the drug is established, large doses are used 
with impunity, as by the arsenic-eaters of Styria, who can swallow at once 
as much as 5 grains with safety. They are careful, however, not to take 
any water into the stomach at the same time, so that the dose is slowly 
absorbed, and probably eliminated rapidly. Not all those who begin its 
use can acquire tolerance of it, but those who do so seem to continue it 
without injury, and live to an old age, undergoing great exertion without 
exhaustion, and being enabled to ascend steep mountains without diffi- 
culty of respiration. 

In full medicinal doses, continued for some time, it causes itching and 
oedema of the eyelids, ptyalism, nausea and vomiting, diarrhoea or dysen- 
tery, epigastric pain and soreness, feeble and irritable heart, dyspnoea, 
disordered sensibility, herpes zoster, urticaria, eczema and other skin 
eruptions, jaundice and albuminuria. 

In large doses, it is a powerful irritant to the gastro-intestinal and 
bronchial mucous membranes. Toxic doses may produce either symptoms 
of gastro-enteritis, or those of profoundly narcotic character. In the 
first and most usual form of acute arsenical poisoning, there is burning 
pain in the throat and stomach extending over the abdomen, vomiting, 
thirst, bloody stools, strangury, suppressed, albuminous or bloody urine, 
rapid and feeble heart, great anxiety, cold breath, finally exhaustion and 
collapse, — a group of symptoms much resembling cholera. Autopsy 
shows erosions, ecchymoses, and softening of the gastro-intestinal mucous 



.ARSENUM. I33 

membrane, congestion of the lungs and bronchi, and fatty degeneration 
of the liver, kidneys and cardiac muscle. The poison is found in the 
urine, saliva, tears, sweat, etc., and may be detected even in the paren- 
chymatous tissues. In the nervous form of poisoning by Arsenic, pro- 
found coma and insensibility come on suddenly without any gastro- 
intestinal symptoms. 

Arsenical preparations are generally classed as alteratives, but they are 
valuable tonics and antiseptics, and possess antiperiodic powers second 
only to those of Quinine. 

Chronic Arsenical Poisofiing may occur from the inhalation of arsenical 
vapors or dust arising from wall-papers or other substances containing the 
poison. The quantity necessary to produce symptoms of poisoning 
when inhaled seems to be very small. The most prominent symptoms 
are, at first increased appetite, next colicky pains, mucous or dysenteric 
stools, irritation of the eyes, coryza, a short, dry cough, and a white and 
silvery tongue, all accompanied by great bodily prostration. 

The long-continued use of arsenic may induce peripheral neuritis, the 
chief symptoms of which when so caused are — severe darting pains in the 
limbs, paralysis of the muscles of the extremities, especially the extensors 
of the hands and feet, ataxic gait, herpes zoster, and rapid muscular 
atrophy. In several cases it has caused general brown pigmentation of 
the skin, and may give rise to brown pigmentation of psoriasis 
patches. After death from chronic poisoning, in addition to the 
gastro-intestinal and nervous lesions, there is found wide-spread fatty 
degeneration, affecting most of the organs, but particularly the liver, 
kidneys, stomach and muscles, including the heart. 

To avoid arsenical poisoning during a course of the drug, full doses 
(t^ x of Fowler's Solution) should be used at the commencement, and 
always taken on a full stomach. The dose should then be steadily re- 
duced. Susceptible persons often tolerate it better if a few drops of 
Tinctura Opii are administered with each dose. 

Antidotes and Incompatibles. 

Poisoning by Arsenic is treated by prompt evacuation of the stomach, and washing it 
by means.of the stomach pump, then Magnesia, Chalk and Lime-water freely, or better 
still, the chemical antidote to Arsenic in solution, viz., the Hydrated Oxide of Iron, 
freshly precipitated and in a soft magma, in the proportion of gr. viij for each grain of the 
poison ingested. (See Ferri Oxidum Hydratum for the preparation of this antidote.) 
Oil or mucilaginous drinks should be given to protect the mucous membranes, and dilu- 
ents, alkaline mineral waters or Iodide of Potassium to promote elimination. Dialyzed 
Iron has been shown to be quite efficient as an antidote, and is more easily obtained than 
the hydrated oxide. It has rendered good service in many cases of poisoning from 
inhalation of arsenical fumes. 

Incompatibles are salts of Iron, Magnesium and Calcium, also Astringents. 

Therapeutics. 
Externally, Arsenic has been employed in the form of paste as a depila- 
tory, and as an escharotic in cancers, but is excessively painful. Most of 



134 ASAFGETIDA. 

the secret " cancer cures " have arsenous acid for their basis. Internally, 
it is used as a tonic and astringent to the intestinal canal, as a tonic and 
antispasmodic in nervous diseases, and for its action on tissue change. It 
is of especial value in irritative dyspepsia, gastralgia, pyrosis, gastric 
ulcer or cancer, regurgitation of food without nausea, diarrhoea coming 
on immediately after taking food, vomiting of drunkards and chronic 
alcoholism. It has proven of signal service in the commencement of 
phthisis, and in catarrhal pneumonia, probably by causing fatty degen- 
eration of the exudation in the alveolar cavities, thus breaking it up and 
quickening its absorption. It is often very serviceable in chronic bron- 
chitis with copious expectoration, in acute catarrh, hay-fever, whooping- 
cough, asthma, chorea, epilepsy, angina pectoris and other spasmodic 
nervous disorders. In many forms of neuralgia it often gives prompt 
and permanent relief, especially in cases due to malarial poisoning. As 
an antiperiodic, it has high rank, being, however, of particular value in 
chronic malarial poisoning, and as an adjunct to Quinine in the intervals 
between the paroxysms of intermittents. Anaemia and chlorosis are re- 
markably benefited by it, and in rheumatic arthritis and chronic rheuma- 
tism it is sometimes of great service. In chronic scaly and papular skin 
diseases its value is very great, but it is not serviceable in acute forms, 
and the more chronic the cutaneous affection the more likely is it to be 
amenable to Arsenic. Epithelioma may be retarded by small doses long 
continued, and it has certainly been useful in delaying the progress of 
other cancers, particularly scirrhus of the stomach and uterine carcinoma. 
Hypodermically its solutions have been extremely efficient in histrionic 
spasm, local chorea of the head and neck, obstinate cases of general 
chorea, and in lymphadenoma. 

The so-called Bromide of Arsenic, in the form of Clemens' Solution, 
has rendered good service as a remedy for diabetes mellitus of hepatic 
origin. Cupric Arsenite is being highly recommended in typhoid fever. 

* ASAFQETIDA, Asafetida, — a gum-resin obtained by incision 
from the living root of Ferula fcetida, a perennial herb of the nat. ord. 
Umbelliferae, native of Persia and Afghanistan. It occurs in whitish 
tears embedded in a grayish sticky mass, of alliaceous odor and taste, 
soluble in alcohol to at least 60 per cent., and triturated with water it 
yields a milk-white emulsion. Its principal constituent is a Sulphuretted 
Volatile Oil, consisting chiefly of Allyl Sulphide, C 6 H 10 S ; it also contains 
a gum and a resin, with ferulaic, malic, acetic, formic and valerianic 

acids. Dose, gr. v-xx. 

1 Preparations. 

Tinctura Asafcetidae, Tincture of Asafetida, — strength 20 per cent. Dose, gss-ij. 
Emulsum Asafcetidae, Emulsion of Asafetida, Milk of Asafetida, — strength 4 per 
cent, in water. Dose, ^ss-ij. 



ASCLEPIAS. I35 

Pilulae Asafcetidae, Pills of Asafetida, — each pill has gr. iij with gr. j of Soap. Dose, 
j-iv pills. 

Pilulae Aloes et Asafcetidae, Pills of Aloes and Asafetida, — each pill has gr. 1^ of 
each ingredient with the same of Soap. Dose, j-iv pills. 

Mistura Magnesias et Asafcetidae, Mixture of Magnesia and Asafetida, Dewees' 
Carminative (Unofficial), has of Magnesium Carbonate 5, Tinct. Asaf. 7, Tinct. Opii I, 
Sugar 10, Aqua Dest. q. s. ad 100 parts. Dose, ^ss-^ss. 

Spiritus Ammoniae Fcetidus (Unofficial), — Asafetida 1^, Liquor Ammonice Fortior 
2, Spirit 20 parts. Dose, % ss-j. 

Physiological Action. 

Asafetida is a powerful antispasmodic, a stimulant to the brain and 
nervous system, a stimulating expectorant, also tonic, laxative, diuretic, 
diaphoretic, emmenagogue, aphrodisiac and anthelmintic in action. Its 
odor and taste are extremely nauseous and persistent. 

In small doses continued it is said to cause impaired digestion, alliace- 
ous eructations, acrid sensation in the fauces, gastralgia, flatulent disten- 
tion, fetid flatulence, burning urination, diarrhoea and tenesmus. Full 
doses produce various nervous or hysterical phenomena, with nausea, 
vomiting and purging. 

The Volatile Oil diffuses into the blood and tissues, and is excreted in 
the urine, sweat, breath, etc. By its action the circulation is stimulated, 
the arterial tension raised, the power of the cardiac motor ganglia is in- 
creased and the inhibition relaxed. Asafetida also stimulates the brain 
even to pleasant intoxication, and produces a subjective sensation of 
warmth without any rise of body temperature. It stimulates the nervous 
system, the secretions and excretions, the menstrual flow and the sexual 
appetite. In Asia it is used as a condiment with food, and though at 
first it is extremely nauseous to most people, a taste for it may be readily 
acquired. 

Therapeutics. 

The disgust which is generally felt for this remedy makes its use very 
restricted, though a valuable medicine. The Emulsion is extremely ser- 
viceable in the flatulent colic of infants, and as an enema in infantile 
convulsions. There is no better remedy in hysteria and hypochondriasis 
with indigestion and flatulence, — in constipation with amenorrhoea of 
anaemic subjects, due to ovarian and intestinal torpor, — in bronchial 
affections, cough of habit, chronic catarrhs, and flatulent indigestion. It 
has recently been highly praised in the treatment of habitual abortion. 



ASCLEPIAS, Pleurisy Root, — is the root of Asclepias tuberpsa, a plant of the 
nat. ord. Asclepiadaceae and a native of the Eastern and Southern States. Two other 
species of Asclepias are used in medicine and were formerly official. 

Extractum Asclepiadis Fluidum, Fluid Extract of Asclepias, — Dose, gss-j. 

An Infusion or Decoction may be made in the proportion of ^j of the powdered root 
to a quart of water, and given in teacupful doses every 2 or 3 hours. 

Asclepias contains two resins, a peculiar principle, tannic and gallic acids, albumen, 



i 



I36 ASPIDIUM ASPIDOSPERMA. 

pectin, gum, various salts and a volatile, odorous, fatty matter. It is emetic and cathartic 
in full doses, also diaphoretic and expectorant, as well as depressant to the action of the 
heart, and probably slightly sedative and astringent. It is a popular remedy in the 
Southern States for pleurisy (hence its common name), and has been used in medicine for 
catarrh, pneumonia, phthisis, diarrhoea, dysentery, rheumatism, gastralgia, and to promote 
the eruption in exanthematous fevers. It is undoubtedly a powerful diaphoretic. 



ASPIDIUM, — is the rhizome of Dryopteris Filix-mas (Male Fern) 
and of Dryopteris marginalis (Marginal Shield Fern), plants of the nat. 
ord. Filices, the former found in most parts of the world, the latter indi- 
genous to N. America. It is 3 to 6 inches long, thick, scaly, having 
fibro-vascular bundles within, arranged in an interrupted circle; odor 
slight but disagreeable, taste sweetish and bitter, astringent and nauseous. 
The above principle is Filicic Acid, C u H 18 5 , which is extracted in the 
oleoresin. It also contains a green, fatty oil, a volatile oil, resin, tannin, 
etc. Dose, gss-^jss in a single dose fasting, or in divided doses at short 
intervals, followed by a purgative. 

Oleoresina Aspidii, Oleoresin of Aspidium, — is an ethereal extract and deposits 
Filicic Acid on standing. It should be well shaken before being used. Dose, gss-^j, 
in capsules, repeated every 3 hours for 2 or 3 doses. 

Aspidium is an efficient vermicide against tapeworm, particularly the 
unarmed variety (Bothriocephalus latus). The oleoresin is the best form 
in which to use it, the patient having fasted for the previous day, or only 
used a milk diet, 3J may then be given in 4 doses }( hour apart. This 
may be repeated the next morning and followed by three drops of 
croton oil in emulsion. This is one of many methods. Cusso may be 
combined with it advantageously. A formula for a mixed treatment 
by Aspidium, Pomegranate and Pumpkin-seed is given under the title 
Granatum. 



ASPIDOSPERMA, Aspidosperma, Quebracho, — is the bark of 
Aspidosperma Quebracho-bianco, a large evergreen tree of the nat. ord. 
Apocynacese, growing in Chili and the Argentine Republic. The name 
is one given in S. America to any very hard wood {quebrar hacho, to 
break the axe), and the particular tree above named is known as Quebracho- 
bianco, from the white color of its wood. It contains several alkaloids, 
no one of which represents the action of the bark itself; the most 
important being Aspidosper?ni7ie, C 22 H 30 N 2 O 2 , and Quebrachine, C 21 H 2G - 
N 2 3 . Several false Quebrachos are found on the market, that most 
frequently seen being the bark of Loxopterygium Lorentzii, or Quebracho 
Colorado, an Argentine tree of the order Terebinthacese. 

Preparations. 
Extractum Aspidospermatis Fluidum, Fluid Extract of Aspidosperma, — is the 
only official preparation. Dose, rr^v-gj. 



AURANTIUM. 1 37 

Tinctura Quebracho, Tincture of Quebracho (Unofficial), — strength 20 per cent. 
Dose, 3J-iv- 

Vinum Quebracho, Wine of Quebracho (Unofficial). Dose, ^j-^j. 
Extractum Quebracho, Extract of Quebracho (Unofficial). Dose, gr. ij to x. 

Physiological Action and Therapeutics. 

Aspidosperma is a bitter tonic of disagreeable taste, promoting appetite 
and increasing digestion. It lowers the action of the heart, reduces arte- 
rial tension, and slows respiration, also decreasing the sensation of need 
of air after active exercise. In large doses it causes severe salivation, 
nausea, vomiting, vertigo and headache. In animals it paralyzes the motor 
nervous system and lowers the reflexes, producing great dyspncea and 
finally death, apparently from asphyxia. 

This drug has long, been used in Chili as an antiperiodic, a stomachic 
tonic, and a remedy for dyspncea. In the latter condition it is reported 
to be remarkably palliative, especially when due to emphysema, ursemic 
and spasmodic asthma, spasmodic cough and chronic bronchitis. It is 
not efficient in dyspncea from organic diseases of the heart, nor in that of 
aged subjects of atheroma. 

Aspidospermine is actively poisonous to the respiratory apparatus and 
circulation in both cold- and warm-blooded animals, in the former the 
respiration being chiefly affected, in the latter the motor ganglia of the 
heart. Lowered temperature, dyspncea, stupor and convulsions occur 
before death. It has been used as an antipyretic, also in cardiac neuroses 
and in asthma. Its salts are freely soluble in water, but the alkaloid 
itself is only soluble in oils and fats, 6 to 8 parts being readily incorpo- 
rated with 100 of cod-liver oil by the aid of heat. The average dose is 
gr- Hj- 

AURANTIUM, Orange, — occurs in two official varieties of fruit 
and flowers, viz., those of Citrus vulgaris, the Bitter Orange, and Citrus 
Aurantium, the Sweet or Portugal Orange, both trees of the nat. ord. 
Aurantiacese, cultivated in almost all warm climates. Other varieties are 
described under Limon. The official titles are — 

Aurantii Amari Cortex, Bitter Orange Peel, — the rind of the fruit 
of Citrus vulgaris, characteristics well known. Contains a Volatile Oil 
isomeric with Oil of Turpentine, C 10 H 16 , and a bitter, crystalline princi- 
ple, Hesperidin or Auraniiin. 

Aurantii Dulcis Cortex, Sweet Orange Peel, — is the rind of the 
fresh fruit of Citrus Aurantium. It contains a Volatile Oil differing from 
that of the bitter orange, and less of the bitter principle. 

Preparations. 
Extractum Aurantii Amari Fluidum, Fluid Extract of Bitter Orange Peel. — 
Used as flavoring. Dose, gss-j. 



I38 AURUM. 

Tinctura Aurantii Amari, Tincture of Bitter Orange Peel, — strength 20 per cent. 
Dose, 5> j-ij. A flavoring preparation. 

Tinctura Aurantii Dulcis, Tincture of Sweet Orange Peel, — strength 20 per cent. 
Dose, gj-ij. A flavoring preparation. 

Syrupus Aurantii, Syrup of Orange, — Sweet Orange Peel 5, Calcium Phosphate 
Precip. 5, Sugar 70, Alcohol and Water to 100. Dose, gj-ij. Used for flavoring. 

Syrupus Aurantii Florum, Syrup of Orange Flowers, — Sugar 85, Orange-flower 
Water to 100. Dose, 3 j-ij. A delicate flavoring agent, but having to some persons an 
extremely sickish taste. 

Spiritus Aurantii, Spirit of Orange, — Oil of Orange Peel 5, Deodorized Alcohol 
95. Dose, to be regulated by the quantity of alcohol desired. 

Spiritus Aurantii Compositus, Compound Spirit of Orange, — Oil of Orange Peel 
20, Oil of Lemon 5, Oil of Coriander 2, Oil of Anise %, Deodorized Alcohol to 100. 
Dose, as for alcohol. 

Aqua Aurantii Florum Fortior, Stronger Orange-flower Water, — is water saturated 
with • the volatile oil of fresh orange flowers. Dose, indefinite, for flavoring. Used to 
prepare — 

Aqua Aurantii Florum, Orange-flower Water, — consists of equal volumes of the 
preceding and Distilled Water, mixed immediately before use. Dose, indefinite. 

Oleum Aurantii Corticis, Oil of Orange Peel', — a volatile oil, obtained by expres- 
sion from the fresh peel of either orange. Is soluble in about 4 times its volume of 
alcohol, and is an ingredient of the two official Spirits of Orange and also of Spiritus 
Myrcise (Bay Rum). Dose, gtt. j-v. 

Oleum Aurantii Florum, Oil of Orange-flowers, Oil of Neroli, — a volatile oil, dis- 
tilled from the fresh flowers of the bitter orange. Is the most important constituent, of 
Cologne Water (Spiritus Odoratus), and is soluble in an equal volume of Alcohol. Dose, 
gtt. j-v. 

Elixir Aromaticum, Aromatic Elixir {Simple Elixir), — has of the Comp. Spt of 
Orange 1.2, Precipitated Calcium Phosphate 1J4,, Syrup 37^» Deodorized Alcohol and 
Distilled Water to 100. A flavoring vehicle. Dose, gj— Jj, or more. 

Physiological Action and Therapeutics. 
Orange is aromatic and tonic, also more or less bitter, but has little 
action except a mild stimulant influence on the nervous system due to its 
volatile oil. Persons much exposed to its fumes are liable to cutaneous 
eruptions and various nervous disorders. The oil may produce violent 
colic and convulsions in children, one case being reported in which 
death resulted from eating the rind. Its use in medicine is confined to 
flavoring purposes, though the preparations of the Bitter Orange may be 
used as gentle tonics and stimulants to the digestion, but they are usually 
combined with more energetic agents for these purposes. 



AURUM, Gold, Au, — is represented by but one official preparation, 
viz. Gold and Sodium Chloride. The Chloride is found in the shops, 
being much used by photographers ; and triturations of the metal itself 
may be prepared according to the general formula for such preparations. 

Preparations. 

Auri et Sodii Chloridum, Gold and Sodium Chloride, — is a mixture composed of 
equal parts of dry Gold Chloride and Sodium Chloride, AuCl a -f- NaCl. An orange- 
colored powder, soluble in water. Dose, gr. -gVrV 

Auri Chloridum, Gold Chloride (Unofficial), — occurs in needle shaped prisms, of an 
orange-yellow color, deliquescent, freely soluble in water. Dose, gr. ^g-gV Is best 
given in solution. 



AVENA SATIVA AZEDARACH. I 39 

Physiological Action. 
Locally used the Chloride is escharotic ; administered internally ks 
action closely resembles that of Mercuric Chloride. In small doses, it 
promotes appetite and digestion, and stimulates the functions of the 
brain, producing marked mental exhilaration and a general sense of well- 
being. Continued, it produces aphrodisiac effects in both sexes, and in 
women increases the menstrual discharge. Full doses cause nausea and 
vomiting, glandular irritation, salivation without loosening of the teeth or 
sore gums, increased urinary discharge, sweat and fever (the auric fever) ; 
nutrition is impaired and rapid waste set up. A toxic dose produces 
effects similar to those from Corrosive Sublimate, namely, violent gastro- 
enteritis, mental disturbance, priapism, tremor, convulsions and paralysis. 

Antagonists. 
Poisoning is treated by Albumen (eggs or flour), and evacuation of the stomach — just 



as 



in the case of Corrosive Sublimate. 



Therapeutics. 
The Chloride is a useful remedy in irritative dyspepsia, gastro-duodenal 
catarrh, hypochondriasis, amenorrhcea, functional impotence, chronic 
metritis, habitual abortion, ovarian dropsy, vertigo and vertiginous sensa- 
tions from disordered stomach. It is especially recommended in chronic 
albuminuria, hepatic sclerosis, granular and fibroid kidney, as it prevents 
hyperplasia of connective tissue. In syphilis its utility is proven beyond 
doubt, particularly in the tertiary manifestations and syphiloma of the 
bones, in which it is fully as efficacious as Mercuric Chloride, with much 
less inconvenience to the patient. 

AVENA SATIVA, — the common Oat, a plant of the nat. ord. Graminacese, — was 
official in the U. S. P. 1870, as Avence Farina, or Oat-meal. A concentrated tincture or 
fluid extract has been extensively advertised by drug manufacturers as a nerve stimulant 
and tonic, especially efficacious in the treatment of chorea, epilepsy, insomnia, nervous 
exhaustion, alcoholism and the Opium-habit. The seeds contain starch, gluten, gum, 
etc., and form a nutritious food, the meal being made into a porridge, or gruel. In the 
latter form it is a good demulcent for coughs. The pericarp contains an amorphous 
alkaloid, which has doubtless some stimulant and narcotic power ; but the claims 
advanced for it, as a specific remedy for the cure of the opium-habit, have been strenu- 
ously denied by many competent observers. Dose of the concentrated tincture or fluid 
extract may be stated at n^ x- 3 ij. 



AZEDARACH (Unofficial),— is the bark of the root of Melia Azedarach, or Pride 
of China, a handsome tree of the nat. ord. Meliacese, indigenous to China and India, but 
naturalized in the Gulf States. It occurs in curved pieces or quills, which are almost 
inodorous and have a sweetish taste, afterwards becoming bitter and nauseous. A decoc- 
tion of the fresh bark ( !|ij to Oj boiled to 0*4) ma y De used in tablespoonful doses. 

This drug is known to produce symptoms of narcotic poisoning, as giddiness, dimness 
of sight, mental confusion, stertorous breathing, dilated pupils and stupor. Large doses 
are necessary to cause these effects, and some authorities question their occurrence. It is, 
however, a gastro-intestinal irritant, producing vomiting and purging, and also an anthel- 
mintic against the round-worm. Its active principle has not been isolated. It is only 



140 BALSAMUM PERUVIANUM BAPTISIA. 

employed as an anthelmintic against lumbricoid worms, and as the fresh bark is difficult 
to obtain in any region where it does not grow, other agents will be more generally used. 
It is given to horses affected with " bots." 



BALSAMUM PERUVIANUM, Balsam of Peru— is a bal- 
sam obtained from Toluifera Pereirce, a Central American tree, of the 
nat. ord. Leguminosae. Occurs as a thick, brown-black liquid, its odor 
reminding of benzoin and vanilla, soluble in 5 of alcohol, almost insolu- 
ble in water, which only extracts from it some Cinnamic Acid and 
Cinnamein. It is not a true balsam, as it contains no volatile oil. Com- 
position is, — Cinnamein (Benzyl Cinnamate, C 16 H u 2 ) 60 per cent., 
Cinnamic Acid 6 per cent., Resins 30 per cent. ; also Benzoic Acid and 
other bodies. Dose n^ x-xxv, in emulsion. There are no official pre- 
parations. 

Physiological Action and Therapeutics. 

The action of Balsam of Peru is that of its several constituents, 
namely, antiseptic, disinfectant, stimulant to the circulation, and sedative 
to the nervous system ; acting chiefly on the mucous membrane, it is tonic 
and expectorant, diuretic and diaphoretic. In large doses, it causes gas- 
tralgia, nausea and vomiting, colic and diarrhoea. It closely resembles 
in physiological action its congeners, Styrax and Benzoin. 

Balsam of Peru is used locally in chronic skin diseases of inflammatory 
type and sore nipples, to relieve itching, cleanse bed-sores, promote the 
healing of wounds and ulcers, and to kill the acarus scabiei, being con- 
sidered by some authorities the best of all applications in itch. Internally, 
it is used as a stimulant and disinfectant expectorant in chronic bronchitis, 
asthma, etc., as well as in gonorrhoea, gleet, leucorrhoea, and other dis- 
charges from mucous membranes. Incorporated with Iodoform it par- 
tially covers the odor of that drug. 



BALSAMUM TOLUTANUM, Balsam of Tolu,— is a balsam obtained from 
Toluifera Balsamum, a tree of the nat. ord. Leguminosse, native in Venezuela and New 
Granada. Its composition and properties are similar to those of Balsamum Peruvianum, 
except that it is of lighter color, more agreeable odor, and contains a volatile oil, Tolene, 
in the proportion of about I per cent. 

Tinctura Tolutana, Tincture of Tolu, — contains 10 per cent, of the Balsam dis- 
solved in alcohol. Dose, y\ x-xxx. 

Syrupus Tolutanus, Syrup of Tolu, — has of the Balsam I per cent., with Sugar 85, 
in Alcohol 5, and Water to 100. Is much used in cough mixtures, and covers the taste 
of Chloral Hydrate well. Dose, gj-ij. 

Balsam of Tolu has similar action to that of Balsam of Peru, but being more agreeable 
in flavor it is used internally more than the latter. It is chiefly employed as a pleasant 
excipient in cough mixtures, and is a constituent of the Compound Tincture of Benzoin. 



BAPTISIA, Wild Indigo (Unofficial),— is the root bark of Bap- 
tisia tinctoria, a plant of the nat. ord. Leguminosae, native in North 



BARII DIOXIDUM BELLADONNA. I4I 

America, and contains an alkaloid and a resin, neither of which have 
been examined critically. The so-called Baptisin is an impure fesinoid, 
obtained by precipitation from the alcoholic extract with water. 

Preparations. 

Extractum Baptisiae, Extract of Baptisia (Unofficial). — Dose, gr. j-x.. 
Extractum Baptisiae Fluidum, Fluid Extract of Baptisia (Unofficial). Dose, 

n^ij-xx. 
Tinctura Baptisiae, Tincture of Baptisia (Unofficial). Dose, TtLv-xxx. 
Baptisin (Unofficial), — the resinoid. Dose, gr. j-v. 

Baptisia has a bitter and acrid taste ; in small doses it is laxative, in 
large ones violently emeto-cathartic, and may excite severe gastrointesti- 
nal inflammation. It is a decided stimulant of the liver, and increases 
the secretions of the glandular appendages of the gastro-intestinal 
mucous membrane. It has considerable power as an antiseptic. 

Baptisia has been used locally in decoction or cataplasm to obstinate 
and painful ulcers, in threatened or existing gangrene, and gangrenous 
sores. Internally, it is a useful remedy in amenorrhcea, typhoid and 
typhus fevers, variola, scarlatina, and epidemic dysentery. In the common 
continued-fever, or in the first stage of typhoid, it will be found of great 
service in drop-doses of a fresh tincture, repeated every hour. 



BARII DIOXIDUM, Barium Dioxide, Barium Peroxide, Ba0 2 — is the com- 
mercial, anhydrous Barium Dioxide, a heavy, grayish-white, amorphous powder, odorless 
and tasteless : gradually decomposed by exposure to the air, from which it slowly 
attracts moisture and carbon dioxide. Used to prepare the Aqua Hydrogenii Dioxidi 
(Solution of Hydrogen Peroxide). 

Though almost insoluble in cold water, Barium Dioxide forms therewith a definite 
hydrate, and imparts thereto an alkaline reaction. It is decomposed by most of the min- 
eral acids, producing the corresponding barium salts, and liberating Hydrogen Dioxide, 
H 2 2 , which remains in the solution for a considerable length of time, if the reaction has 
taken place in the cold, and if an excess of the acid is present. In this way is prepared 
the official Aqua Hydrogenii Dioxidi (Solution of Hydrogen Peroxide), for which see 
the title Hydrogenii Dioxidum. 



BELLADONNA, Deadly Nightshade.— The Atropa Belladonna 
is an herbaceous, perennial plant, of the nat. ord. Solanaceae, having 
dark-purple, bell-shaped flowers, and glossy, purplish-black berries about 
the size of cherries. It is indigenous in the mountainous districts of 
Central and Southern Europe and Asia, and is cultivated in Europe and 
in the United States. It contains two alkaloids, — the official Atropine 
(see below), and Belladonnine, the latter being considered by many 
authorities as identical with Hyoscyamine, Daturine, and Duboisine. 
These exist in the plant in combination with Malic Acid. The plant also 
contains the usual vegetable constituents, as albumen, gums, etc., and a 
coloring principle named Atrosin. 



142 BELLADONNA. 

The official titles are as follows : — 

Belladonnae Folia, Belladonna Leaves, — ovate and tapering, brown- 
ish green above, grayish-green below, of slight odor and bitter, disagree- 
able taste. Stramonium leaves are more wrinkled, Hyoscyamus leaves 
are more hairy. Dose, gr. j, gradually increased. 

Belladonnae Radix, Belladonna Root, — cylindrical, tapering, 
wrinkled pieces, ^ to 1 inch thick, nearly odorless, taste bitter and 
acrid. Dose, gr. j, cautiously increased. 

Preparations of the Leaves. 

Extractum Belladonnae Foliorum Alcoholicum, Alcoholic Extract of Belladonna 
Leaves. — Dose, gr. J^ to \. 

Tinctura Belladonnae Foliorum, Tincture of Belladonna Leaves, — 15 per cent. 
Dose, rt\j-xxx. 

Emplastrum Belladonnae, Belladonna Plaster, — has of the above extract 20 per 
cent., mixed with Resin and Soap Plasters, of each 40 per cent. May produce the 
physiological action of the drug. 

Unguentum Belladonnae, Belladonna Ointment, — has of the above extract 10, 
Diluted Alcohol 5, Benzoinated Lard 85. 

Preparations of the Root. 

Extractum Belladonnae Radicis Fluidum, Fluid Extract of Belladonna Root. — 
Dose, rr\J-v. 

Linimentum Belladonnae, Belladonna Liniment, — has of Camphor 5, dissolved in 
Fluid Extract of Belladonna Root to 100. 

Atropine and its Derivatives. 

Atropina, Atropine, C 17 H 23 N0 3 , — in white, acicular crystals, odorless, of bitter taste 
and alkaline reaction; very soluble in alcohol and in chloroform, also in 130 of water at 
59 F. Is decomposed by prolonged contact with caustic alkalies and is resolvable into 
Tropin and Tropic Acid. 

Atropinae Sulphas, Atropine Sulphate, (C 17 H 23 N0 3 ) 2 H 2 S0 4 , — a white powder of 
bitter taste and neutral reaction, soluble in 0.4 of water and in 6.2 of alcohol at 59 F. 
Dose, gr. T \^-^. 

Homatropina, Ho7?iatr opine, C 16 H 21 N0 3 (Unofficial), — is a derivative alkaloid ob- 
tained by the action of dilute HC1 on Amygdalate of Tropin. The Hydrobromate is 
used by ophthalmologists as a mydriatic, its effects passing off much sooner than those 
of Atropine. Homatropine slows the heart, Atropine quickening it. 

Tropeius (Unofficial), — is a result of the action of a mineral acid on Tropin. 

Physiological Action. 
Belladonna is an irritant narcotic, a mydriatic, an antispasmodic and 
an anodyne ; in small doses a cardiac, respiratory and spinal stimulant — 
in large doses a paralyzer of the cardiac and respiratory centres, the 
spinal cord, the motor nerves and involuntary muscles. It produces con- 
gestion and dryness of the mucous membrane of the throat, mouth, nose 
and larynx, and at first lessens the gastric and intestinal secretions, but 
soon reproduces these in large quantity. The heart rate is at first slowed, 
but soon becomes very rapid and vigorous, the pulse being doubled in 
rapidity ; the arterial tension being at the same time raised, the circula- 
tion is greatly increased. This is accomplished by stimulation of the 



BELLADONNA. I43 

cardiac sympathetic, and paralysis of the pneumogastric, thus stimulating 
the accelerator apparatus while lessening the inhibitory. [Digitalis in- 
creases both.] The vasomotor ganglia are stimulated all over the body, 
but are afterwards paralyzed by over-stimulation, the heart weakens, the 
vessels relax, and the blood-pressure becomes greatly reduced. Complete 
motor-paralysis follows, delirium, stupor, and finally death, which usually 
occurs by asphyxia. 

The pupils are dilated by either the local or systemic use of the drug, 
it stimulating the end-organs of the sympathetic and paralyzing those of 
the motor oculi, thus increasing the power of the radiating iris fibres and 
lessening the action of its circular ones. Atropine locally also para- 
lyzes accommodation and increases the intraocular pressure. The least 
quantity of Atropine which will affect the pupil is stated at gr. 10 q 00 
(Wood), gr. 20W0 (Roosa), gr. ^^ (Ely), gr. 12& \ 00 (Trousseau), 
g r - 46-tooo ( L o rin g)> g r - tooVoo (Bonders). 

The brain is congested by Belladonna, headache, vertigo, busy delirium, 
hallucinations, etc., being produced, the latter from a selective action on 
the cells of the gray matter. The spinal cord is stimulated from the 3d 
cervical vertebra to the 10th dorsal, resulting in complete motor paraly- 
sis, central and peripheral, power being lost first in the lower extremi- 
ties. Sensation is also impaired somewhat, but the muscular irritability 
is not. Respiration is increased and the body temperature elevated. 
Metamorphosis is greatly promoted by the increased activity of the 
circulation. 

A diffused eruption of scarlet color, greatly resembling the eruption of 
scarlet fever, is often produced on the skin and fauces by Belladonna, 
with dysphagia and sore throat, and is sometimes followed by desquama- 
tion of the epidermis. It is due to capillary congestion caused by the 
greatly increased circulation. 

Belladonna is rapidly diffused and quickly eliminated, particularly by 
the kidneys. The urine of an animal under the action of the drug will 
dilate the pupil of another animal. Herbivorous animals and birds are 
scarcely susceptible to it, and pigeons are not affected by it at all. 

Atropine has the same actions as above described, being the active 
principle of the plant. Belladonnine was long supposed to be inert, 
but has recently been shown to be identical with Hyoscyamine. It is a 
mydriatic when given internally, but not when used locally. 

Antagonists and Incompatibles. 

Opium is the physiological antagonist to the effects of Belladonna on the cerebrum, 
pupil, heart, respiration, arterial tension and kidneys. Physostigmine, Aconite, Pilocar- 
pine and Quinine are each antagonistic to some of its effects, Muscarine, to most of them. 
In poisoning by this drug, Tannic Acid and emetics should be used, then Morphine, 
Physostigmine or Pilocarpine for the nervous disturbance. Caustic alkalies decompose 
Atropine and are therefore incompatible with the preparations of Belladonna. 



144 benzinum. 

Therapeutics. 

Belladonna is one of the most valuable drugs in the Materia Medica, 
ranking with Aconite, Arsenic and Opium in efficacy and wide range 
of use. It is especially useful in the pain of inflammation, particularly 
that of rheumatism, gout, neuralgia due to peripheral disturbance, sciatica, 
cancer and pelvic affections. In cerebral and spinal hyperaemia, conges- 
tive headaches, encephalitis, meningitis and myelitis it proves one of the 
very-best remedies. In erysipelas of superficial and non-vesicular charac- 
ter and when cerebral, it is really curative locally and internally adminis- 
tered. Inflammations of the lungs, iris, bladder, kidneys and breasts are 
all amenable to it. In constipation from atony of the bowels it is re- 
markably efficient, and in the enuresis of children it is equally. so if used 
freely, 10 to 20 drops of the tincture thrice daily. In recent cystitis 
from chill, spasm of the urethra, bladder, and sphincter ani, typhus and 
typhoid fevers, acute nasal catarrh, sore throat with fever, inflammation, 
and swollen tonsils, many skin diseases, asthma and whooping-cough 
epileptic and puerperal convulsions, spermatorrhoea and seminal losses, 
Belladonna is often a highly useful agent. Its local application is effi- 
ciently used in ulcers of the rectum, anal fissure, abscesses, boils, carbun- 
cles, and other superficial inflammations. In scarlet fever it relieves 
many of the symptoms, and is especially indicated in this disease when 
the rash is imperfect, the pulse feeble and the condition one of adynamia. 
Its prophylactic power against scarlet fever is believed in by many of our* 
best practitioners, though questioned by many others. 

Atropine is used in poisoning by Opium, Physostigma, and Hydro- 
cyanic Acid ; in ptyalism from mercury, pregnancy, etc. ; in the sweats 
of phthisis, in sudden cardiac failure, and by eye-surgeons to paralyze 
accommodation, dilate the pupil, contract the vessels, lessen pain, and 
diminish (?) intra-ocular tension. In opium-poisoning it should be given 
in very small doses, and repeated for effect, as most of the unsuccessful 
cases of its use in this connection were due to overdosing with the antag- 
onist, superinducing belladonna-narcosis upon the opium-narcosis. In 
cases of heart-failure from Chloroform or Ether inhalation, the hypoder- 
mic injection of Atropine has, in the writer's hands, saved several lives 
when all other methods of resuscitation had failed. It is highly efficient 
in lead poisoning, if used in combination with Potassium Iodide; and 
has given the most satisfactory results as a haemostatic in profuse metror- 
rhagia after abortion, in metrorrhagia of obscure origin, and in phthisical 
haemoptysis. 



BENZINUM, Benzin, Petroleum Ether, — is a purified distillate from American 
petroleum, consisting of hydrocarbons, chiefly of the marsh-gas series, (C 5 H 12 ,C 6 H U , 
and homologous compounds). It is a transparent, colorless liquid, very diffusive, highly 
inflammable, insoluble in water, soluble in alcohol, ether, chloroform, benzol and fixed 



BENZOLUM — BENZOINUM. 145 

and volatile oils. Its sp. gr. is o 670 to 0.675, an & i ts boiling point 122 to 140 F. 
It should be carefully kept in well-stoppered bottles or tin cans, in a cool place, remote 
from lights or fire. Dose, gtt. v-x, on sugar or in mucilage. 

Benzin is reported to have caused death in one case from gastro- enteritis, but ordinarily 
it does not produce vomiting or diarrhoea. It has been used with some success externally 
as a remedy for rheumatic pain, neuralgia, itch and prurigo; and internally as a vermicide 
against tapeworm. In pharmacy it has many uses on account of its power as a solvent 
for oils, fats, resins, caoutchouc and some alkaloids. In the household it is used as a 
solvent application for removing grease from clothing. 



BENZOLUM, Benzol, Benzene, Phenyl Hydride, C 6 H 6 (Unofficial), — is a constit- 
uent of coal-gas tar, obtained by distilling coal naphtha. It is a thin, colorless, oleagi- 
nous liquid, very inflammable, of agreeable odor, and sp. gr. 0.850. It is very diffusible, 
and the vapor, when inhaled, acts as an anaesthetic. Dose, gtt. v-x, on sugar, in emul- 
sion or capsules, up to ^jss daily. 

Benzol is a reliable pulmonary antiseptic, and has been used successfully in the treat- 
ment of whooping-cough, the vapor being diffused throughout the room, and proximity to 
a light or fire being carefully avoided. It has made quite a reputation in the treatment 
of influenza, and has been found effectual in destroying both head and body lice, for 
which purpose a single application is usually sufficient. It has also been given internally 
for the destruction of trichinae, followed by a brisk laxative; and, mixed with lard, is 
used externally in parasitic skin diseases, especially scabies; also in rheumatism and 
neuralgia. 



BENZOINUM, Benzoin, — is a balsamic resin obtained from 
Styrax Benzoin, a tree of the nat. ord. Styracese, native in Sumatra and 
Siam, by incision of its bark. It occurs in agglutinated tears or a brown, 
mottled mass, is soluble in alcohol and solution of potassa, and is com- 
posed of Resins 80 per cent., Benzoic Acid 10 to 20 per cent., and a 
trace of Volatile Oil. Some varieties of benzoin yield also Cinnamic 
Acid. 

Preparations of Benzoin. 

Adeps Benzoinatus, Benzoinated Lard, — has of Benzoin 2 parts in 100 parts of 
Lard. 

Tinctura Benzoini, Tincture of Benzoin, — has of Benzoin 20 parts, Alcohol 100. 
Dose, gss-j. 

Tinctura Benzoini Composita, Compound Tincture of Benzoin, Friar's Balsam, — 
has of Benzoin 12, Aloes 2, Styrax 8, Balsam of Tolu 4, Alcohol to 100. Dose, ^ss-ij. 

Preparations of Benzoic Acid. 

Acidum Benzoicum, Benzoic Acid, HC 7 H 5 2 , — occurs in light, feathery plates and 
needles, and is obtained from Benzoin by sublimation, or prepared artificially, chiefly 
from Toluol. It is soluble in 500 of water, and in 2 of alcohol at 59 F., but its solu- 
bility in water is aided by Borax, one part of each being soluble in 100 parts. It is a 
constituent of Tinctura Opii Camphorata. Dose, gr. x-x'xv, in wafers. 

Ammonii Benzoas, Ammonium Benzoate, — is soluble in 5 parts of water and in 28 
of alcohol. Dose, gr. v-xxx. 

Lithii Benzoas, Lithium Benzoate, — soluble in 4 parts of water and in 12 of alcohol. 
Dose, gr. v— xxx. 

Sodii Benzoas, Sodium Benzoate, — is efflorescent on exposure to air, soluble in about 
2 parts of water and in 45 of alcohol. Dose, gr. v-gj. 

Physiological Action. 
Benzoin is decidedly antiseptic and disinfectant, and when used exter- 
nally is somewhat stimulant to the vessels. Its action is due to its Ben- 



I46 BERBERIS. 

zoic Acid, which taken internally produces slight epigastric heat, increases 
the pulse-rate, and stimulates the action of the skin, the salivary glands, 
and of the bronchial mucous membrane. It is chiefly excreted by the 
kidneys, in part as hippuric acid by combination with glycocoll, and in 
part unchanged. It renders the urine acid and increases its quantity. 
Benzoin is irritant to the fauces, and the powder inhaled excites sneezing 
and coughing. 

Therapeutics. 

Benzoin is principally used as a stimulant expectorant, especially in 
the chronic bronchitis of the aged, and by atomization in laryngeal affec- 
tions. The compound tincture, gj to % in a pint of boiling water, is a 
useful sedative inhalation for the irritation and cough of subacute laryn- 
gitis and tracheitis. It has also been used beneficially in chlorosis and 
some uterine disorders. The compound tincture is a good local appli- 
cation ( 1 to 4 of glycerin and water) for sore nipples and chaps of the 
hands and lips. For use as a cosmetic, either tincture is mixed with 20 
parts of water, and employed to remove freckles and other skin affections, 
especially urticaria. They are excellent applications to foul-smelling 
wounds, and form the basis of all the proprietary preparations sold for 
that purpose. 

Benzoic Acid and its salts are the only certain means we possess, by 
which to neutralize morbid alkalinity of the urine. In cystitis, with 
phosphatic deposits and alkaline urine, they are extremely valuable, acid- 
ulating the secretion, and stimulating and disinfecting the mucous surfaces 
involved. Phosphatic calculi are said to be dissolved by the long-con- 
tinued use of Ammonium Benzoate. 

Sodium Benzoate has been largely used as a substitute for the salicy- 
lates in the septic diseases, being equally antiseptic and antipyretic. 
Though slower in action, its effects are more permanent, and it is capable 
of being used in larger doses (3'j-iij daily). In diphtheria and scarlet 
fever it has been highly efficient, and in acute rheumatism, typhoid and 
the malarial fevers, it has rendered good service. In phthisis, its use by 
inhalation to the extent of y^Vrr °f tne body-weight daily has seemed to 
be of value in some cases. It has also proven very efficient in whooping- 
cough. 

Lithium Benzoate is intended for use in gout and the uric acid 
diathesis, with the object of forming -the very soluble urate of lithium in 
the system, as also on the theory that, as benzoic acid is converted into 
hippuric acid at the expense of nitrogenous material which would other- 
wise become uric acid, the latter product will be lessened. 

BERBERIS, Barberry (Unofficial), — is the root of several species of the nat. ord. 
Berberidaceas, the one generally used being the Berberis aqtiifolium, or Oregon grape, 
which grows on the Pacific slope of the United States. Its value is probably due to its 



BERGAMOTT.E OLEUM BISMUTHUM. 1 47 

alkaloid, Berberine, C 20 H 17 NO 4 , a yellow, crystalline 'body, soluble in hot water and 
alcohol, but not in ether, which is found also in several other plants, as Hydrastis, Coptis, 
Podophyllum, Menispermum, Calumba, Xanthoxylum, etc. 

Preparations. 

Extractum Berberidis Fluidum, Fluid Extract of Berberis (Unofficial), — Dose, 
rr\,v-xxx. 

Tinctura Berberidis, - Tincture of Berberis (Unofficial), — I to 5. Dose, rr\x- :^j. 

Berberina, Berberine (Unofficial), — Dose, gr. j-x. Usually occurs in commerce as 
" Hydrastin," which is a Berberine Muriate prepared from Hydrastis. 

Physiological Action and Therapeutics. 

Berberis is an astringent bitter, a tonic and stomachic in small doses, but in large doses 
it is cathartic, producing watery diarrhoea with abdominal pain. It is also believed to 
possess considerable alterative powers. It has been successfully used as a local applica- 
tion in conjunctivitis, and internally as a remedy for intermittent, remittent and typhoid 
fevers, diarrhoea and dyspepsia. As an alterative and tonic it is useful in syphilitic and 
strumous affections, and in pain, soreness and burning sensations along the biliary or 
urinary tracts with a tendency to gravel or gall-stones it will be found a useful remedy. 

Berberine has some antiseptic and antiperiodic value, but in large doses is a gastro- 
intestinal irritant. The Muriate is a useful injection in gonorrhoea, in which it acts by 
virtue of its antiseptic and astringent powers. 



BERGAMOTT^E OLEUM, Oil of Bergamot,— is a volatile oil, extracted from 
the rind of the fresh fruit of Citrus Bergamia, an orange-tree of the nat. ord. Aurantia- 
cese, native in Southern Europe. It is of greenish color, faintly acid, sp. gr. 0.88, and 
is soluble in alcohol, glacial acetic acid and liquor potassse. It contains several hydro- 
carbons of the formula C 10 H 16 , together with Bergaptene or Bergamot Camphor. It is 
an ingredient of Spiritus Odoratus, and is exclusively used as a perfume in the manufac- 
ture of toilet articles. 



BISMUTHUM, Bismuth, Bi. — This metal is represented in med- 
icine by four official salts, and several unofficial ones ; — the most import- 
ant of which are the following : — 

Official Salts of Bismuth. 

Bismuthi Citras, Bismuth Citrate, BiC 6 H 5 T , — a white, amorphous powder, odor- 
less and tasteless, insoluble in water or alcohol, soluble in Water of Ammonia. Used 
only for pharmaceutical purposes. 

Bismuthi et Ammonii Citras, Bismuth and Ammonium Citrate, — is a combina- 
tion of the citrate with aqua ammonise, and has no definite chemical composition. Small, 
pearly scales, very soluble in water, sparingly in alcohol. Dose, gr. j-v. 

Bismuthi Subcarbonas, Bismuth Subcarbonate, — a white or yellowish-white pow- 
der, of somewhat varying chemical composition, tasteless and odorless, insoluble in water 
or alcohol. Dose, gr. v— xxx, in powder or emulsion. 

Bismuthi Subnitras, Bis7?iulh Subnitrate, — a heavy, white powder, of somewhat 
varying chemical composition, odorless and almost tasteless, of slightly acid reaction; 
insoluble in alcohol, almost insoluble in water. Dose, gr. v-xxx, several times a day, in 
powder, pill, or milk ; often combined with opium, morphine or belladonna. 

Unofficial Salts of Bismuth. 
Bismuthi Salicylas, Bismuth Salicylate, — exists in two forms, the acid salt and the 
basic salt, the latter being the one used therapeutically. It contains 76 per cent, of the 
oxide of bismuth, and 23 per cent, of salicylic acid ; and occurs as a white, crystalline 
salt, almost entirely insoluble in water, alcohol or glycerin. It should give no reaction 
with perchloride of iron. Dose, gr. v-xx. 



I48 BISMUTHUM. 

Bismuthi Subiodidum (Oxyiodidum), Bismuth Subiodide, — a brick-red, heavy, 
amorphous powder, insoluble in water, insoluble in any reagent without decomposition. 
Used locally as an antiseptic dusting powder, and internally in doses of gr. jss-iij. 

Bismuthi Subgallas, Bismuth Subgallate, "Dermatol", — a fine, odorless, saffron- 
yellow powder, insoluble in all ordinary solvents. Used locally. 

Bismuthi Oleas, Bismuth. Oleate, — a pearly-gray, soft, bland substance. [See under 
Acidum Oleicum, ante, p. 78.] 

* 

Physiological Action and Therapeutics. 

The action of the insoluble Bismuth salts is chiefly a local one, they 
being sedative to the end-organs of the nerves, though a minute quantity 
passes into the blood and acts as a tonic, promoting constructive meta- 
morphosis by increasing the appetite and digestion. They are also 
feebly astringent, and produce constipation after a time, coloring the 
stools and tongue a dark clay color, from their conversion in part into the 
sulphide. Toxic effects when occurring are chiefly due to Arsenic, with 
which the commercial preparations are usually contaminated. 

The Bismuth and Ammonium Citrate being soluble, is more rapid in 
action, more astringent and irritant, though it is probably precipitated in 
the stomach by the hydrochloric acid of the gastric juice. It is service- 
able in diarrhoea without irritation of the intestinal mucous membrane, 
but rather relaxation thereof. 

The insoluble Bismuth salts are used internally in many forms of dis- 
ordered digestion, gastralgia, vomiting and diarrhoea, especially in chil- 
dren, but large doses are necessary for efficiency. The best vehicle for 
them is milk. Locally they are used with advantage in acne rosacea, 
stomatitis, nursing sore mouth, eczema, intertrigo, ulcers, conjunctivitis, 
coryza, gonorrhoea, gleet and leucorrhcea. 

The Subnitrate is regarded by many practitioners as almost a specific 
in cholera infantum, given in hourly doses of 3 to 6 grains : also in the 
diarrhoea of phthisis, in dysentery and intestinal ulceration, it is highly 
efficient, in doses of 15 grains every hour or two. Externally, it is em- 
ployed as a dusting powder, either pure or mixed with starch (1 to 5) ; 
as a drying application for the nasal, pharyngeal and laryngeal mucous 
membranes; in suspension as an injection in gonorrhoea (4 to 10 per 
cent.) : and with vaseline (10 to 15 per cent.) as an ointment in eczema, 
burns and wounds. 

The Salicylate (basic salt) when pure, is well borne by the stomach, 
and can be used for longer periods than the subnitrate. It has been es- 
pecially serviceable in the diarrhoea of phthisis, in that of typhoid fever, 
and in 'chronic gastric and intestinal disorders. It is highly praised as 
an internal antiseptic in dilatation of the stomach, and to prevent ferment- 
ation in the intestinal canal after operations. 

The Oleate is credited with mildly astringent and emo^ient properties, 
having been used with benefit in pustular affections of the skin and in acne. 



BROMUM. I49 

Under the fancy name " Dermatol," the Subgallate was introduced as 
a substitute for Iodoform. It has great stability, as well as valuable 
drying and bactericidal qualities, and is perfectly non-irritant. It is an 
excellent vulnerary for wounds and burns, and has proven useful in the 
treatment of moist eczema, ulcers, and other affections of the eye, dis- 
eases of the middle ear, and dental caries. 

The Subiodide is an exceedingly valuable agent in the treatment of 
burns, wounds, ulcers, and similar affections, as a substitute for Iodoform. 
[See under Iodum.] 

It should not be forgotten that the too free use of Bismuth salts for 
prolonged periods has produced toxic symptoms, similar to those of 
mercury. 



BOLDUS, Boldo (Unofficial), — the leaves and stems of Peumus Boldus, an ever- 
green shrub of the nat. ord. Monimiacese, found in Chili. It contains a volatile oil and 
a bitter alkaloid, Boldine. A tincture is made (1 to 5), of which the dose is TT^ v-viij, 
gradually increased, but large doses have a somewhat narcotic effect, besides causing 
vomiting and purging. 

Boldo is used in anaemia, rheumatism, dyspepsia and general debility, also in catarrhal 
affections of the urinary passages, and as a substitute for Quinine. In France it is 
employed as a tonic, especially for cases with chronic torpor of the liver; and in South 
America it is much used in gonorrhoea and in chronic cystitis. 



BROMUM, Bromine, Br, — is a dark, brownish-red, volatile liquid, 
evolving an irritant vapor of peculiar and suffocating odor. It is soluble 
in 30 of water at 59 F., very soluble in alcohol, ether, chloroform and 
carbon disulphide ; is a non -metallic element found in sea- water, and in 
the mother-liquor of certain salt-works, usually in combination. On 
exposure to air or heat it is completely volatilized. It destroys the color 
of solutions of litmus and indigo, and imparts a yellow color to solution 
of starch. It is only used by inhalation and locally as an escharotic. 

Bromides and their Preparations. 

Potassii Bromidum, Potassium Bromide, KBr, — colorless, cubical crystals, soluble 
in 1.6 of water, and 200 of alcohol. Dose, gr. v-gj. 

Sodii Bromidum, Sodium Bromide, NaBr, — colorless, monoclinic crystals, soluble in 
1.2 of water, and 13 of alcohol. Dose, gr. v-gj. 

Lithii Bromidum, Lithium Bromide, LiBr, — a white, granular, deliquescent salt, 
very soluble in water and alcohol. Dose, gr. v-xx. 

Ammonii Bromidum, Ammonium Bromide, NH 4 Br, — colorless, prismatic crystals, 
soluble in 1.5 of water, and 30 of alcohol. Dose, gr. v— xx. 

Calcii Bromidum, Calcium Bromide, CaBr 2 (Unofficial), — a white, granular, deli- 
quescent salt, very soluble in water and alcohol. Dose, gr. v-^j. 

Strontii Bromidum, Strontium Bromide, SrBr 2 (H 2 0) 6 , — colorless, hexagonal crys- 
tals, very deliquescent, very soluble in water and in alcohol; insoluble in ether. Dose, 
gr. v— xxx. 

Zinci Bromidum, Zinc Bro?nide, ZnBr 2 , — a white, granular, deliquescent powder, 
very soluble in water and alcohol. Dose, gr. ^-ij. 

Arseni Bromidum, Arsenic Bromide, — see under Arsenum, ante, page 132. 



I50 BROMUM. 

Syrupus Ferri Bromidi, Syrup of Iron Bromide (Unofficial), — is a syrupy liquid 
containing 10 per cent, of Ferrous Bromine, FeBr 2 , prepared by acting on Iron Wire 35 
parts wilh Bromine 75, adding Sugar 600 and Water up to 1000 parts. A translucent, 
pale green, odorless liquid of sweet, ferruginous taste and neutral reaction. Dose, g ss-j. 

Bromoformum, Bromoform, Tri-bromo-methane, CHBr 3 , (Unofficial), — is prepared 
by the action of sodium hypobromite on acetone, or by the action of bromine upon a 
solution of equal parts of caustic potash and methyl alcohol. A clear and colorless 
liquid, of pleasant odor and sweet, agreeable taste; slightly soluble in water, readily 
soluble in alcohol, and in glycerin. Dose, TT^ v-xx. If it has color it should be rejected 
as unsafe by reason of decomposition. 

Hydrobromic Acid is described on page 72, Ethyl Bromide on pages 86, 89, and 
Camphora Monobromata under Camphora. 

Physiological Action. 

Bromine is an active and very painful escharotic, a deodorant and an 
antiseptic, setting free ozone. Its vapor is highly irritant to the respira- 
tory mucous membrane and the eyes, producing cough, hoarseness and 
dyspnoea. Internally, it is an active, corrosive poison, causing violent 
gastritis, depression and collapse. 

The Bromides are preeminently depressants of the cerebral and spinal 
functions, also alterative, antispasmodic and hypnotic. The Potassium 
salt is especially a cardiac and muscular paralyzant. 

They have a saline taste, and are very diffusible, but slowly eliminated. 
They are decomposed in the blood, and re-formed at the points of elimi- 
nation (fauces, bronchi, intestines, skin and kidneys), where they irritate 
the mucous membranes. Continued for some time, they produce severe 
gastric catarrh. They reduce the number of the respirations, and the 
heart's action and force; and though diminishing the calibre of the arte- 
rioles, they lower arterial tension. They lessen the activity of the brain 
cells, producing somnolence ; and diminish the sensibility of the periph- 
eral nerves, causing anaesthesia of the skin and mucous membranes. They 
impair motility and the sexual function, cause great pallor and emacia- 
tion, lowered body-temperature, acne on the face and upper extremities, 
fetid breath, dysphagia, sluggish reflexes and defective coordination ; and 
if long continued may even impair the mental faculties, producing hallu- 
cinations in some cases, in others melancholia with suicidal tendency ; 
also incompetence of the sphincters and paralysis, beginning at the 
periphery and extending to the centres. They sometimes cause maniacal 
excitement, as in the case of a physician who committed suicide in a 
frenzy caused by bromidizing himself for sea-sickness. 

The general result of their action is termed "Bromism," and is her- 
alded by the acne and lowered faucial sensibility. It is probably due to 
the sedative influence of these agents on the sympathetic system, causing 
general anaemia of the brain, spinal cord, sexual organs, and skin. 

Several cases of Poisoning by Potassium Bromide have recently been published by 
Dr. Greenless. The first was that of an epileptic who took 75 grains a day for three 
weeks, when stupor, coma, and extreme prostration and death followed. The post mor- 



BROMUM. 151 

tern showed intense congestion of the meninges. In another case, an epileptic, the same 
amount of potassium bromide, 75 grains a day, was given, and in ten days coma and 
death followed. Both the brain and meninges were congested and the kidneys were in 
the advanced stage of cirrhosis. The other cases were less prominent and clearly from 
bromidism which was the result of long use of the drug. In some cases of inebriety 
larger doses of bromides produce stupor and prostration, from which recovery is slow, and 
followed by continued prostration. 

Differences in Action between the Bromides. 

Potassium Bromide is the most toxic to the heart and the muscular system, and is 
the least hypnotic. It contains 66 per cent, of Bromine. 

Sodium Bromide is the least toxic, but the most hypnotic, and acts most energetically 
on the circulation. It contains 78 per cent, of Bromine. 

Ammonium Bromide resembles the Potassium salt in action, except that it exerts less 
influence on the heart and muscular system, and is somewhat more stimulating. 

Lithium Bromide contains the most Bromine, 92 per cent., and resembles the sodium 
salt in action. It has proved better than the others in some cases of epilepsy, and is by 
several authorities considered to be the best hypnotic of the series. 

Calcium Bromide is an efficient hypnotic, but otherwise much less active than the 
other salts. 

Strontium Bromide is said to be less apt than the other bromides to produce the 
bromic acne and the other results of bromism. 

Zinc Bromide, in large doses, is violently irritant. It is supposed to combine the 
tonic effects of zinc with the sedative actions of the bromides. 

Ferrous Bromide is not official. It is supposed to combine the actions of iron and the 
bromides, and to produce the effects of a sedative chalybeate tonic. It is not an eligible 
chalybeate. 

Antagonists and Incompatibles. 

Vaso-motor stimulants, as Digitalis, Ergot, Belladonna, antagonize many of the effects 
of the Bromides, but Morphine is the most efficient antagonist, especially for the mental 
symptoms. Nitrous Ether is incompatible with the Bromide of Ammonium, and Acids 
and metallic salts are so with all the Bromides. 

Therapeutics. 
The Bromides are used as sedatives to the nervous system, to lower 
reflex activity, to produce sleep, to subdue excitement of the genital appa- 
ratus, and to antagonize congestion of the brain. Their use is that of a 
specific in epilepsy, but therein are terribly abused, by patients, nurses, and 
even by physicians, — as Dr. Hammond well elucidates in the last chapter 
of his book on Nervous Diseases. They should not be used in anaemic 
conditions, and never for any length of time without the daily supervis- 
ion of a physician. The combination of Potassium Bromide with Chloral 
is very unsafe in cases where fatty or weak heart exists, both drugs being 
active cardiac depressants. In convulsive and spasmodic affections, the 
bromides are very efficient, and in epilepsy, especially when the seizures 
are diurnal, the sodium salt is used with great advantage over a long 
period, in sufficient quantity to maintain anaesthesia of the fauces. It re- 
quires occasional purgation to prevent its accumulation, and arsenic to 
combat the acne. In diabetes of nervous origin, the ammonium salt, 
long used, has proved curative by its sedative influence on the medulla ; 
and in acute rheumatism it is an excellent alkali. In muscular rheuma- 
tism, rheumatic arthritis and myalgia, also in the uric acid diathesis, and 



152 BRYONIA. 

the various affections due to undeveloped gout, the lithium salt gives 
good results. In tetanus and strychnine-poisoning the potassium salt, in 
large doses, is antagonistic. These agents are generally efficient in ner- 
vous erethism, insomnia with congestion, infantile colic, cholera infantum, 
vomiting of cerebral origin, cardiac irritability when not due to anaemia, 
delirium tremens, melancholia, whooping-cough and other reflex coughs, 
seminal losses when plethora exists, and nymphomania. The potassium 
salt is, by some writers, considered almost specific in subinvolution of the 
womb, and in uterine hemorrhage not due to a mechanical cause. 

Strontium Bromide has been favorably known for some time for its 
beneficial action in gastric affections, particularly in dyspepsia, acetic 
and lactic fermentation, flatulence from decomposition and vomiting of 
various origin, including the vomiting of pregnancy. In severe cases of 
the latter affection it proved entirely successful, administered in doses of 
gr. xv with meals, twice daily for a month. In epilepsy it has been em- 
ployed with advantage, in doses of gr. xx thrice daily, gradually increased : 
and has been used in the treatment of nervous and sick headaches, sea- 
sickness, insomnia, and other conditions for which the bromides are con- 
sidered suitable. It is said to be less 1 productive of the bromic acne than 
are the other bromides in general use. 

The Syrup of Iron Bromide has been reported by some observers as 
very efficient in chorea, and its usefulness therein is as strenuously denied 
by others. 

Bromine is not much used. Its vapor may be inhaled from hot water 
in acute coryza, hay-asthma, etc., and in chancre and hospital gangrene 
it is the best escharotic. In diphtheria and membranous croup, a solution 
of ttl viij to the g, used internally, and inhalation of the vapor, have been 
used successfully in the most severe cases. 

Bromoform is an analogue of Chloroform, and was discovered in 1832 by Lowig. In- 
haled, it produces anaesthesia on animals, but of shorter duration than that of ether or 
chloroform. Deep narcosis has been produced in children by overdoses, taken internally; 
the little patients having been tempted, by the pleasant taste of the medicine, to the 
surreptitious ingestion of more than was prescribed. It has proven of special efficacy in 
whooping-cough, administered in daily doses of 5 to 20 minims, administered in glycerin 
and alcoholic solution. It aborts the paroxysms and reduces their number somewhat, 
but has little influence otherwise on the regular course of the affection. Increasing doses 
must not be pushed very far, for fear of toxic symptoms, and the drug must be abso- 
lutely colorless if pure. 

Inhalations of Bromoform have been used with some success in the treatment of diph- 
theria ; and it has been employed locally with benefit, as a deodorizer, disinfectant and 
analgesic, in ozaena and in tuberculous and other ulcers of the larynx. 



BRYONIA, Bryonia, Bryony, — is the root of Bryonia alba and of 
Bryo?iia dipica, European perennial plants of the nat. ord. Cucurbitaceae. 
It occurs in transverse sections about 2 inches in diameter, having numer- 
ous small wood-bundles arranged in circles and projecting lines in the 



BRYONIA. I 5 3 

central portion, which is white or grayish. Its taste is acrid and bitter, 
but it is inodorous. The active principle is the glucoside Bryonin, 
Q 8 H 80 O 19 , which is intensely bitter, and soluble in water and in alcohol, 
but insoluble in ether. Dose, of powdered root, gr. x-xxs, 

Preparations. 

Tinctura Bryonise, Tincture of Bryonia, — a io per cent, solution of the root in 
alcohol. Dose, Vf\v- ^ ss. 

Bryonin (Unofficial), — is a violent poison in doses of from 3 to 4 grains. Dose, as a 
drastic purgative, gr. ^-^. 

Physiological Action and Therapeutics. 

Bryonia is a»pure irritant, setting up local inflammation wherever ap- 
plied, with febrile phenomena. It has a vesicant action on the skin, and 
is violently irritant to the serous and mucous membranes. Taken inter- 
nally, it has caused fatal gastritis ; introduced into the pleura, fatal 
pleuritis has resulted with fibrinous effusion. It has a specific determina- 
tion to serous and synovial membranes, especially the pleurae, and is also 
irritant to muscular fibre, and to the bronchial mucous membrane, caus- 
ing dry, continuous, shaking cough, with soreness behind the sternum. 
It produces cerebral congestion, with frontal headache, vertigo, and epis- 
taxis; also, hepatic and renal congestion, burning pain and tenderness in 
the hepatic region with bilious disturbance amounting sometimes to severe 
jaundice, vesical tenesmus, and depression of the action of the heart. It 
is a drastic purgative and a powerful diuretic. 

Bryonia is a very old medicine, its most ancient reputation having 
been in epilepsy, hysteria and mania, conditions in which it is now 
superseded by other agents. It is a most valuable drug in the second 
stage of serous inflammations, especially in pleurisy, pleuro-pneumonia, 
and pericarditis, after Aconite has reduced pyrexia, to limit the extent 
of the effusion and to promote its absorption. For this, small doses fre- 
quently repeated are required. Also, in rheumatic fever, after the swell- 
ing of the joints has been reduced by other means, Bryonia is extremely 
efficient for the pain and stiffness. It is one of the best remedies for a 
"cold-on-the-chest," with dry, shaking cough, soreness, or shooting 
pains. It has been used with success in common, continued, or "gas- 
tric" fever, relapsing fever, congestive headaches increased by stooping, 
bilious headache with vomiting, gastralgia with pyrosis and soreness of 
the epigastrium, constipation, cholera infantum during dry, hot weather, 
congestion of the liver, croup, and threatened mammitis. Pains of shoot- 
ing or tearing character, which are increased by movement, are often 
quickly relieved by this drug. In dropsies of various forms it is used as a 
drastic purgative and diuretic to remove the accumulated fluid. 



154 BUCHU — CADMIUM CAFFEA. 

BUCHU, Buchu, — is the leaves of Barosma betulina, B. crenulata, 
and B. serralifolia, S. African shrubs, of the nat. ord. Rutacese, each 
species having differently shaped leaves, but all having crenated or ser- 
rated margins^ and conspicuous oil-glands at the edges and on their under 
surface. They contain a Volatile Oil, which is probably the active prin- 
ciple, and gives them a peculiar and penetrating odor, resembling that of 
peppermint ; also, Barosmin, a bitter extractive, and resin, gum, lignin, 
etc. Dose, of the leaves, gr. xv-xxx. 

Preparations. 
Extractum Buchu Fluidum, Fluid Extract of Buchu. — Dose, TT^x-gj. 
Infusum Buchu, Infusion of Buchu (Unofficial), — ^j to the pint. Dose, ^ss-ij. 

Physiological Action and Therapeutics. 

Buchu in small doses causes a sense of heat in the stomach, which is 
gradually diffused over the body. It increases the pulse-rate, stimulates 
the appetite, and produces slight moisture of the skin. It increases the 
flow of urine, which becomes of darker color and strongly aromatic odor, 
and deposits a brownish sediment. In large doses it produces vomiting, 
purging, and strangury, with a burning sensation at the stomach. 

Buchu is of especial value in chronic affections of the genito-urinary 
mucous membrane, on which the volatile oil acts topically, being elimi- 
nated by the kidneys. It is a very useful remedy in pyelitis, cystitis, and 
urethritis; also, in lithiasis, chronic bronchitis, and affections of the 
prostate gland. It is recommended in atonic dyspepsia, chronic rheuma- 
tism, affections of the skin, and for dropsy, but it is not so actively 
diuretic as to be very efficient in the latter condition. 

The Infusion makes an excellent* vehicle for saline diuretics. 



CADMIUM, Cd (Unofficial). — This metal' was official in the Pharmacopoeia of 1870, 
but is no longer so. In its physiological action it resembles both Antimony and Zinc, 
being escharotic, astringent, and a very depressant emetic. In over-doses, its salts act as 
irritant poisons, with cerebro- spinal symptoms, such as coma and convulsions. It is never 
used internally. Its salts in general use are — 

Cadmii Sulphas, Cadmiuvi Sulphate, (Unofficial), — transparent oblique prisms, efflor- 
escent, and very soluble in water. Used externally in a solution of gr. ss-iv ad ^j aq. 
destil., or as an ointment (1 to 40 of fresh lard). 

Cadmii Iodidum, Cadmium Iodide, (Unofficial), — large, white, pearly crystals, soluble 
in water and alcohol. Used as an ointment, I to 8 of lard. 

The Sulphate has been used almost exclusively as a stimulating astringent in gonor- 
rhoea and diseases of the eye. Corneal opacities are absorbed under the use of a solu- 
tion of gr. ij to the ^ , and in gonorrhoea a mild injection (gr. % ad ^j) is very benefi- 
cial. An ointment of the Iodide has been usefully employed for enlarged glands, 
chronic joint affections, cutaneous diseases, nodes and chilblains. 



CAFFEA, Coffee, the seed of Coffea Arabica, is officially repre- 
sented only by its active principle, Caffeine. The coffee-plant is a small 
tree of the nat. ord. Rubiacese, 15 to 30 feet high, native of South Arabia 



9 CAFFEA. 155 

and Abyssinia, but cultivated in various parts of the world. Its seeds 
contain Caffeine (partly free, partly as a tannate), tannic and caffeic 
acids, sugar, legumin, etc. By roasting them, part of the caffeic acid is 
converted into methylamin, the sugar is changed into caramel, and several 
volatile substances are formed, which give to coffee its peculiar aroma and 
some of its stimulant qualities, and are collectively known as Caffeone, 
one of them being called Caffeol. 

Caffeina, Caffeine, {Theine), C 8 H 10 N 4 O 2 +H 2 O. The U. S. Phar. 
1890 defines Caffeine (Theine) as a feebly basic, proximate principle, 
obtained from the dry leaves of Thea Sinensis, or from the dried seeds of 
Coffea Arabica, and found also in other plants. In the Phar. 1880, 
Guarana was included by name among its sources. Therefore, the prin- 
ciples named Caffeine and Theine are now officially declared to be iden- 
tical, and their identity with Guaranine is left unsettled. That all three 
are identical was the general opinion until recently, their composition 
being expressed by the formula C 8 H 10 N 4 O 2 , 'and the physiological action 
of one being accepted for the others. Some investigators, however, 
doubt the identity of the first two, and some observers maintain that 
Guaranine also is a separate body, distinct from either of the others. The 
Caffeine of commerce is usually obtained from old tea leaves, and is in 
reality Theine. , It contains more nitrogen than almost any other proxi- 
mate vegetable principle. It occurs in colorless, flexible crystals, which 
are soluble in 80 of water and $$ of alcohol at 59 F. Dose, gr. j-v. 

Theine is contained in the leaves of Thea Sinensis, the tea-plant, a native of China 
and Japan, and a member* of the nat. ord. Ternstromiaceae. The tea -plant also contains 
tannic acid, and a volatile oil, the latter being most abundant in green teas. Theine is 
found on the market, that of Merck being considered to be the most reliable. Its solu- 
bility in water is much increased by adding an equal part of Sodium Benzoate, say gj 
of each to the fluid ^ , with gr. x of Sodium Chloride. Of this, TT^vj equals gr. ]/ 2 of 
Theine. Dose, gr. i-j, hypodermically, several times a day, for relief of pain. 

Preparations. 

Caffeina Citrata, Citrated Caffeine, — is a very uncertain mixture, and is not considered 
to be a definite compound. It is prepared by dissolving equal weights of Caffeine and 
Citric Acid in double the quantity of hot distilled water, evaporating the solution to dry- 
ness, and powdering the product, which is white, odorless, of acid taste and acid reaction, 
soluble in about 3 parts of water, precipitated as Caffeine on further dilution with water, 
and redissolved with about 25 parts of water. Dose, gr. ij-x. 

Caffeina Citrata Effervescens, Effervescent Citrated Caffeine, — composed of Caf- 
feine 1, Citric Acid 1, Sodium Bicarbonate 33, Tartaric Acid 30, Sugar 35, triturated, 
mixed with Alcohol to a paste, dried, and powdered. Dose, 2>j-ij, in a glassful of water, 
as an effervescing drink. 

Extractum Caffese Viridis Fluidum (Squibb), Fluid Extract of Green Coffee (Un- 
official), — is intended as a substitute for the fluid Extract of Guarana. Dose, 3 ss— ij. 
[Compare the title Guarana.'] 

Physiological Action. 
Coffee is a cerebro-spinal stimulant, a stomachic tonic, and a laxative. 
It is decidedly diuretic, and is somewhat antiperiodic and highly anti- 



156 CAFFEA. % 

septic. The green bean produces very different effects from those of the 
roasted one, exhibiting the action of Caffeine alone, unmodified by that 
of the empyreumatic products. A tincture of green coffee, besides being 
an efficient diuretic, has marked anti-lithic powers, and promotes the 
elimination of the poison of gout from the system. 

As a beverage, if used with moderation Coffee assists digestion, promotes 
intestinal peristalsis, allays the senses of fatigue and hunger, lessens 
tissue- waste and consequently decreases the formation and excretion of 
urea (?). Used to excess it disorders digestion,- and causes functional 
disturbances of the nervous system, shown by headache, vertigo, mental 
confusion, and palpitation of the heart. 

It increases secretion, blunts sensation, exalts reflex excitability, in- 
creases mental activity, and may produce insomnia and great nervous 
restlessness. It first briefly stimulates the heart and raises arterial tension, 
but soon depresses both. The wakefulness is usually preceded by a brief 
period of drowsiness. 

The brief stimulation of the intellect, consequent on drinking a cup of 
good coffee, cannot be obtained from an infusion of raw coffee, and is 
probably due to the volatile constituents developed in roasting. Caffeone 
opposes Caffeine in its action on the circulation, as it quickens the pulse 
and lowers arterial tension. Its action, however, is of brief duration, and 
soon gives way to the influence of the principal constituent. The Tannin 
is the ingredient which enables it to produce dyspepsia, and is most abun- 
dant in those infusions which are kept a long time on the stove before 
being served. 

The Common Stimulant Beverages Compared. 
The qualities possessed in common by these substances* and for which 
they are so universally esteemed by mankind, are three-fold. They all 
(1) retard the retrograde metamorphosis of the body-tissues (tissue- 
waste), — thereby enabling the work of the individual to be done upon a 
smaller supply of reparative material (food), and with less fatigue. 
Furthermore, when used in moderation, they are all (2) more or less stimu- 
lating to the mental processes, and (3) sedative to the nervous system. 

This similarity of action they owe to the possession of .principles, which, if not iden- 
tical, are so closely related to each other that until very recently they have been so con- 
sidered both by chemists and pharmacologists. Their divergence from each other, in the 
finer shades of their action, depends most probably on the existence in each of differing 
aromatic and volatile principles, which modify the action of the alkaloid in some degree. 
Similar principles are developed in them by the various processes of preparation (as 
roasting, drying, etc.), all of which have 1 some part in determining the general action of 
the beverage containing them. 

Coffee is more stimulating than Coca, and less sustaining. It is apt 
to cause severe palpitations of the heart ; and may disorder digestion, if 



CAFFEA. I57 

long stewed. The Coffee-bean contains only 0.2 to 0.8 per cent, of 
Caffeine. 

Tea (Thea Sinensis) is the most refreshing and stimulating member of 
the group. Used to excess, it powerfully affects the stability of the motor 
and the vaso-motor nerves, the action of the heart, and the digestive 
function, — producing flatulent dyspepsia, tremulousness of the limbs, 
pallor of the surface, irregular cardiac action, and feeble impulse, hallu- 
cinations, night-mare, anorexia, headache, nausea and vomiting, obstinate 
neuralgias — especially of the supra-orbital and occipital nerves ; also con- 
stipation, and a pain in the left side are not infrequent. The condition 
of chronic tea-poisoning is termed "Theism," — and is very often seen 
among women of the lower class in cities, who do not indulge in alcoholic 
beverages, but freely accept the dominion of the "cup that cheers " and 
worse than inebriates. 

Mate (I/ex Paraguay ensis, Paraguay tea), is supposed to be inter- 
mediate in its effects between tea and coffee. It also contains Caffeine, 
in the proportion of 1.2 per cent. 

Guarana (Paullinia Cupana of Brazil), contains an alkaloid — Guara- 
m'ne, in the proportion of 5 per cent., which is probably identical with 
Caffeine, though some think it more analogous to Theine. It is especially 
noted for relieving a nervous headache, for which purpose the official fluid 
extract may be used in doses of r^xx, three or four times daily, when the 
basis of that preparation happens to be of good quality. 

Coca, or Cuca (Erythroxylon Coca), is more sustaining and less of a 
direct stimulant, than either tea or coffee. The proportion of Cocaine in 
the leaves varies greatly in different samples, as they occur in commerce. 

Cocoa ( Theobrbma Cacao, the Chocolate-tree), is more directly nutri- 
tious than any of the group, containing a large quantity of fat, Oleum 
Theobromatis (cacao-butter), which makes it difficult of digestion to many 
persons. Its alkaloid, Theobromine, is closely allied to Caffeine, the latter 
being considered a Methyl-theobromine. The various preparations of 
this agent are made from the seeds, after the oil has been expressed from 
them. They are ground in a mill, mixed with rice, barley, sugar, flour, 
etc., and put up in powdered form, called Cocoa, — but if flavored with 
vanilla and pressed into a cake, the product is Chocolate. The thin husks 
which envelope the seeds are known as "Shells," and are used to make a 
beverage similar to but milder than cocoa or chocolate. 

Physiological Action of Caffeine, Theine, etc. 

Caffeine is in general terms a stimulant at first, and subsequently a 

paralyzant, to the nerve-centres in the cerebrum, medulla and cord. In 

small doses it quickens the action of the heart and raises arterial tension; 

stimulates the cerebral functions, by increasing the supply of blood to the 



I58 CAFFEA. 

brain ; increases the respiration rate and the secretion of urine. Larger 
doses (gr. v-viij), often over-stimulate the cerebral circulation, causing 
thereby great heaviness of the head, flashes of light before the eyes, 
tinnitus aurium, insomnia, restlessness, and even delirium, — the pulse 
becoming rapid, feeble, irregular and intermittent, and the general body- 
temperature elevated, though that of the periphery may be lowered. 
Large doses depress the heart and respiration, and lower the blood-pres- 
sure ; — in the smaller animals exalting the reflex excitability of the cord 
and producing tetanic convulsions ; — and in lethal doses paralyzing the 
cardiac muscle as well as its motor ganglia, but causing death by paralysis 
of respiration. It powerfully affects muscular fibre, both voluntary and 
involuntary kinds, throwing it into a state of tetanic contraction resem- 
bling rigor mortis. If administered in sufficient quantity it would doubt- 
less prove fatal to man, — but its lethal dose for him would be very large. 
Caffeine is excreted unchanged in the bile and urine, and is a reliable 
hydragogue diuretic ; acting by stimulation of the secreting apparatus in 
the kidney, as well as by generally raising the arterial tension. (Brunton.) 

Theine, upon the smaller animals, agrees in most respects with Caf- 
feine, except that it requires much larger doses to produce the same effects. 
It differs, however, in some important particulars. Theine chiefly affects 
the sensory, Caffeine the motor system. Theine causes spasms and con- 
vulsions, and impairs the nasal reflex, early in the course of the poisoning 
process ; — while Caffeine does so late, if at all. Theine decreases the 
body-temperature, — Caffeine increases it. Theine causes convulsions in 
frogs, a power now denied to Caffeine, though hitherto ascribed to it. 
Both alkaloids tend to produce muscular contraction, but Theine causes 
a peculiar rhythmical contraction in voluntary muscles, which lasts for 
several hours, and seems to act transversely across the fibre, as the 
muscle is elongated at each contraction. In man, the principal action of 
the hypodermic injection of Theine is the production of a profound local 
anaesthesia at and below the point of injection, — acting therefore outwards 
along the nerve-trunk, and not towards the centre. It does not affect the 
motor apparatus, nor does it seem to produce narcosis. 

Guaranine is generally considered as identical with Caffeine, though 
some few observers find in its action a closer analogy to Theine. It affects 
both sensory and motor nerves, the sensory first, paralyzing them from 
the centres outwards. \_Cocaine and Brucine act from the periphery 
inwards.] It causes general hypersesthesia, and subsequently convulsions 
of spinal origin, — at first increases and afterwards depresses respiration 
and the action of the heart. It seems to have a stronger affinity for 
the sensory than for the motor nerves, and hence resembles Theine more 
than Caffeine. 

Theobromine has the formula C 7 H 8 N 4 2 , and is closely allied to 



CAFFEA. I59 

Caffeine, physiologically and chemically. In fact, Caffeine may be con- 
sidered a Methyl-theobromine, C 7 H 9 (CH 3 )N 4 2 . During roasting the 
cocoa-bean develops an aromatic principle which gives to chocolate its 
peculiar flavor. In large doses Theobromine is fatal to small animals. 

Sodio-Theobromine Salicylate, Diuretin, (Unofficial), — was introduced under the 
latter title as a proprietary preparation. It occurs as a colorless powder, of sweetish, 
saline and alkaline taste, soluble in ^ its weight of water, and should contain 46^ per 
cent, of Theobromine. Being a very unstable compound, it should not be prescribed in 
combination with other drugs, and when dispensed it should be well sealed from contact 
with the air, from which it rapidly absorbs carbonic acid, thereby undergoing decomposi- 
tion. If ordered under its chemical name, and insisted on,, the cost should be less than 
y z that of the same article under its proprietary title. (Squibb). Dose, gr. x-xv, in 
powder or aqueous solution, several times a day, as a diuretic. 

Diuretin was introduced as a soluble preparation of Theobromine, of value for its 
prompt diuretic action, influencing the kidneys without causing serious or dangerous 
results upon the heart, the action of which, however, it strengthens and regulates. Given 
to healthy persons it does not increase the quantity of the urine, but during its adminis- 
tration in morbid conditions of the renal or cardiac apparatus the volume of urine 
excreted daily increases three and four-fold, and exudations of non-inflammatory charac- 
ter are rapidly absorbed. It may give rise to slight diarrhoea, and the author has found 
the body-temperature uniformly subnormal in non-febrile patients while under its influ- 
ence. 

Diuretin has been employed with marked benefit in both cardiac and renal dropsy, 
in hepatic cirrhosis, and in various diseases of the heart and kidneys accompanied by 
oedema. The author has seen a large pleuritic effusion disappear rapidly under its use, 
the fluid having re-accumulated after having been once removed by tapping the pleural 
cavity. It should be administered in aqueous solution, avoiding acids or acid vegetable 
juices, which are chemically incompatible, as they precipitate the alkaloid in the form of 
a thick white sediment. 

Therapeutics. 

Although without a very extensive range of usefulness, Caffeine is a 
valuable stimulant in many forms of nervous and cardiac depression, and 
has proved especially efficacious in headaches of neuralgic or nervous 
type, the pain being general over the head ; gr. j of Caffeine every half 
hour, or the fluid extract of Guarana, in 20-minim doses every 2 or 3 
hours. In choleraic diarrhoea, and that of phthisis, it checks outward 
osmosis by stimulating the depressed nervous apparatus. In dropsy, car- 
diac and renal, Caffeine is a diuretic and cardiac stimulant. In cervico- 
brachial neuralgia, Caffeine may be used hypodermically in doses of gr. j, 
increased to gr. v. In lithsemia and gout, a tincture of the green bean 
has marked diuretic and antispasmodic powers, and is very useful in these 
conditions. In the insomnia of chronic alcoholism, gr. y 2 of Caffeine 
hypodermically, is often efficient. For adynamic fevers, it may well be 
used in place of alcoholic stimulants. In intermittents, Coffee has a cur- 
ative reputation among the inhabitants of the Philippines, which is corrob- 
orated by the Dutch physicians. In asthma, Coffee is valuable for the 
paroxysm if not used habitually. In opium narcosis, Caffeine hypoder- 
mically, or better still, strong black coffee by the mouth, to antagonize 
the increasing torpor of the nervous centres. 

Theine is a valuable analgesic, especially so by reason of its prolonged 



l6o CAJUPUTI OLEUM CALAMUS CALCIUM. 

influence over sensation. Its great field of employment is in neuralgia of 
any kind, cervico-brachial, sciatic, etc., in which doses of gr. yfc to gr. % 
hypodermically are efficient, and may be kept up as long as required. 
To make a cure, however, the nutrition of the nerves must be attended to. 
In locomotor ataxia, lumbago, etc., it has been used with prompt benefit, 
in the same manner, promptly relieving pain, without producing any 
narcotic effect. (Mays.) 



CAJUPUTI OLEUM, Oil of Cajuput,— is a volatile oil distilled from the leaves 
of Melaleuca Leucadendron, a tree of the nat. ord. Myrtaceas, native of the Molucca 
Islands. It is a bluish-green or colorless liquid, of camphoraceous odor, and neutral 
reaction. Specific gravity 0.922 to 0.929, freely soluble in alcohol. It contains Cajupu- 
tol or Bihydrate of Cajuputene, which forms % of it, the other ^ being another oil. 
Dose, Tr\J-v. 

Cajuput Oil resembles Oil of Turpentine, and has similar action to that of the other 
volatile oils, being a stimulant carminative, somewhat diuretic and diaphoretic, antiseptic, 
parasiticide and anthelmintic. Externally used, it is irritant to the skin. Swallowed, it 
produces a sense of warmth in the stomach and accelerates the pulse. 

It is not much used internally, though it has been given with benefit in flatulent colic, 
dropsy, hysteria, chronic rheumatism, scrofula, and syphilis, also in elephantiasis and 
other cutaneous disorders. Externally, as a strong, stimulating rubefacient, it is efficient 
in chilblains, muscular rheumatism and nervous headaches. 



CALAMUS, Sweet Flag, — is the rhizome of Acorus Calamus, a plant of the nat. ord. 
Aracese, native in Europe and North America, having an aromatic odor and pungent 
taste. The unpeeled root should only be used, peeled or bleached calmus being almost 
inert. It contains a volatile oil and Acorin, which is a nitrogenous, bitter principle, also 
benzoic acid, starch, etc. Dose, indefinite. 

Extractum Calami Fluidum, Fluid Extract of Calamus, — is made with Alcohol as 
a menstruum. Dose, n\, xv-g j. 

Calamus is an aromatic bitter, and stomachic tonic, increasing the appetite and stimu- 
lating digestion. It is one of the constituents of the preparations termed "bitters," 
and is chewed as an appetizer. 



CALCIUM, Ca, — is the metal characteristic of Lime, Chalk, and all 
calcareous substances, and though itself unofficial is represented by several 
official salts and preparations. 

Official Sails of Calcium. 

Calcii Carbonas Praecipitatus, Precipitated Calciu?n Carbonate, CaC0 3 , — a fine im- 
palpable, white powder, odorless and tasteless, insoluble in water or alcohol, but soluble 
in mineral acids or acetic acid with effervescence. Creta (chalk) is native Calcium Car- 
bonate. (See below). Dose, gr. v-xx. 

Calx, Lime, Calcium Oxide, CaO, — is Lime prepared by burning white marble, oyster- 
shells, or the purest varieties of native Calcium Carbonate. Occurs in hard, white 
masses, gradually resolving to a white powder in the air, odorless, of sharp caustic taste 
and alkaline reaction, soluble in 750 "of water and 1300 of boiling water, insoluble in 
alcohol. Not used internally except in solution. Is a constituent of Potassa cum Calce. 
(See under Potassium.) 

Calcii Chloridum, Calcium Chloride, CaCl 2 , — hard, colorless masses, deliquescent, 
of sharp, saline taste, soluble in 1^ of water and 8 of alcohol at 59 F. Dose, gr. x-xx 
in solution. 

Calcii Sulphas Exsiccatus, Dried Calcium Sulphate, Dried Gypsum, — contains 
about 5 per cent, of water. A fine, white powder, without odor or taste, insoluble in 






CALCIUM. l6l 

alcohol, soluble in 410 of water at 59 F., in 388 of water at ioo° F., and in 476 of water 
at 212° F. Used in the preparation of Calx Sulphurata. 

Calcii Sulphidum, Calcium Sulphide, and Calx Sulphurata, Sulphurated Lime, — 
are described under Sulphur; Calcii Bromidum, Calcium Bromide, under Bromum; 
Calcii Hypophosphis, Calcium Hypophosphile, and Calcii Phosphas Praecipitatus, 
Precipitated Calcium Phosphate, under Phosphorus. 

Preparations of the Carbonate. 

Creta Preparata, Prepared Chalk, CaC0 3 , — is native Calcium Carbonate, freed from 
most of its impurities by elutriation; a white, amorphous powder, odorless and tasteless, 
insoluble in water or alcohol. Dose, gr. v-xx. Is a constituent of Hydrargyrum cum 
Creta, and also of the following: 

Pulvis Cretae Compositus, Compound Chalk Powder, — has of Prepared Chalk 30, 
Acacia 20, Sugar 50 parts. Dose, gr. v-sjj. 

Mistura Cretae, Chalk Mixture, — has of the preceding 20 parts, Cinnamon Water 40, 
Water to 100, rubbed together and made fresh as required. Dose, J ss. 

Trochisci Cretae, Troches of Chalk, — each contains of Prepared Chalk 4 grains, 
Acacia I, Sugar 6, with a little Nutmeg. Dose, indefinite. 

Testa Preparata, Prepared Oyster-shell (Unofficial), — contains animal matter inti- 
mately mixed with the carbonate of calcium. Dose, gr. x-xx or more. 

Preparations of the Oxide. 

Liquor Calcis, Solution of Lime, Lime-water, — contains about 0.17 per cent, of Cal- 
cium Hydrate, Ca(HO) 2 . A clear, colorless liquid, of saline taste and alkaline reaction. 
Dose, ^ ss— ij . 

Syrupus Calcis, Syrup of Lime {Saccharated Solution of Lime), — contains b% per 
cent, of Lime, and 40 of Sugar, the latter aiding the solvent power. Dose, ^ss-ij. Is 
the antidote to poisoning by Carbolic or Oxalic Acid. 

Linimentum Calcis, Lime Liniment, Carron Oil, — contains equal volumes of Lime- 
water and Linseed Oil, mixed by agitation. For local use. 

Calx Chlorata, Chlorinated Lime, is described under Chlorum; Potassa cum 
Calce, Potassa with LJme, under Potassium. 

Preparations of the Phosphate and Hypophosphite. 
Syrupus Calcii Lactophosphatis, Syrup of Calcium Lactophos- "] 



phale, 

Syrupus Hypophosphitum, Syrup of Hypophosphites, 
Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites 

with Lron, 



under 
Phosphorus. 



Physiological Action. 

Lime before it assumes the condition of Hydrate is irritant and caustic, 
and if inhaled or swallowed may produce dangerous inflammation. The 
preparations of Lime and Chalk are feebly alkaline and astringent; they 
neutralize the acid of the gastric juice and are sedative to the mucous 
membrane of the stomach. A small quantity of the oxide passes into 
the blood and promotes constructive metamorphosis, — but if used in 
large quantity or for a long time it will act in the opposite manner, pro- 
ducing waste. 

Calcium Chloride is a gastro-intestinal irritant, very diffusible and 
remarkably alterative, being apparently a powerful antagonist to the 
strumous diathesis. 

The action of the other salts of Calcium is described under the titles 

of their respective bases. 
11 






1 62 . CALENDULA. 

Antagonists and Incompatibles. 

The preparations of Lime and Chalk are incompatible with acids and metallic salts. 
In poisoning by Lime the antidote is a dilute Vegetable Acid, followed by demulcents or 
the fixed oils to protect the mucous membrane. 

Therapeutics. 

Lime may be used as a caustic and depilatory, but is better known as 
an agent for hastening decomposition, which it does by its affinity for 
water, the resulting Hydrate absorbing many of the products. Chlor- 
inated Lime is an excellent antiseptic and disinfectant, but as it owes its 
energy entirely to its chlorine it will be described under that title. Lime- 
water is a favorite remedy for vomiting, especially in children, and is 
added to milk to increase its digestibility. It is also efficient for acid 
dyspepsia and mucous enteritis, as an antacid and astringent. Locally it 
is usefully employed as an enema against thread-worms, as a lotion in many 
mucous and purulent discharges, and in aphthae. The vapor of slaking 
lime or lime-water as spray are often very serviceable inhalations in diph- 
theria. Syrup of Lime contains more lime in solution than lime-water, 
and may be used instead of the latter where a diluent is not advisable. 
It is the antidote for poisoning by Carbolic or Oxalic Acid, while lime in 
any form (as wall-plaster) is a valuable antidote for poisoning by any 
mineral acid. 

Chalk-mixture is used in the diarrhoeas of children with sour-smelling, 
watery stools; and may be conveniently prescribed in combination with 
other astringents. Lime Liniment is used on cotton or lint as a dressing 
for burns. 

Calcium Chloride has been advantageously employed in the various 
manifestations of the strumous diathesis. It sometimes resolves glandular 
enlargements, calcines tubercular deposits, aids the cicatrization of ulcer- 
ating cavities, and has been curative in eczema and lupus. It is strongly 
recommended in chorea, phthisis and in the colliquative diarrhoea of 
.strumous children. In solution externally as a fomentation it will hasten 
the maturation of boils. 

The therapeutics of the other salts of Calcium are included under those 
of their respective bases. 



CALENDULA, Marigold, — is the florets of Calendula officinalis, the common 
Garden Marigold, a plant of the nat. ord. Composite, frequently cultivated for ornament. 
The tincture (20 per cent.) is also official, and is exclusively used as a local application to 
promote the healing process in wounds, ulcers, burns and other breaches of tissue. Ex- 
travagant views of its powers as a vulnerary are promulgated by the so-called " homoeo- 
pathic surgeons," and serve as one of their excuses for professing an exclusive position in 
the art of surgery. 



CALUMBA CAMBOGIA. 1 63 

CALUMBA, Columbo, — is the root of Jateorhiza palmata, a plant 
of the nat. ord. Menispermacese, native in southeastern Africa, but culti- 
vated in the East Indian Islands. It occurs in nearly circular disks, 
having two or three interrupted circles of projecting wood-bundles, 
odor slight, taste mucilaginous, aromatic and bitter. It contains the 
alkaloid Berberine (see under Berberis, ante, page 147), a bitter princi- 
ple named Calumbin, also Calumbic Acid and Starch, but no Tannin. 
Dose, gr. v-xxx. 

Preparatio7ts. 
Extractum Calumbae Fluidum, Fluid Extract of Calumba. — Dose, rt^ v-xxx. 
Tinctura Calumbae, Tincture of Calumba, — I in 10. Dose, ^ss-ij. 

Calumba is the first in alphabetical order of the simple bitters, having 
no astringency or aroma, and its action, as herein described, will apply 
to other members of that class (Quassia, Gentian, Cornus). It stimu- 
lates the nerves of taste, increases the flow of saliva, excites the flow of 
the gastric juice and the gastric circulation, thus increasing the appetite 
and promoting digestion, and so promoting the constructive metamor- 
phosis. As it also increases the gastric mucus, its continued use will set 
up catarrh of the stomach, and interfere with digestion, though it is one 
of the least irritant of stomachic tonics. 

As^Calumba contains no Tannin, it may be administered with- the salts 
of Iron, and is often prescribed with the sub-carbonate. It is useful in 
atonic dyspepsia with pain after eating, in the convalescent stage of dis- 
ease to promote appetite and digestion, in diarrhoea and dysentery, 
vomiting, sea-sickness, cholera morbus and cholera infantum. An Infu- 
sion of Calumba with Ginger and Senna is effective in flatulence, and the 
same preparation is a good vehicle for the administration of acids and 
alkalies, tonics, aromatics, and mild cathartics. Having little or no irri- 
tant quality, it is an excellent tonic in the hectic of phthisis. 



CAMBOGIA, Gamboge, — is a gum-resin, obtained from Garcinia Hanburii, a 
Siamese tree of the nat. ord. Guttiferae. It occurs in cylindrical pieces, of orange-red 
color, but yellow when powdered. Its taste is very acrid. It contains 73 per cent, of 
Gambogic Acid, a resinous substance, also 25 per cent, of gum and 2 of water. It is 
partly soluble in alcohol and ether. The only official preparation is the Pil. Catharticae 
Co. (described under Colocynthis), each pill containing gr. j^ of Gamboge. Its dose, 
as a cathartic, is gr. ij-v, — as a diuretic, gr. j at short intervals. 

Gamboge is an irritant purgative, decidedly diuretic, and its powder is sternutatory, 
Its catharsis is accompanied by vomiting and colic, and the stools produced are watery, 
but not so much so as generally believed. It has no cholagogue action. Full doses are 
liable to produce violent gastro-enteritis, and incautiously used (as in Morrison's pills) it 
has frequently caused death. On the other hand, large doses have been given continu- 
ously in some cases, without producing any dangerous symptoms. 

Gamboge was formerly much used as a hydragogue cathartic and diuretic in dropsies, 
but its irritant qualities have caused it to be superseded by other agents (elaterium, digi- 
talis, etc.). However, for dysentery, especially when in young subjects, very small doses 
(gr. Jjj) at short intervals, up to gr. 3^ in 24 hours, have proven to be remarkably effi- 
cacious. 



164 CAMPHORA. 

CAMPHORA, Camphor, C 10 H 16 O, — is a stearopten (solid volatile 
oil), derived from Cinnamomum Camphora, a tree of the nat. ord. Lauri- 
neae, and purified by sublimation. Occurs in white, translucent, waxy 
masses, of penetrating odor and pungent taste, lighter than water, in 
which it is sparingly soluble (1 to 1300), but dissolves readily in alcohol, 
ether, chloroform, benzin, oils, etc. The camphor-tree is indigenous in 
China, Japan, Formosa and other parts of Eastern Asia. Borneo Camphor 
has the formula C 10 H ]8 O, bears the same relation to Japanese Camphor as 
alcohol bears to aldehyde, and is heavier than water. Dose, gr. j-xx. 

Derivatives of Camphor are — Camphor- cy mo I which is obtained by its 
distillation with zinc chloride, — Camphoric a?id Camphretic Acids, which 
result respectively from its lesser or greater oxidation, — Safrol, also con- 
tained in Sassafras oil, but obtained in much larger quantities from Cam- 
phor oil, a waste by-product in the production of crude camphor. 

Preparations. 

Aqua Camphorae, Camphor-water, — Camphor 8, Alcohol 5, Distilled Water to 1000. 
Used externally or as a vehicle. Dose, 3J-iv. 

Spiritus Camphorae, Spirit of Camphor, — 10 per cent, in Alcohol. Dose, n\v-xx. 

Linimentum Camphorae, Camphor Liniment, — Camphor 20, Cotton-seed Oil 80. 

Ceratum Camphorae, Camphor Cerate, — has of the Liniment 10, White Wax 30, 
Lard 60. Used for itching skin- affections. 

Camphora Monobromata, Monobromated Caryphor, C 10 H 15 BrO, — colorlesl, pris- 
matic needles or scales, of mild camphoraceous odor and taste, and neutral reaction, 
almost insoluble in water, slightly in glycerin, freely in alcohol, ether, oils, etc. Dose, 
gr. j-x, in emulsion. 

Acidum Camphoricum, Camphoric Acid, C 8 H u (COOH) 2 (Unofficial), — is a dibasic 
acid, obtained by the action of nitric acid on camphor. Occurs in white, acicular, odor- 
less crystals, of feebly acid taste ; insoluble, or nearly so, in cold water, readily soluble in 
hot water, alcohol, ether and fatty oils. Dose, gr. x-xxx, dry on the tongue. 

Rubini's Tincture of Camphor (Unofficial), — is a saturated solution in alcohol, 
E'i in "%,)%, of which the dose is from 4 to 10 drops. TT\,vij have caused toxic symptoms 
in an adult. 

Raspail's "Eau Sedative" (Unofficial), — contains Aq. Ammonige ^ij, Sodii 
Chloridum ^ij, Camphorated Spirits of Wine sjiij, Water Oij. Used externally. 

Camphor is also an ingredient of Linimentum Saponis, Linimentum Sinapis Com- 
positum, and Tinctura Opii Camphorata. 

Physiological Action. 
Camphor is antispasmodic, anodyne, antiseptic, diaphoretic, a stimu- 
lant expectorant, a cerebral excitant, a gastro-intestinal irritant, and a 
rubefacient. It has an acrid, hot taste, and irritates the skin and mucous 
membranes, in quantity exciting severe gastric inflammation with all the 
effects of an irritant poison. In medicinal doses it stimulates the vaso- 
motor system and the cardiac motor ganglia, and lessens the influence of 
the pneumogastric, — thus increasing the circulation and raising arterial 
tension. It also stimulates respiration and mental activity, even produc- 
ing intoxication; promotes diaphoresis, allays pain, and increases the 
menstrual flow and the sexual appetite, but its continued use depresses 
the generative function. " Camphora per nares castrat odore mares." 



CAMPHORA. 165 

Large doses cause gastrointestinal inflammation, depress the heart and 
lower arterial tension, diminish the reflex function of the spinal cord, 
produce coldness of the surface, insensibility, coma, convulsions and per- 
haps death. 

As many as 200 grains have been taken without fatal result, yet 6 or 7 
grains have produced extreme drowsiness and weakness of the pulse, and 
20 grains laid an Alpine guide up for a day. 

It is eliminated by the bronchial mucous membrane, skin and kidneys, 
and 'has often caused dysuria. 

Monobromated Camphor resembles the bromides in action, but is not 
identical therewith. In mammals it produces muscular weakness passing 
into paralysis, lowered temperature and respiration, stupor and death. In 
some cases its use by man has been followed by epileptiform convulsions. 
It is a nervous sedative and hypnotic, and a gastric irritant. 

Antagonists and Incompatibles. 

Arterial sedatives, coffee, cold, etc., antagonize its action. Water precipitates it from 
the alcoholic solution, alkalies and earthy salts precipitate even the small quantity which 
is soluble in water. Emetics to remove as much as possible. Opium and Bromides for 
the convulsions. 

Therapeutics. 

Camphor was much used by the older physicians as an antispasmodic, 
and is yet greatly valued in China and Japan. It has a reputation for 
uncertainty of therapeutic action, but is usefully administered in cholera 
and choleraic diarrhoea, summer diarrhoea and that of infants, vomit- 
ing, gastralgia, cardiac depression, nervousness and nervous headache, 
nymphomania, capillary bronchitis, typhoid and eruptive fevers, dysmen- 
orrhoea, afterpains, chordee, strangury, and catarrhal colds. Locally it is 
effective in myalgia, lumbago, toothache, gangrene, and other conditions 
where counter-irritation or a local anodyne are required. A solution in 
ether has been found to be a beneficial application in erysipelas. 

Monobromated Camphor is used as a nerve sedative and hypnotic, 
but is not particularly efficient in this regard. It has been used with 
advantage in whooping-cough, neuralgia, chorea, hysteria, delirium tre- 
mens and epilepsy. 

Camphora Carbolata is a name given to a mixture of iy^ parts of camphor with one 
each of carbolic acid and alcohol. This preparation, mixed with olive-oil, is a good 
non-irritating and antiseptic dressing for wounds and breaches of surface. 

Camphor-Chloral is a fluid obtained by triturating together equal parts of camphor 
and chloral hydrate. It has decided solvent powers, dissolving sulphate of morphine 
readily (gr. xx in gij), and many other salts of alkaloids. It is often a serviceable ap- 
plication in superficial neuralgia, and is said to allay spasmodic cough if painted over the 
larynx. 

Camphora Salicylata is obtained by heating together 11 parts of salicylic acid and 
14 of camphor. An ointment prepared from this substance has been used with very 
satisfactory results in the treatment of phagedena, spreading syphilitic sores, epithelioma, 
lupus, etc. 



1 66 CANNABIS INDICA. 

Camphoric Acid in solutions of x / 2 to 6 per cent, strength, has been used with benefit 
as a topical agent in cystitis, and in coryza, acute bronchitis, and other affections of the 
respiratory tract. Internally administered it gives good results as an intestinal disinfect- 
ant, and has lately come into prominence as one of the most efficient agents against 
sweating from various causes, especially the profuse night-sweats of pulmonary tubercu- 
losis. For this purpose it is best administered dry on the tongue, in dose of io to 30 
grains, not more than two hours before the time for the expected sweating to occur, — as it 
is quickly and abundantly eliminated by the urine. 



CANNABIS INDICA, Indian Cannabis, Indian Hemp,— is the 

flowering tops of the female plant of Cannabis saliva, grown in the East 
Indies; a coarse, pubescent, somewhat viscid annual of the nat. ord. 
Urticacese, having an erect, branching stem, 3 to 6 feet high, with alter- 
nate or opposite digitate leaves on long, weak petioles. The tops are 
about two inches long, branching, compressed and brittle, having a few 
digitate leaves with linear-lanceolate leaflets, and numerous bracts, each 
containing two small pistillate flowers, sometimes with the nearly ripe 
fruit, the whole more or less agglutinated with a resinous exudation. 
Color brownish, odor peculiar and narcotic, taste slightly acrid. 

Cannabis Americana, American Cannabis (Unofficial), — is the same 
plant, Cannabis sativa, grown in the Southern States. 

The two varieties are specifically identical with each other, differing 
only in the degree of their action, that grown in India being the most 
powerful. They contain a resin named Cannabin, and a Volatile Oil, from 
the latter of which are obtained Canttabene, a light hydrocarbon, and 
Caiinabene Hydride, a crystalline body. Cannabis should not be con- 
founded with the so-called "Indian or Canadian Hemp," Apocynum 
cannabinum (see ante, page 121). 

Preparations. 

Extractum Cannabis Indicse, Extract of Indian Cannabis. — Dose, gr. %-}, if 
active. Hering's English Extract is one of the best. 

Extractum Cannabis Indicae Fluidum, Fluid Extract of Indian Cannabis, — is an 
alcoholic preparation which in mixtures must be thoroughly emulsified with Acacia, 
otherwise the resinous drug will separate and float to the top or adhere to the sides of the 
bottle. The Dose is put at TT\J— v or x, but the author has frequently administered 3 j of 
a good fluid extract without untoward results. Whatever may be the reason, it is a fact 
which he has often verified, that if the precipitate, formed when the alcoholic preparation 
is added to water, be of a brownish hue, a dirty, yellow-brown, the sample will prove to 
be almost inert ; — but if of a decided olive-green color, the preparation will be active. 
The activity will be found to increase almost in direct proportion to the decided green of 
the precipitate. Samples from the same manufacturer show this difference, often seen 
between two bottles in the same shipment. The active principle seems to be intimately 
connected with the chlorophyll or other coloring matter present, and to be destroyed 
therewith by whatever injures the latter. 

Tinctura Cannabis Indicae, Tincture of Indian Cannabis, — strength 15 per cent. 
Dose, TTLxx-gj. The above remark on mixtures containing the fluid extract applies also 
to the tincture of this drug. 

Similar preparations of Cannabis Americana are prepared by the manufacturers and 
may be used in larger quantities The dosage of all preparations of hemp is uncertain, 
as specimens of the plant vary very much in activity. The best rule is to begin with a 
small dose, gradually testing the activity of the drug and the susceptibility of the patient 
by carefully increased doses. 



CANNABIS INDICA. 1 67 

Cannabin Tannate (Unofficial), — is a yellowish-brown permanent powder, insoluble 
in water and ether, slightly soluble in alcohol, having a not unpleasant odor and a bitterish, 
astringent taste. No formula has been published for it, but it is claimed to be the tannate 
of a glucoside by Merck, of Darmstadt, who placed it on the market. Dose, as a hyp- 
notic, gr. v-x. 

Preparations used in the East. 

Churrus is an impure resin, prepared by rubbing the leaves of the plant together and 
scraping off the adhering resin. 

Gunjah is the dried leaf and tops as sold in the bazaars for smoking purposes. 

Hashish, Bhang or Siddhi is a confection consisting of the leaves and small stalks 
coarsely broken and mixed with fruits and aromatics. It is employed in the preparation 
of various electuaries and beverages, and is also smoked with or without tobacco. 

Physiological Action. 

Cannabis Indica is antispasmodic, analgesic, anaesthetic and narcotic, 
a cerebro-spinal stimulant and a powerful aphrodisiac. It increases intel- 
lectual and motor activity, stimulates the vaso-motor nerves, raising arterial 
tension, depresses sensation, and strengthens the energy of the uterine 
muscular fibre, but has no power to initiate uterine contractions. In 
large doses it causes a pleasurable intoxication, during which the peculiar 
traits of the individual are exalted, and the ideas follow each other so 
rapidly as to produce a sense of great prolongation of time, minutes seem- 
ing as if hours or even days. With this occurs increased sexual desire, 
great uterine activity, and sensations of double consciousness and enor- 
mous dimensions. The sight and hearing are exalted, pupils dilated, 
anaesthesia sets in, the reflexes are lowered by stimulation of inhibition 
(Setchenow's centre?), and if the dose be a heavy one a cataleptic state 
is induced. Sleep or coma follows according to the size of the dose, but 
death has never been produced by this drug. 

After-effects are dullness, heaviness, vertigo, headache, and confused 
thought, anaesthesia of the skin, and marked diuresis, — but no nausea, 
no vital depression, no constipation. Repeated use of the drug causes 
mental weakness and impotence, the result of over-stimulation. A raven- 
ous appetite is usually one of its effects. 

Antagonists and Incompatibles. 

Strychnine and Faradism are antagonistic. Caustic Alkalies are incompatible. In 
poisoning by it the stomach should be evacuated, stimulants given cautiously, and respira- 
tion maintained. The effects of a large dose last over 24 hours. Lemon-juice is said to 
antagonize its effects. 

Therapeutics. 
Cannabis Indica was formerly much employed as an anodyne and 
hypnotic, also as an anaesthetic during surgical operations. It is now 
somewhat out of fashion. In migraine it is useful to prevent recurrence 
of the attack, and in neuralgia it is often very efficient. Uterine affec- 
tions, as — chronic metritis, subinvolution, menorrhagia, dysmenorrhcea, 
etc., are greatly benefited by its anodyne quality and its power over the 



1 68 CANTHARIS. 

uterine muscular fibre. It is the best hypnotic in delirium tremens, and 
in traumatic tetanus and paralysis agitans large doses will lower the reflex 
activity. Dysuria and retention of urine are often relieved by it, while 
in spasm of the bladder and other painful affections of that organ it will 
be found a most efficient remedy. It is useful in functional impotence, 
especially if combined with Ergot and Nux-vomica. In gonorrhoea it 
lessens the discharge, relieves the inflammation, burning pain and rest- 
lessness, and allays chordee. The tincture of Cannabis Americana is the 
most useful in this affection, being fully as efficient as Copaiba or Sandal 
Oil, and much more agreeable. It should, however, be prepared from 
the fresh plant, and be given in 3 to 5 drop doses 3 or 4 times daily after 
the subsidence of the acute symptoms. Full doses of the tincture of the 
Indian plant are extremely efficient in many cases of headache at the 
menopause, but should be used cautiously until the activity of the sample 
and the susceptibility of the patient are tested. 

Cannabin Tannate is recommended as a powerful hypnotic, not in 
any degree dangerous and neither disturbing the secretions nor leaving 
unpleasant after-effects. It has been used with benefit in acute mania. 



CANTHARIS, Cantharides, Spanish Flies,— -is the dried beetle, 
Cantharis vesicatoria, an insect of the nat. ord. Coleoptera, about an inch 
long, of a shining green color, the powder being grayish-brown, with 
green particles, odor very disagreeable. Contains Cantharidin, C 10 H 12 O 4 , 
the active principle, — also a greenish volatile oil and peculiar fatty bodies. 

Preparations. 

Tinctura Cantharidis, Tincture of Cantharides , — strength 5 per cent. Dose, 
n\, j-xx. 

Ceratum Cantharidis, Cantharides Cerate, Blistering Cerate, — Cantharides 32, Yel- 
low Wax, Resin, Lard, of each 18, Oil of Turpentine 15. 

Collodium Cantharidatum, Cantharidal Collodion, Blistering Collodion, — Canthar- 
ides 60, Flexible Collodion 85, Chloroform to loo. 

Emplastrum Picis Cantharidatum, Cantharidal Pitch Plaster, Warming Plaster, 
— Cerate of Cantharides 8, Burgundy Pitch to 100. 

Physiological Action. 
Cantharis applied to the skin is a rubefacient and vesicant, acting more 
slowly than mustard but much more severely. Internally it is also irri- 
tant, causing heat of stomach, gastralgia, nausea, and vomiting, the circu- 
lation is stimulated, temperature elevated, urine becomes scanty and 
irritating, is voided with difficulty and pain, and often contains blood and 
albumen. Afterwards the pulse falls, temperature and arterial tension are 
lowered, and depression ensues. A toxic dose produces severe gastro- 
enteritis, abdominal tenderness, tenesmus, mucous or bloody stools, pain 
in the stomach and loins, dysphagia, ptyalism, strangury, priapism, hema- 



CANTHARIS. 1 69 

turia, swollen genitals, abortion, muscular tremor, convulsions, coma and 
insensibility. Post-mortem shows evidences of violent metritis, gastro- 
enteritis and general peritonitis. Cantharis is aphrodisiac by causing 
vascular turgescence of the genital apparatus, but only in doses which 
produce dangerous symptoms. It is abortive only in toxic doses. In 
small doses it is diuretic and emmenagogue. 

Counter-irritation by rubefacients or blisters acts on disease probably 
through the nervous system. Its influence is explained by the theory that 
the peripheral extremities of the nerves supplying the skin of the part to 
which the agent is applied undergo some molecular change, which extends 
to the nerve centre and is thence radiated to centrifugal or trophic nerves, 
effecting various changes in nutrition and secretion over the areas to 
which they are distributed. In addition to this method of action, neigh- 
boring parts are affected by direct extension of the inflammation pro- 
duced, and distant parts are also affected by absorption through the ves- 
icated surface of agents having special affinities for certain organs. 

Blisters act primarily as a stimulant to the body generally as well as to 
the organs in its vicinity, but if permitted to remain long enough to pro- 
duce large blebs, the result is depression proportionate to the amount of 
serum abstracted, the serum containing nearly as much albumen as the 
blood itself. 

Antagonists. 

There is no chemical or physiological antagonist to Cantharis. Evacuation of the 
stomach, mucilaginous drinks freely, Opium for the gastro- enteritis, are the best measures 
ia poisoning by this agent. 

Therapeutics. 

As a counter-irritant and vesicant Cantharis is of great value in neu- 
ralgia if applied close to the emergence of the nerve from the spinal 
column, also in sciatica and neuritis, and in acute rheumatism around the 
affected joints. A blister at the nape of the neck controls many head- 
aches, and one behind the ear will modify inflammatory affections of the 
eye. In pleuritic effusions a succession of small blisters (flying-blisters) 
will promote absorption of the pleural contents, and a blister applied to 
the perineum will often cure a rebellious gleet. Though valuable as a 
therapeutic measure in very many conditions, blistering is going out of 
fashion except in hospitals and among people who believe in heroic 
treatment. It is invaluable in subacute joint affections. 

As an internal remedy Cantharis must be employed in very small doses 
("ij-iij of the tincture) in order to be efficient. When so used it is an 
admirable agent in acute desquamative nephritis after the active inflamma- 
tion and fever have subsided, to reduce the albumen and blood in the 
urine. Drop-doses are particularly useful in irritable bladder with frequent 
desire to micturate, so often observed in women, also in the incontinence 



I/O CAPSICUM. 

of the aged and of children, and in cystitis, gonorrhoea and gleet. The 
same dose thrice daily will generally abate chordee. In spermatorrhoea, 
prostatorrhoea, scanty menstruation and menorrhagia in subjects of lax 
fibre and general want of tone it is often very serviceable. Cutaneous 
squamae and vesiculse are greatly improved by small doses frequently ad- 
ministered and gradually increased, and it is one of the best remedies for 
psoriasis. For alopecia areata it is of the utmost value as an external 
application, and the tincture, greatly diluted, is an ingredient of all the 
hair-renewers in common use. In pleurisy, after effusion has taken place, 
it will be found admirable in 1 to 2 drop doses every 2 or 3 hours, and in 
the after-prostration of diphtheria it proves a serviceable stimulant. One 
of the best applications to burns or scalds is a cloth dipped in a lotion of 
the tincture one part to thirty or forty of water. The same lotion is an 
efficient application to vesicular erysipelas and herpes zoster. 



CAPSICUM, Cayenne Pepper, African Pepper, — is the fruit of 
Capsicum fastigiatum, a plant of the nat. ord. Solanaceae, native in tropi- 
cal Africa and America. Occurs in small red pods, enclosing two cells 
containing flat, yellowish seeds, and has a peculiar odor and an intensely 
hot taste. It contains Capsici/i, which is a thick, red liquid, and is the 
active principle, — also a volatile alkaloid having the odor of Coniine. 
Dose of the powdered drug, gr. v-x. 

Preparations. 

Extractum Capsici Fluidum, — Fluid Extract of Capsicum, — alcoholic. Dose, 
rr^v-xxx. 

Tinctura Capsici, Tincture of Capsicum, — 5 per cent, strength. Dose, TT^x-^j. 

Oleoresina Capsici, Oleoresin of Capsicum, — -prepared by ether. Dose, TTLJ-v. 

Emplastrum Capsici, Capsicum Plaster, — prepared from the Oleoresin of Capsicum 
and Resin Plaster. An excellent warming plaster. 

Physiological Action. 
Capsicum is irritant to the skin and mucous membrane. Externally 
used for sufficient length of time it will produce vesication, internally in 
quantity it will excite gastritis. In medicinal doses it increases the saliva, 
excites a sensation of warmth in the stomach, promotes appetite and di- 
gestion, and produces more easy and copious alvine evacuations. It 
stimulates the action of the heart, is diaphoretic and diuretic, also 
decidedly aphrodisiac. It is a general stimulant to the nervous system, 
but in repeated doses produces a slight narcotic effect upon the brain. 
On the vascular system it acts like ergot, powerfully constringing the 
vessels by influencing the unstriped muscular fibre in their walls, either 
directly or through the vaso-motor nerves. 



CARBO. i;i 

Therapeutics. 

Capsicum is an excellent stomachic tonic in atonic dyspepsia and in 
that of chronic alcoholism with tremor and insomnia. In acute dipso- 
mania and delirium tremens large doses are efficient in producing sleep 
and promoting appetite. It is the best substitute for alcohol and opium 
in attempts to cure those habits. It is well used in intermittent^, chiefly 
as an adjuvant to more active drugs, — in flatulent colic, especially when 
occurring in hysterical women and hypochondriacs, — also in low fevers 
and cholera as a stimulant. It gives good results in functional impotence, 
in spermatorrhoea from loss of tone, in chronic parenchymatous nephritis 
to check the waste of albumen, and is beneficial in chronic cystitis and in 
prostatorrhcea. The tincture internally, and a plaster externally over the 
loins, are efficient in cases of renal congestion with habitual pain in the 
back and a trace of albumen in the urine. 

Locally the tincture diluted (gj to ^viij) or the powder with honey, 
form excellent gargles for relaxed throat and its accompanying cough, 
relaxed uvula, inflammatory sore throat, and the cynanche of scarlet fever, 
but they must be used with caution, as such applications are sometimes 
very irritating. 

The Capsicum-plaster is a mild counter-irritant, of great value in lum- 
bago and other muscular rheumatisms as a palliative application. 



CARBO, Carbon, C, — exists in nature in many forms, of which two 
are official, namely, the charcoals specified below. 

Carbo Animalis, Animal Charcoal, — prepared from bone, occurring 
in dull black fragments or powder, odorless and nearly tasteless, insoluble 
in water or alcohol. 

Carbo Ligni, Charcoal, — prepared from soft wood, and very finely 
powdered ; is black, shining, brittle, inodorous, tasteless and insoluble. 

Preparations. 

Carbo Animalis Purificatus, Purified Animal Charcoal, — the bone -phosphate and 
calcium carbonate being removed by digesting with Hydrochloric Acid and washing. 
Dose, gr. xx-^j. 

Carbonei-Disulphidum, Carbon Disulphide, CS 2 , — is a clear, colorless, diffusive 
liquid, of strong, offensive odor, aromatic taste and neutral reaction ; soluble in alcohol, 
ether, chloroform and oils, and in 535 of water; vaporizes at ordinary temperatures, and 
is highly inflammable. Dose, nvss-j. 

Physiological Action. 

Charcoal is an efficient deodorant and disinfectant, as it absorbs and 
condenses many gaseous bodies and vapors. It is evacuated unchanged 
by the bowel and exerts no specific action on the body. 

Carbon Disulphide is largely used in the arts, hence its effects are fre- 



172 CARDAMOMUM. 

quently observed. Persons exposed to its fumes are affected by headache, 
vertigo, over-excitement of the nervous system, emaciation, incoordination 
of movement, depression of all the special senses with impairment of sen- 
sation and motility and perhaps insanity. Inhaled directly, it excites vio- 
lent coughing, and produces anaesthesia characterized by great muscular 
rigidity. Being a powerful cardiac paralyzant, it is extremely dangerous 
as an anaesthetic. In 3-drop doses it produces severe nausea and vomit- 
ing, with a sense of heat in the stomach and a weak and rapid action 
of the heart. It is a good solvent for Caoutchouc and many other 
substances. 

Therapeutics. 

Charcoal is used in pharmacy for decolorizing vegetable principles, 
removing alkaloids from infusions of plants, and making several prepara- 
tions, as acidum sulphurosum, potassii iodidum, etc. 

Externally, it makes an efficient disinfectant, absorbent and deodorant 
application to cancerous discharges, foul ulcers and gangrenous wounds. 
Having no odor it is not open to the charge of substitution of one smell 
for another. A small quantity added to water will keep it sweet for a long 
time. It is an excellent dentifrice if finely powdered. 

Internally, it is used for the same purposes, namely, to absorb gases and 
offending products of indigestion. In flatulent dyspepsia, gastralgia, 
pyrosis, diarrhoeas, nausea of pregnancy, epidemic cholera, and constipa- 
tion, it has warm advocates. When used internally for any time, an 
occasional purgative should be given to prevent its accumulation in the 
intestines. It has been proposed as an antidote for several alkaloidal 
poisons on theoretical grounds, but its efficacy in this respect is doubtful. 

Carbon Disulphide has such a horribly offensive odor that it will never 
be used for any purpose for which another agent can be found. It relieves 
the pain of gastric cancer, and in ^-drop doses will alleviate nausea and 
vomiting, also gastralgia. Locally it has been used as a counter-irritant 
and a local anaesthetic, for deafness due to want of nervous energy, in 
facial neuralgia and various local pains. 



CARDAMOMUM, Cardamon, — Is the fruit of Eletlaria repens, a plant of the 
nat. ord. Scitaminese, cultivated in Malabar. Occurs as dried capsules, containing small, 
reddish-brown seeds, of warm, aromatic taste and agreeable odor. Contains about 4^ 
per cent, of a Volatile Oil, C 10 H 16 , isomeric with Oil of Turpentine, which oil is the active 
principle, also a fixed oil, coloring matter, etc. It is an ingredient of Pulvis Aromaticus 
and of Extractum Aromaticum Fluidum (See under Cinnamomum), as well as of several 
compound preparations. 

Tinctura Cardamomi, Tincture of Cardamon, — 10 per cent, strength. Dose, 

3 Hi- 

Tinctura Cardamomi Composita, Compound Tinctwe of Cardamon, — Cardamon 
20, Cinnamon 20, Caraway 10, Cochineal 5, Glycerin 50, Diluted Alcohol q. s., ad 1000. 
Dose, 3J-ij. 



CARDUUS — CARUM CARYOPHYLLUS. 1/3 

• Infusum Cardamomi, Infusion of Cardamon (Unofficial), — may be made in the 
strength of 3 j to 0)4, and used in wineglassful doses. 

Cardamon is aromatic, carminative and stomachic, and is used as an agreeable flavoring 
for bitter mixtures in dyspepsia and other stomach affections. It is especially useful when 
combined with purgatives to check flatulence and griping, and it makes the best flavoring 
for saline solutions or mineral waters. 



CARDUUS (Unofficial), the seeds of Carduus marianus, or St. Mary's thistle, an 
annual European plant of the nat. ord. Compositae. A decoction (31J ad Oj) is the pre- 
paration usually employed. It is an old remedy recently revived as a hemostatic, and 
reported as very efficient in hemoptysis, uterine hemorrhage, melsena and amenorrhcea 
connected with derangement of the portal circulation. It has proved curative in conges- 
tion of the liver and simple jaundice, and in Germany it has long been popularly deemed 
efficacious in gall stones, and liver affections generally. Dose of the decoction, ^j-^s, 
— of a tincture, TT^x-xx. 

Carduus Benedictus, the " blessed thistle," also called Cnicus benedictus and Cen- 
taurea benedicta, is another plant of the same order, formerly held in high esteem as a 
popular " cure-all." It contains Cnicin, an amorphous bitter principle, which has been 
used as an antiperiodic in doses of gr. v-x, but generally produces burning sensations and 
pharyngeal constriction, with nausea, vomiting, colic, and diarrhoea. It acts chiefly as a 
bitter tonic, resembling Calumba and Taraxacum most closely. 



CARUM, Caraway, — is the fruit of Carutn Carvi, a European plant of the nat. ord. 
Umbelliferse, and is of oblong shape, ^th of an inch in length, separating into two parts, 
each having 5 ribs and 6 oil-tubes. Its odor and taste are aromatic and agreeable. The 
active principle is the Volatile Oil, which is also official. Caraway is an ingredient of 
Tinctura Cardamomi Composita. 

Oleum Cari, Oil of Caraway, — is the volatile oil distilled from Caraway, and is 
resolvable into Caruen, C 10 H 16 , isomeric with Turpentine, and Caruol, C 10 H n O, isomeric 
with Thymol. It is an ingredient of Spiritus Juniperi Compositus. Dose, n\, j-v. 

Infusum Cari, Infusion of Caraway (Unofficial), — 3J-ij ad Oss. Dose, 3 ss— ij. 

The Oil of Caraway is fatal to small animals, and in one case ^j produced cerebral 
congestion, delirium and rigors in man. The chief use of Caraway is as a flavoring agent, 
but it is efficient in the flatulent colic of children, and to prevent griping from the use of 
purgatives. 



CARYOPHYLLUS, Cloves,— are the unexpanded flowers of 
Eugenia aromatica, a handsome evergreen tree of the nat. ord. Myr- 
taceae, cultivated in the East and West Indian Islands. They are about 
^-inch long, of a dark brown color, consist of a calyx-tube terminated 
by four teeth and surmounted by a globular head formed by four petals, 
which cover numerous curved stamens and one style. They emit oil when 
scratched, have an aromatic odor, and a pungent, spicy taste, and are 
contained in Tinctura Lavandulae Composita, Tinctura Rhei Aromatica 
and Vinum Opii. They contain a heavy Volatile Oil, which is official, — 
also Eugenin, C 10 H 12 O 2 , a crystalline body ; Caryophyllin, C 10 H 16 O, a cam- 
phor ; Caryophyllic Acid, and tannin, gum, etc. 

Preparations. 

Oleum Caryophylli, Oil of Cloves, — a volatile oil distilled from Cloves, soluble in 
alcohol, and of sp. gr. 1.060. It consists of a light and a heavy oil, the latter containing 



174 CASCA BARK CASCARA AMARGA. 

Engenol, C 10 H 12 O, a phenol-like compound, and CaryophyUin, C 10 H 16 O, which yields as 
a product of its oxidation Caryophyllinic Acid, C 20 H 32 O 6 . Dose of the oil, TT\J-iv. 

Infusum Caryophylli, Infusion of Cloves (Unofficial), may be made of strength I to 
40, and used in doses of one to two fluid ounces. 



Physiological Action and Therapeutics. 

Cloves maybe considered as a type of several agents yielding aromatic 
oils, which as a rule consist of terpenes with camphors, resins, fatty and 
other acids, etc., closely allied to phenol and benzoic acid, the balsams 
and gum-resins. Such are Orange, Lemon, Allspice, Cajuput, Caraway, 
Peppermint, etc. Their oils are antiseptic, locally anaesthetic, stimulant, 
and irritant, antispasmodic, stomachic and carminative. Internally they 
increase*circulation and temperature, promote digestion and nutrition (in 
quantity may cause inflammation), relieve pain and spasm, and are excre- 
ted by the kidneys, skin, liver and the bronchial mucous membrane, 
stimulating and disinfecting their routes through the organism. 

These agents are used to. flavor pharmaceutical preparations, to correct 
the griping tendency of many purgatives, to correct flatulence, to relieve 
pain in the stomach and bowels, and to promote the flow of saliva and 
gastric juice. As external applications they are efficiently employed for 
anaesthetic and counter-irritant purposes, to relieve pain in chronic rheu- 
matism, myalgia, lumbago, superficial neuralgia, toothache, etc. The 
Oil of Cloves is an effective deodorizer for sponge-tents, a good applica- 
tion to a painful tooth, and is occasionally applied over the course of an 
aching nerve with relief to the pain. 



CASCA BARK, Sassy Bark, Ordeal Bark (Unofficial),— is the bark of Ery- 
throphlceam Guinense, an African tree used by the negroes as an ordeal in trials for 
witchcraft. It contains a poisonous glucoside, Erythropklein, and when used in quantity 
produces nausea and vomiting, stricture across the brow, severe cephalalgia, narcosis and 
death. It is used as a remedy in Africa for intermittent fever, dysentery, diarrhoea and 
colic, and in*England is considered to resemble Digitalis in action and uses. A tincture 
is made ( Jij ad Oj) of which the dose is ttVx; or a watery Extract may be used in 
doses of gr. j. 

Erythrophloein, the active principle, is a glucoside, and is said to be a local anaesthetic 
of extraordinary power, even surpassing Cocaine. It is found in Africa in a red mass, 
called " Hayah," which is proven to be identical with an extract of the original plant 
described by CErtel early in this century, and deposited by him in the Berlin museum. It 
closely resembles Digitalis in action, being a cardiac tonic and a hydragogue diuretic. 



CASCARA AMARGA, Honduras Bark (Unofficial),— is the bark of a Mexican 
tree of the nat. ord. Simarubaceae, which has been used with apparent success as an 
alterative tonic and diuretic in syphilis and various chronic skin affections. The use of 
tobacco and alcohol seems to counteract its usefulness. It is certainly a very powerful 
tonic and has been employed by competent observers with uniformly good results in 
syphilis and syphilodermata, chronic liver complaints, chronic eczema, chronic nasal 
catarrh and psoriasis. A Fluid Extract is on the market, of which the dose is gss-j 
thrice daily. 



CASCARILLA — CASSIA FISTULA — CASTANEA — CATECHU. 1 75 

CASCARILLA, — is the bark of Croton Eluteria, a shrub or small tree of the nat. ' 
ord. Euphorbiaceae, growing in the Bahamas. It occurs in grayish-brown quills, having 
a warm, bitter taste, and a fragrant odor when burned. Contains Cascarilhn, a crystal- 
line principle, two resinoid extracts, aromatic volatile oils, with tannic acid, etc. There 
are no official preparations, but an Infusion (1 to 10) or a Tincture (i to 10) may be pre- 
pared and given in doses of ^j-,^ j. 

Cascarilla is an aromatic bitter. It increases appetite and digestion, the mucous 
secretion, the flow of saliva and gastric juice, stimulates the intestinal secretions, and acts 
as a mild astringent by the influence of its tannin. Large doses produce nausea, vomiting 
and diarrhoea, and in medicinal doses continued it will set up gastric catarrh and con- 
sequently indigestion. It has slight antiperiodic powers. 

It has been used with success in epidemic dysentery, flatulent dyspepsia, debility, chronic 
bronchitis, intermittents, and low nervous fevers. It is difficult to dispense, as the infusion 
decomposes quickly, and acids precipitate the resin from the tincture. 

CASSIA FISTULA, Purging Cassia, — is the fruit of Cassia Fistula, a tree of the 
nat. ord. Leguminosse, growing in tropical regions of Asia, Africa and America. It occurs 
in long, brown pods which are divided into numerous transverse cells, each containing a 
dark pulp in which is a glossy seed. No active principle has been isolated as yet. The 
pulp is the only valuable part of the drug. There are no official preparations, but it is 
one of the ingredients of Confectio Sennse. 

Cassia-pulp is laxative in doses of £j-ij, and purgative in large quantities, producing 
nausea, flatulence and griping. It is rarely prescribed alone, owing to its tendency to 
cause colic and flatulence. 

CASTANEA, Chestnut,— the leaves of Castanea deniata, a stately tree of the nat. 
ord. Cupuli ferae, which should be collected while green. Chestnut leaves are 5 to 10 inches 
lung and about 2 broad, have a slight odor and somewhat of an astringent taste. They 
contain tannic and gallic acids, salts, gum, etc. 

Extractum Castanea Fluidum, Fluid Extract of Castanea. — Dose, ^ss-gij. 

This drug has not been studied as to its physiological action, if it has any. It is classed 
among the vegetable astringents by reason of its containing tannin. Its only reputation 
therapeutically is as a remedy for whooping-cough, in which it is said to be very effica- 
cious. An infusion or decoction of the leaves has been used, in indefinite doses. 

CATECHU, — is an extract prepared from the wood of Acacia Cate- 
chu, a tree of the nat. ord. Leguminosae, native of the East Indies. 
Occurs in irregular masses, dark brown and brittle, nearly inodorous, but 
of astringent and sweetish taste, soluble in alcohol, and partly so in water. 
It contains Catechutannic Acid 50 per cent. ; and Catechuic Acid, which 
is converted into the former by heat. Dose, gr. j-gss. 

Preparations. 

Tinctura Catechu Composita, Compound Tincture of Catechu, — contains Catechu 
10, Cinnamon 5, Diluted Alcohol q. s. ad 100 parts. Dose, Tt\ x-^j. 

Trochisci Catechu, Troches of Catechu, — each troche contains of Catechu nearly I 
grain, mixed with Sugar, Tragacanth and Orange-flower Water. 

Catechu is a powerful astringent, acting by virtue of its tannic acid, 
(See ante, page 81, for action and incompatibles). Its uses depend en- 
tirely on its astringency. In the diarrhoea of children the Tincture with 
Chalk-mixture is very serviceable, and with Opium it is efficient in dysen- 
tery. It is also used as a gargle and mouth-wash in relaxed conditions of 
the pharyngeal mucous membrane, as an injection in leucorrhcea, and to 
control passive hemorrhages, spongy gums, etc. 



1/6 CAULOPHYLLUM CERA CERII OXALAS. 

CAULOPHYLLUM, Blue Cohosh,— is the rhizome and rootlets of Caulophyllum 
thalictroides, a plant of the nat. ord. Berberidacese growing in Canada and the northern 
United States. Rhizome about 4 inches long, thick and bent, rootlets numerous and 
matted, taste sweetish, bitter and acrid. Contains Saponin, a glucoside, and two resins. 
Dose, gr. v-xx. There are no official preparations. The eclectic preparation Caulophyllin 
is a resinous precipitate obtained by pouring an alcoholic extract into water. 

Caulophyllum is a new addition to the pharmacopoeia, and has not yet been made the 
subject of experimental work by reliable observers.. It was much used by the aborigines 
of this country in all affections to which their women were peculiarly subject, and was 
known among them by the name '' squaw-root." It is said to produce intermittent con- 
tractions of the gravid uterus, to have diuretic, emmenagogue, and antispasmodic powers ; 
and is used as a remedy for deficient labor-pains, spasmodic after-pains, spasmodic pains 
in the uterus at any time, spasmodic dysmenorrhcea, and pains in other organs seemingly 
in sympathy with uterine affections. It has somewhat of a reputation in acute rheuma- 
tism of the hands and fingers, and as a preparative medicine for labor. 



CERA, Wax, — is a mixture of Myricin, Cerotic Acid, and Cerolein, is 
formed by the honey-bee, and exists in the pollen and leaves of many 
plants, particularly in Myrica cerifera, the wax myrtle. That produced 
by the bee is alone official. 

Cera Alba, White Wax, — is yellow wax bleached. 

Cera Flava, Yellow Wax, — is a peculiar concrete substance prepared 
by Apis mellifica, the honey-bee. It is a yellowish solid, of agreeable 
odor and faint, balsamic taste, melting at 145. 4 to 147 F., of sp. gr. 
0.945-0.967, insoluble in water and also so in cold alcohol, but soluble 
in 35 of ether, 11 of chloroform, boiling alcohol, fixed and volatile oils. 

Ceratum, Cerate, — consists of White Wax 30, Lard 70. 
Unguentum, Ointment, — consists of Yellow Wax 20, Lard 80. 

Wax is also a constituent of the 5 compound Cerates, 2 of the 22 compound Ointments, 
and 2 of the 13 Plasters. 

Wax owes its value to its power of resistance to decomposition and to 
many chemical agents. Its fusibility at a moderate degree of heat, and 
its solidity at the temperature of the body, together with its unirritating 
quality, make it a valuable ingredient of the cerates and ointments to 
give them consistence. 

Ceratum and Unguentum may be used as simple protective applica- 
tions. They form the bases of the most of the compound preparations 
so named. 



CERII OXALAS, Cerium Oxalate, Ce 2 (C 2 4 ) 3 -f- 9H 2 0,— is a white, slightly 
granular powder, odorless and tasteless, insoluble in water or alcohol, but soluble in 
diluted sulphuric or hydrochloric acid. Dose, gr. j-x, in pill or powder. 

Cerium Oxalate is a gastric sedative, and is thought to possess selective action as such 
on the motor distribution of the pneumogastric nerve. It is considered to be particularly 
useful in vomiting of reflex origin, especially in the vomiting of pregnancy, but it often 
fails, probably because not given in sufficient doses. To be effective, at least 4 or 5 grains 
should be given 3 times a day to adults, and no results promised until after it has been 
used several days. It is also recommended in the vomiting of phthisis and bronchitis, 
cough with vomiting, gastralgia, chorea, and diarrhoea. 



CETACEUM — CETRARIA CHELIDONIUM. I J J 

CETACEUM, Spermaceti, — is a peculiar, concrete, fatty sub- 
stance obtained from Physeter macrocephalus, the sperm whale. Occurs 
in white, pearly masses, odorless, of bland taste, and neutral reaction, 
becoming rancid in the air, soluble in ether, chloroform, carbon disul- 
phide and boiling alcohol. Is a constituent of — 

Ceratum Cetacei, Spermaceti Cerate, — has of Spermaceti 10. White Wax 35, 
Olive Oil 55. 

Unguentum Aquae Rosas, Ointment of Rose Water, Cold Cream, — has of Sperma- 
ceti 12^, White .Wax 12, Expressed Oil of Almond 60, Stronger Rose Water 19, 
Sodium Borate %_. 

Unguentum Cetacei, Spermaceti Ointment (Unofficial), — has of Spermaceti 5, 
White Wax 2, Almond Oil 18. The ointment of the B. P. has Benzoin y 2 in addition, 
rendering an emollient preparation irritant, and therefore unsuitable for eye-ointment, for 
piles, etc. 

Spermaceti consists of Cetin (Cetyl PaLmitate) with several other fats 
in small quantities. Its action is solely that of an emollient, and it is 
rarely used internally, though an alcoholic preparation was once a regu- 
lar prescription for coughs, bronchial irritation, and for a recently deliv- 
ered woman. The Cerate is employed as a bland ointment for blisters, 
abrasions and ulcers, but is too stiff for easy application, and the unoffi- 
cial Ointment is preferred in practice. The latter on lint to broken blis- 
ters from walking affords great relief, and is employed to prevent injure- 
to the feet by smearing on them before starting for a rough tramp over 
broken ground. The Ointment of Rose Water, popularly known as 
"cold cream," is one of the most agreeable emollient and protective 
applications for chapped hands, chilblains and other slight affections of 
the skin. 

CETRARIA, Iceland Moss, — is the lichen Cetraria islandica, found in northern 
latitudes. Occurs about 2 to 4 inches long, brown above, whitish beneath, taste mucila- 
ginous and bitter. Contains Lichenin or lichen starch, which forms as a jelly when the 
plant is boiled in water ; also Cetraric Acid. 

Decoctum Cetrariae, Decoction of Cetraria, — 5 per cent, strength. Dose, ^ij-iv. 

Cetraria is nutrient, demulcent and feebly tonic. It has a popular reputation in pulmo- 
nary affections, and is of value in chronic catarrhs, chronic bronchitis, purulent discharges 
from mucous surfaces generally, also in chronic diarrhoea and dysentery. 

CHAULMOOGRA OIL (Unofficial),— is a fixed oil expressed from the seeds of 
Gynocardia odorata, an East Indian tree of the nat. ord. Bixacese. It is nauseous and 
bulky, solid at 62. 6° F. } and soluble in alcohol, ether, chloroform, etc. Its active principle, 
Gynocardic Acid, is the best preparation for use, and may be given internally in doses of 
gr. ss-iij, or applied as an ointment, gr. xx ad ^j of Petrolatum. Dose of the oil, gtt. 
v-x, in capsules. 

Chaulmoogra Oil is credited with a few cures of leprosy, and several cases improved 
by its use both internally and externally. It is recommended as an external application 
in scaly eczema, psoriasis, syphilitic skin-diseases, chronic rheumatism, rheumatic arthritis 
and tabes mesenterica. 

CHELIDONIUM, Celandine, — is the plant Chelidonium majns, nat. ord. Papa- 

veraceae, which grows in Europe and N. America, about rocky places. It has a peculiar, 

unpleasant odor, and a pungent, acrid taste. Contains 2 alkaloids, Chelidonine, 

C ]9 H n N 3 3 , and Chelerythrine, the latter being identical with Sanguinarine : also Cheli- 

12 



I78 CHENOPODIUM — CHIMAPHILA — CHINOLINUM. 

doxanthin, a yellow, crystalline substance, and Chelidonic Acid, supposed to be identical 
with Succinic Acid. Dose of the plant, gr. x-xxx, — of the fresh juice Tl^v-xx. There 
are no official preparations. 

Chelidonium used externally is irritant, internally it is a drastic purgative but an unre- 
liable one. It is also perhaps diuretic, diaphoretic and expectorant. In overdoses it is 
considered poisonous. It is an old remedy for jaundice and liver affections, but has 
been obsolete for some time. The fresh juice is a popular application for warts and 
corns, and a tincture in whiskey is used in Indiana as a remedy for phthisis, the men- 
struum being probably the most useful agent. It seems to be of real service in simple 
jaundice, whooping-cough, right-sided pneumonia with hepatic involvement, and the 
catarrhal pneumonia of children. 

CHENOPODIUM, American Wormseed, — is the fruit of Chenopodium ambro- 
sioides, var. anthelminticu/n, a plant of the nat. ord. Chenopodiaceoe, indigenous in the 
United States. It is about y 1 ^ inch in diameter, and contains a glossy, black seed, has a 
peculiar terebinthinate odor, and a pungent, bitter taste. Its active principle is a Volatile 
Oil which is official. 

Oleum Chenopodii, Oil of C/ie-noJ>odium,—a. thin, colorless or yellowish liquid, of 
aromatic odor and pungent, bitter taste. Dose, tt^v-xv. 

The Oil is the only preparation used and that rarely, its odor and taste being very dis- 
agreeable. It increases the cardiac rate, and promotes the secretions of the skin, bronchi 
and kidneys. It is an efficient anthelmintic against the round worm in doses of gtt. x 
three times a day for two days, followed by a cathartic. It seems to possess some tonic 
properties, and certainly is a diffusible stimulant. As such it has been used with benefit 
in chorea, hysteria, flatulent dyspepsia, and chronic malaria. 

CHIMAPHILA, Pipsissewa, — the leaves of Chimaphila umbellata, or Prince's 
Pine, an evergreen plant of the nat. ord. Ericaceae, indigenous in all parts of the United 
States. The leaves are about 2 inches long, serrate above, wedge-shaped towards the 
base, having an astringent and bitter taste. Contains Chimaphilin, a yellowish crystalline 
principle, Arbutin, also crystalline but colorless, with tannic acid, etc. 

Extractum Chimaphilse Fluidum, Fluid Extract of Chimaphila, — Dose, gss-ij. 

Decoctum Chimaphilae, Decoction of Chimaphila (Unofficial), — I to 17. Dose, 

Chimaphila is a tonic, astringent diuretic, belonging to the same group as Buchu, Uva 
Ursi, Pareira and Scoparius. It is probably the most active diuretic among them, stimu- 
lating all the excretory organs but especially the kidneys. It is an agreeable tonic, excites 
the appetite and promotes digestion. The fresh leaves, bruised and applied to the skin, 
are rubefacient and vesicant, showing the presence of some irritant principle. 

Chimaphila is a good diuretic in dropsy, and is efficient in several forms of chronic 
kidney disease with albuminuria, and in chronic catarrhal affections of the urinary pas- 
sages, as hematuria, ischuria, dysuria and gonorrhoea. It is believed to check the secretion 
of uric acid, and should prove useful in gout and rheumatism. Externally, it has been 
applied to ulcers and tumors with benefit. 

CHINOLINUM, Chinolin, Leucolin, C 9 H 7 N (Unofficial), a con- 
stituent of coal-tar oil — but may be obtained from Quinine or Cinchonine 
by their destructive distillation with potassium hydrate, and artificially 
prepared by heating Anilin or Nitro-benzol with glycerin in the presence 
of a dehydrating agent. Chemically, it is considered to be formed by a 
union of Benzene and Pyridine atoms. (Compare the article Cinchona.) 
It is a colorless, oily liquid, strongly refractive, boiling at 460 F. without 
decomposition, turns dark on exposure to the air; soluble in alcohol, 
ether and carbon disulphide, sparingly so in water. It combines, like an 
alkaloid, with acids to form crystalline salts; all of which, except the 
tartrate, are very deliquescent. 



CHIRATA CHLORAL. 1 79 

Chinolini Tartras, Chinolin Tartrate, (Unofficial), — a white, micaceous, crystalline 
powder, of pungent odor and sharp taste, stable in the air and soluble in water. Dose, 
gr. v— xx. 

Physiological Action and Therapeutics. 
Chinolin is a valuable antiseptic, and antipyretic, being nearly as 
effective in this respect as Quinine, which it closely resembles in chemical 
character and physiological action. It is one of the most powerful anti- 
pyretics of the substances which have been discovered in the search for 
an artificial quinine (Hydroquinone, Antipyrin, Pyrocatechin, Resorcin, 
Thallin, Kairin, etc.). Chinolin has a very disagreeable taste and smell, 
and is irritant in action, hence the tartrate is preferred for medicinal use. 
It has been extensively used as an antipyretic in pneumonia, typhus, 
diphtheria, typhoid and other fevers, with varying success. In diphtheria, 
a 5 per cent, solution in weak alcohol is painted on the affected surface 
with great benefit. The tartrate has been used beneficially in neuralgia 
and whooping-cough, and as an antiperiodic in intermittents. 



CHIRATA, Chirata, (C/iiretta), — is the Indian plant Swertia Chirata, nat. ord. 
Gentianacese, occurring in bundles composed of all but the coarser woody stems. It is 
inodorous but intensely bitter, and contains Chiratin and Ophelic Acid, two amorphous, 
bitter principles, but no tannin. Dose of the powdered plant, gr. xv-xxx. 

Extractum Chiratae Fluidum, Fluid Extract of Chirata, — made with glycerin and 
diluted alcohol. Dose, TlLxv-xxx. 

Tinctura Chiratae, Tincture of Chirata, — 10 per cent. Dose, ^ss-ij. 

The action of this plant is that of a simple bitter, like its congener Gentian. It is an 
excellent tonic, in this respect rivalling Cinchona, and is used in India as a substitute for 
the latter. It is laxative and stomachic, diminishes flatulency and acidity, and is particu- 
larly serviceable in the dyspepsia of gouty subjects. As it contains no tannin, it may be 
administered with preparations of Iron. 



CHLORAL, Chloral, Chloral Hydrate, C 2 HC1 3 + H 2 0,— is a 
crystalline solid, composed of Trichloraldehyde or Chloral with one 
molecule of water. It occurs in colorless, transparent, rhomboidal crys- 
tals, slowly volatilizing when exposed to the air; of aromatic, penetrat- 
ing and slightly acrid odor, bitterish, caustic taste, and neutral reaction. 
It is freely soluble in water, alcohol, ether, chloroform, oils, etc. \ lique- 
fies when triturated with about an equal quantity of camphor, menthol, 
thymol or carbolic acid; melts at 136 F. and is decomposed by alkalies 
into Chloroform and a formiate of the alkaline base. Its aqueous solu- 
tion becomes acid, but the alcoholic solution remains neutral. 

Chloral itself, (Trichloraldehyde, C 2 HC1 3 0), is an unstable, oily, color- 
less fluid, formed by the action of chlorine upon alcohol, whence its 
name, Chlor-al. The Hydrate is the only official preparation. 

The Dose varies much with individual susceptibility and with the presence or absence of 
cardiac and pulmonary disease. Death has been caused in several instances by gr. xxx, 
in one case by gr. x, and in another gr. vijss produced alarming symptoms, all being 



l80 CHLORAL. 

adults. On the other hand several hundred grains have been ingested at one time with- 
out lethal effects, and where tolerance has been established by habitual use, gij-giij are 
frequently taken without poisonous symptoms. An average dose for a healthy adult is 
gr. xv, for a child gr. j for each year of age up to gr. vj. It is best given in Syrup 
of Tolu. 

Caution is necessary when prescribed in combination with alcoholic preparations, as 
Chloral Hydrate is then very apt to separate as an alcoholate, especially if the Bromides 
of Potassium or Sodium are used in the same mixture and if the solutions are at all con- 
centrated. In this way great clanger is incurred of giving a heavy overdose, as the alco- 
holate floats on the surface of the mixture, and the entire Chloral contained therein may 
be taken at a single dose. 



Hypnotic Analogues of Chloral. 

Amylene Hydrate, C 5 H 12 0, Di-methyl-ethyl-carbinol {\]no&ic\sX), — a tertiary alcohol, 
occurring as a clear, colorless fluid, of peculiar odor, soluble in 8 of water and readily 
miscible with alcohol. It is one of the most valuable hypnotics, in power standing between 
chloral and paraldehyde, but being much more agreeable to the taste and safer than either 
of those agents. Its action is exerted chiefly on the cerebrum in doses sufficient to pro- 
duce profound narcosis ; and in medicinal doses it leaves behind no unpleasant effects, 
and has no perceptible influence on the heart or respiration. By very large dosage the 
medullary centres are paralyzed, including those governing respiration and cardiac action. 
Dose, 3J-3Jss. 

Cannabini Tannas, Cannabin Tannate (Unofficial), — is not more reliable than the 
Extract of Cannabis Indica, though devoid of the exciting qualities of the latter prepara- 
tion. Dose, as a hypnotic, gr. ij-x, the average being gr. v. Fronmuller considers it a 
very useful hypnotic, powerful and not dangerous, not disturbing the secretions, nor leav- 
ing unpleasant after-effects, if used in proper doses. (See ante, page 1 68). 

Chloralamid, — is described under its own title. 

Chloral Butylicum, Croton- Chloral, (Unofficial), — is described under its own title. 

Hyoscinae Hydrobromas, Hyoscine Bydrobromate, — is an efficient hypnotic, with 
the advantage of being tasteless, and having a very small dose (gr. y^o - ^)' so tnat **■ 
may be given in tea, coffee, etc. It is apt to affect the head afterwards, and soon loses 
its power by repetition. In large doses it is a dangerous respiratory depressant. (See 
under Hyoscyamus.) 

Hypnal is a combination of Antipyrin and Chloral, occurring as tasteless and odor- 
less rhombic crystals, soluble in 6 of water, and credited with simultaneous action as a 
hypnotic and analgesic. Dose, gr. xv-xxx in aqueous mixture with some alcohol, flavored 
with syrup of orange. It is said to cause no gastric disturbance. 

Although Chloral and Antipyrin are incompatible with each other, they form, when 
heated together, the above described compound, which resembles both and yet differs 
from each. Its chemical appellation is Tn-chloraldehyd-phenyl-dimethyl-pyrazolon, and 
its formula is C 13 Ch 3 N 2 H ]5 :v 

Hypnone, C 6 H 5 (CO)(CH s ), Phenyl-methyl-acetone, (Unofficial),— a member of the 
Ketones, occurring above 70 F. as a colorless, mobile liquid, having a strong almond 
and orange odor. It is insoluble in water or glycerin, and is best given in capsules. It 
is a hypnotic, of only moderate intensity, but said to be especially useful in the insomnia 
of alcoholism. Its use is devoid of danger, and leaves behind no unpleasant effects, 
except a disagreeable odor of the breath, the drug being eliminated by the lungs as well 
as by the kidneys. In very large doses it has induced coma, followed by paralysis of the 
heart and respiration. Dose, n\v-x, in capsule, n\vij to rri^viij being usually required. 

Methylal, CH 2 (OCH 3 ) 2 , Methylene-di-methyl Ether, (Unofficial), — one of the products 
of the oxidation of Methylic Alcohol, occurring as a volatile, mobile liquid of pleasant, 
aromatic odor and taste, readily soluble in water, alcohol, etc. It is a local anaesthetic, 
and an efficient hypnotic, producing a deep sleep of short duration, with more or less 
general anaesthesia and lowered reflex excitability. It is depressant to the heart, respira- 
tion and body temperature, but in medicinal doses does not leave any bad after-effects. 
Dose, per orem n\iv-v, repeated thrice at short intervals. 

Somnal, (Unofficial), — a liquid hypnotic, made by the union of Chloral, Alcohol and 
Urethan, is described under its own title. 

Sulphonal, Trional and Tetronal, are synthetical hypnotics, described under the title 

SULPHONAL. 



CHLORAL. l8l 

Urethan, Ethyl Carbamate, NH 2 CO.,C 2 H 5 (Unofficial), — occurs in crystals which are 
readily soluble in water, with scarcely any taste or odor, devoid of irritant action, and 
hence may be administered hypodermically. It is a pure hypnotic, but a mild one at 
best, and not so reliable as Paraldehyde or Chloral. It does not affect the circulation, 
nor does it depress (but rather stimulates) the respiration. It acts directly on the cere- 
brum, causing a sleep which closely resembles the normal, and has no unpleasant after- 
effects. In very large doses it slows the heart, lowers the temperature, and induces mus- 
cular resolution and general anaesthesia. In small animals it effectually antagonizes the 
action of Strychnine. Dose, gr. xv-gj, an average hypnotic dose being gr. xxx ; but it 
is best given in 5-grain doses repeated frequently, as a large dose may cause vomiting. 
It is a safe and efficient hypnotic for children. (Squibb.) 

Physiological Action. 

Chloral is a powerful hypnotic, also an antispasmodic, an antiferment, 
a preventive of the coagulation of fibrin, indirectly an anaesthetic, and 
especially a depressant of the cerebral, medullary and spinal centres and 
of the cardiac muscle. It is more hypnotic than chloroform but less of 
an anaesthetic. Applied to the skin or mucous membranes a 1 per cent., 
solution (gr. v ad S|j) is antiseptic, but strong solutions are irritant and 
vesicant, may produce sloughing ulcers, and if taken internally may, 
excite gastritis with nausea and vomiting. 

After a brief period of stimulation a medicinal dose depresses the heart 
and lowers arterial tension, diminishes oxidation and decreases the body 
temperature. On the brain cells it has a selective action, producing a 
deep sopor very like normal sleep, from which the patient may be awak- 
ened, but immediately falls asleep again, and which is not followed by 
headache or depression. This effect is considered by some authorities to 
be the result of cerebral anaemia produced by the drug. In some persons, 
instead of sleep it causes headache, insomnia and delirious excitement. 
It is not an anodyne, as it does not affect the conductivity of the sensory 
nerves, and does not interrupt the transmission of pain ; but by over- 
whelming the centres it drowns the consciousness of pain, and is therefore' 
indirectly anaesthetic. A toxic dose produces profound narcotism, abol- 
ishment of reflexes and sensibility, complete muscular relaxation, and" 
a great fall of body temperature. Death may result in the chloral sleep 
from paralysis of the respiratory centre or the cardiac motor ganglia, or 
by sudden failure of the heart-muscle in cases of fatty degeneration or in 
old drunkards. 

On the blood its action is to increase the fluidity, crenate the red cor- 
puscles, and to destroy the leucocytes if used in large quantity. It is 
rapidly diffused and is excreted by the kidneys partly unchanged, but 
chiefly as urochloralic acid, producing some diuresis, — also by the skin, 
causing various eruptions if used for any lengthened period. It has been 
held that the blood, being an alkaline fluid, decomposes it, setting free 
chloroform, but there are many facts against this theory. 

The Chloral-habit produces a state of marked anaemia and muscular 
weakness, especially of the legs (DaCosta) ; its subject presenting a weak, 



1 82 CHLORAL. 

irritable, often irregular heart, deranged hepatic functions, jaundice, 
bileless stools, perhaps purpura and sloughing of a finger from decreased 
blood-supply. Its votaries are on the border of insanity, excitable, un- 
controllable in speech and action, talking in a silly manner and very 
volubly, and showing a marked loss of power of the limbs, so much so as 
to simulate paralysis thereof. Many cases of insanity have their origin in 
chloralism. 

Chloral and Atropine, though antagonistic in their action on the 
spinal cord, both produce motor paralysis, the former by paralyzing the 
cord, the latter by direct paralysis of the motor nerves. 

Antagonists and Incompatibles. 

Atropine antagonizes its cardiac, respiratory and spinal depression, and should be in- 
jected in small doses frequently repeated, until its effects are apparent. Morphine admin- 
istered with Chloral antagonizes the tendency to cardiac failure, .while synergistic to the 
hypnotism. While Chloral is the antagonist to Strychnine, opposing the spinal action of 
that drug, the reverse is only true to a very limited extent. Heat is a necessary application, 
to maintain the body-temperature, and artificial respiration should be practiced if required. 
All alkalies are incompatible. 

Therapeutics. 
Chloral Hydrate is of great value as a hypnotic and antispasmodic, but 
must be cautiously used if at all in old alcoholics or persons with weak or 
fatty hearts, atheromatous vessels or advanced pulmonary disease. In 
combination with Potassium Bromide it is much used in asylum and 
general practice, and equally abused, both drugs being active cardiac 
poisons. It is by far the best hypnotic in acute mania and in delirium 
tremens, but has been too incautiously employed therein. The condition 
of alcoholic intoxication seems, however, to antagonize its depressant 
action on the heart to a great extent, even in old topers, for 30-grain 
doses, repeated twice within 7 or 8 hours, are commonly used in inebriate 
asylums, and by police surgeons, for the purpose of straightening up a 
case of acute alcoholism, without fatal results from its direct action. 
Chloral is highly serviceable in fevers, when high temperature exists with 
excitement, restlessness and a sthenic condition, as it lowers temperature 
and prevents the coagulation of fibrin. In the algid stage of cholera and 
in violent cases of cholera morbus it has been injected hypodermically in 
15-grain doses with extraordinary efficacy. In sea-sickness small doses 
(gr. v) two or three times a day are generally very efficient. In obstetrics 
it is used to relieve suffering, relax the os uteri, palliate convulsions and 
relieve after-pains. For nocturnal epilepsy a full dose at bedtime is a 
useful palliative. In neuralgia it may be triturated with camphor and 
applied over the course of the affected nerve. Tetanus is best treated by 
chloral and potassium bromide. Chloral is an excellent remedy for 
infantile convulsions and colic, chorea, spasmodic asthma, whooping- 



CHLORAL BUTYLICUM CHLORALAMIDUM. I 83 

cough, laryngismus stridulus, and in the first stage of diphtheria, but not 
when the heart is weak. In cancers and ulcers a 25 per cent, solution is 
a good antiseptic and anodyne application. In Strychnine poisoning 
Chloral is the antagonist. It is generally given by the mouth in dilute 
solution with some simple elixir, syrup of tolu, or cinnamon-water, but is 
well absorbed by the rectum. Its hypodermic administration is liable to 
result in great local irritation and even sloughing ulcers. 

The mixture of Chloral and Camphor is a good local application in 
superficial neuralgia, and may be painted over the larynx for spasmodic 
cough. It makes a good remedy for internal use in colic, cholera and 
cholera morbus, especially if combined with Morphine. 



CHLORAL BUTYLICUM, Butyl-chloral Hydrate, Croton-chloral, C 4 H 5 C1 3 - 
0,H 2 (Unofficial), — is formed by the action of Chlorine upon Aldehyde, then adding to 
the Butyl Chloral thus produced the necessary water. It occurs in crystalline scales, insol- 
uble in chloroform, sparingly soluble in water, (1 in 100), but freely soluble in alcohol, hot 
water and glycerin, (I in 4). Dose, gr. v-xx, in syrup or pill; — but the best method is 
to give 5 grains every half-hour until 20 grains have been taken or relief afforded. 

The action of Croton-chloral closely resembles that of chloral, but it is feebler as a hyp- 
notic, less depressant to the heart, and generally less poisonous, but more disagreeable to 
the taste. It has a specific paralyzant power over the fifth nerve, and over its distri- 
bution causes an anaesthetic condition long before it produces general anaesthesia 
(Liebreich). 

It has been used with benefit in various neuralgiae, especially tic-douloureux, also in 
sciatica and dysmenorrhoea. All statements concerning the action and therapeutics of 
this drug are to be received with hesitation, as wide differences therein are reported by 
the best authorities. 



CHLORALAMIDUM, Chloralamid, Chloral Formidale, (Unof- 
ficial), — is chemically a union of Chloral anhydride (C 2 HC1 3 0) with 
Formamide (CHO.NH 2 ). It is a proprietary drug, having been both 
patented and trade-marked, wherever possible, by its proprietor and ex- 
clusive manufacturer, Schering, of Berlin. It occurs as colorless, faintly 
bitter, odorless crystals, which are decomposed in hot water or warm 
solutions. Soluble in 20 parts of cold water, or in \y 2 of alcohol ; — 
rapidly decomposed by caustic alkalies and slowly by alkaline carbonates. 

The Dose is put at from 10 to 60 grains. The average adult hypnotic quantity about 
30 grains, given in a teaspoonful of whiskey or brandy, or in any alcoholic compound; — 
for example, 30 grains in 2 drachms each of Tinct. Cardamom. Co. and Elixir Simplex, 
at one dose. By some observers a 45-grain dose is considered the limit of safety and 
equal to 30 grains of Chloral hydrate ; by others this amount is considered necessary for 
its certain hypnotic action. Sixty grains have frequently been administered, and in one 
case 140 grains were taken at one dose, without producing unpleasant symptoms; — but, 
as Dr. Steele has pointed out, the slow solubility of the drug in the watery contents of the 
stomach must be taken into account, and when considering its action, the menstruum and 
the condition of the gastric mucous membrane should be known. 

Physiological Action and Therapeutics. 
The action of Chloralamid is essentially a hypnotic one ; it is exten- 
sively advertised as the least depressant and most efficient sleep-producer 



184 CHLOROFORMUM. 

at our command, — without unpleasant after-effects from ordinary doses, 
except in 2 per cent, of the cases in which used, 1 per cent, having 
gastric and the other 1 per cent, having cerebral symptoms ; while these 
were always slight unless the dose of 30 grains had been exceeded. The 
more severe and unusual effects (from doses above 30 grains) are vertigo, 
thirst, nausea, dry mouth, vomiting, anorexia, slight delirium, cardiac 
weakness, rapid and feeble pulse, and restlessness. The drug does not 
seem to have any cumulative action, nor any tendency to provoke a habit 
of using it. It is also credited with considerable analgesic power in cer- 
tain conditions (see below), as well as with anti-dyspnceic and anti- 
hydrotic action. 

The main field for the use of Chloralamid has been in the treatment of 
insomnia, particularly the simple or idiopathic form, and when not due 
to excitement or severe pain, but from nervousness, hysteria, chronic 
alcoholism, and similar states ; also in that accompanying typhoid fever, 
asthma (both cardiac and bronchial), organic heart disease, the opium 
habit, and diabetes mellitus (Steele). It is less effective in organic 
nervous affections and mental disorders, and is useless in these conditions 
when the insomnia is due to excitement, hallucinations, or severe pain. 

As an analgesic, it has lessened and checked the pains of aneurism, 
carcinoma of the stomach and liver, sarcoma of a rib, erysipelas, rheu- 
matic fever, gall-stone, etc. ; — and in dysmenorrhea has given entire 
relief, used just as the painful period approached, in a single dose of 30 
grains. It has been reported curative of chorea, in doses of gr. 15 thrice 
daily for five days, in a boy of eleven years ; and in a girl who had 
resisted all other treatment for the same affection, it was successful in 
8 days. 

Compared with Sulphonal, Chloralamid is preferred for all cases in 
which collapse is feared, by reason of its apparent freedom from depressant 
action on the cardiac centres or the respiratory mechanism. In phthisis 
it has proven efficient against the most obstinate night-sweats, while at 
the same time securing rest in cases in which the cough was not very 
violent. To secure the best results as a hypnotic, the drug should be 
given about an hour and a half before sleeping-time, in a dilute alcoholic 
menstruum, and on a stomach containing little or no watery fluids to 
interfere with its solution and absorption. 



CHLOROFORMUM, Chloroform, CHC1 3 (or CHC1 2 C1), Ab- 
solute Chloroform, the Terchloride of Methyl, or the Chloride of Bichlor- 
inated Methyl, (Di-chlor-methyl Chloride), — is formed by the substitution 
of 3 atoms of Chlorine for 3 of Hydrogen in Methyl Hydride (marsh- 
gas, CH 4 ). In practice it is obtained from Ethylic Alcohol or Methylated 



CHLOROFORMUM. I 85 

Spirit by the action of Chlorinated Lime, or from Chloral by an alkaline 
hydrate, and is known chemically as Normal Chloroform. If prepared 
from Methylic Alcohol (wood-spirit) it is called Methylic Chloroform, and 
is purified with great difficulty. The object of purification is to remove 
the chlorinated pyrogenous oil. Absolute Chloroform has a sp. gr. of 
1.500, and decomposes easily in sunlight or diffused daylight, but when 
reduced to a sp. gr. of 1.485 to 1.490 by alcohol it will keep well. The 
official. form is — 

Chloroformum, Chloroform, CHC1 3 , — a liquid consisting of 99 to 
99.4 per cent, by weight, of absolute Chloroform, and 1 to 0.6 per cent, of 
Alcohol. A heavy, clear, colorless, mobile and diffusible liquid, of char- 
acteristic, ethereal odor, a burning, sweet taste, neutral reaction ; volatile, 
not inflammable ; soluble in 200 of water, freely so in alcohol or ether, 
also in oils, benzol or benzin. Sp. gr. not below 1.490 at 59 F., or 
1.473 at 77° F. Dose, internally, y\ ij-xx, for inhalation gj, repeated 
until the desired effect is produced. 

Chloroformum Venale, Commercial Chloroform, (Unofficial), — is a liquid containing 
at least 98 per cent, of Chloroform, and having a sp. gr. not lower than 1.470. It con- 
tains sundry Hydrocarbons, free Chlorine, Aldehyde and Hydrochloric Acid, and is used 
only for external applications, or to make the purified article. 

Preparations. 

Aqua Chloroformi, Chloroform Water, — a saturated solution, prepared by agitating 
an excess of chloroform in distilled water and pouring off the needed quantity of the 
solution. 

Emulsum Chloroformi, Emulsion of Chloroform, — has of Chloroform 4, Expressed 
Oil of Almond 6, Tragacanth 1^, Water to 100. Dose, gj-^j. 

Spiritus Chloroformi, Spirit of Chloroform, — has of Chloroform 6, Alcohol 94. 
Dose, rr^x-gj, well diluted. 

Linimentum Chloroformi, Chloroform Liniment, — has of Chloroform 30, Soap 
Liniment 70. 

Linimentum Chloroformi Compositum, Coj?ipound Chloroform Liniment, (Un- 
official), — has of Chloroform ^j, Oil of Turpentine ^j, Tincture of Opium ^ss, Tincture 
of Aconite 3 ij. 

Chlorodyne, (Unofficial), — is a celebrated secret mixture, put forth by Dr. J. Collis 
Browne, of London, and since imitated by many others. It is supposed to contain 
Chloroform, Ether, Morphine, Cannabis Indica, Hydrocyanic Acid, Capsicum, etc., and 
is powerfully anodyne, antispasmodic and narcotic, and therefore highly dangerous in non- 
professional hands. Dose, n\x-xxx, according to the quantities of Morphine and Chloro- 
form present, these being the active agents in the preparation. A comparison of the 
principal formulae which have been used in imitation of Browne's Chlorodyne is given in 
the appendix, and will show the wide differences between them. A list of 25 formulae 
for Chlorodyne was published in the Therapeutic Gazette for October, 1883. 

Tinctura Chloroformi et Morphinae (B.P.), — has been recently made official as a 
substitute for Chlorodyne. Each dose of 10 minims contains of Chloroform XC\\%-, Ether 
m^, Alcohol tilX' Morphine Hydrochlorate gr. J ¥ , Dilute Hydrocyanic Acid TT\,^, 
Oil of Peppermint m^V Fluid Extract of Liquorice V\}%, Treacle and Syrup q. s. 

Tinctura Chloroformi Composita (B. P.), — has of Chloroform 2, Alcohol 8, and 
Compound Tincture of Cardamoms 10. Dose, H\,xx- 3 j. 

Anaesthetic Mixtures containing Chloroform, — see under vEther, ante, page 87. 

Some Unofficial Chlorinated Anesthetic Compounds. 
Ethylene Bichloride, Dutch Liquid, Chloric Ether, C 2 H 4 C1 2 , — is a rapid and power- 
ful anaesthetic, probably safer than Chloroform and less so than Ether. It always paralyzes 



1 86 CHL0R0F0RMUM. 

the respiratory centre before the heart, so that its effects may be easily watched and con- 
trolled. This is the substance which Guthrie supposed he had obtained when he discov- 
ered Chloroform. 

Ethylidene Chloride, Chlorinated Muriatic Ether, CH 3 ,CHC1 2 , — is a mixture of 
varying sp. gr., and is not inflammable. It closely resembles Chloroform both physically 
and physiologically, but is less depressant to the heart, consequently safer, and recovery 
from its effects is very prompt. 

Methyl Chloride, CH,C1, — a colorless gas, slightly soluble in water, of sweetish odor 
and taste, inflammable, burning with a greenish flame. Cold liquefies it, and the liquid 
boils at — 7. 6° F. It is used locally in neuralgias to produce intense cold, and with re- 
markable success. 

Methylene Bichloride, Dichloro-methane, CH 2 C1 2 , — is an effective anaesthetic which 
it was supposed would displace Chloroform as being much safer. Dr. Richardson intro- 
duced it and Sir Spencer Wells advocates its use, but though little used as compared 
with other anaesthetics several deaths have occurred from its employment. It kills by 
paralyzing the heart. 

Carbon Tetrachloride, CC1 4 , — is less irritant than Chloroform, but far more danger- 
ous to the heart. 

Physiological Action. 

The action of Chloroform is similar to that of Ether (see ante, page 87) 
with several important differences, as follows : It is more irritant to the 
mucous membranes, and if swallowed undiluted it produces violent gastro- 
enteritis, which becomes apparent after the subsidence of the profound 
narcotism which at first follows its ingestion in quantity. A dose of ^j 
internally will cause death. It is less of a stimulant than Ether, and 
more depressant to the heart and circulation. It clots the blood outside 
the body, making a mass like sealing-wax. 

Inhaled for anaesthetic purposes it is considered much more dangerous 
than Ether, from its direct paralyzant effect on the heart. Its vapor 
requires admixture with 96^ per cent, of air to produce anaesthesia with 
safety, according to the authorities on the subject. As compared with 
Ether its vapor is less irritant to the air passages, uninflammable, more 
pleasant, more prompt in action, has a shorter stage of excitement and a 
more profound narcosis, and produces much less vomiting. Its mortality 
is greater, being about 1 to 3000, against 1 in 16,000 for Ether, fatal 
cases being constantly reported, none of which, however, were in obstet- 
rical practice. 

The result of the labors of the Hyderabad Chloroform Committee, 
conducted under the direction of Dr. Lauder Brunton, show that Chloro- 
form and Ether act in the same way upon the heart and respiration, both 
paralyzing the respiratory centre before the heart, — Chloroform acting 
more quickly and more powerfully than Ether in both directions. This 
would necessitate that the person administering chloroform as an anaes- 
thetic should give his undivided attention to the respiration, the pulse 
being of secondary importance as long as the breathing is normal. Prior 
to this investigation it was taught that death from Chloroform-inhalation 
is almost always sudden and by cardiac paralysis, — from Ether slow and 
usually by paralysis of respiration. 



CHLOROFORMUM. I 87 

[For modes of death from anaesthetic vapors and the treatment of dan- 
gerous symptoms, see ante, page 88.~\ 

Antagonists. 

There is no chemical antidote. If swallowed, the stomach should be evacuated and 
the case treated as one of poisoning by an irritant. Amyl Nitrite by inhalation, and 
Atropine hypodermically, to sustain the heart. 

Therapeutics. 

Chloroform is used for the same conditions as is Ether. It is much 
employed in liniments as a rubefacient and anodyne application, as in 
pruritus, rheumatic and neuralgic pains, etc. Internally it is advanta- 
geously administered in true cholera, in which it has been probably 
more efficacious than any other single remedy; in cholera morbus, vomit- 
ing, colic, dysmenorrhcea ; in hepatic colic, and other pains of internal 
and spasmodic character. In sciatica, tic-douloureux and other neuralgiae 
of important nerves the deep injection of n^v-xv of pure Chloroform in 
the vicinity of the nerve is highly recommended, though it may cause 
dangerous local disturbance. The writer has, in several cases of severe 
supra-orbital neuralgia, injected two or three minims of Chloroform into 
the vicinity of the supra-orbital nerve just above its foramen of exit, with 
the most gratifying permanent results, though severe local pain and 
considerable swelling were experienced for several days. The vapor 
in small quantities inhaled from warm water is useful in many neuroses, as 
hay-fever, spasmodic asthma, reflex cough. 

As an Anaesthetic the use of Chloroform is decreasing every year in 
favor of Ether, except for young children and in obstetrical practice. Its 
vapor being four times denser than air, and the rule for its effective use 
requiring fully 96^ per cent, of air with it, its administration according 
to the orthodox fashion requires most careful management, and should 
never be attempted in any but the recumbent posture. An ounce of 
Brandy and a hypodermic injection of Morphine, gr. \, with Atropine, 
gr. -j-i-g-, given 20 minutes before commencing the inhalation, are means 
of great utility in sustaining the heart and respiration, as well as in ren- 
dering the anaesthesia more profound. No operation, especially on parts 
supplied by the fifth nerve, should be undertaken during partial chloro- 
form anaesthesia, for the reasons given on page 88. 

Syme administered Chloroform in five thousand cases without a single 
death therefrom. He ascribed this excellent record to his adherence to 
the following rule : "Never mind the pulse, never mind the heart, leave 
the pupil to itself, but keep your eyes on the breathing, and if it becomes 
embarrassed to a grave extent, pull the tongue well out with an artery 
forceps." 

Dr. Sayre administers Chloroform in a manner which is calculated to 



I 88 ' CHLORUM. 

strike terror to the heart of an emotional observer who is impressed by the 
orthodox rule of g6}4 per cent, air with 3*4 per cent, of the anaesthetic 
as the only safe proportion. Having been made familiar with the prac- 
tice of Dr. Sayre through observance of his method as employed by some 
of his pupils, the writer sought for more direct instructions from that dis- 
tinguished surgeon, and received from him a letter from which the fol- 
lowing paragraphs are extracted : — 

"I have employed no other method for more than twenty years, have used it in this 
manner in some thousands of cases without the least appearance of danger, and can 
therefore speak with confidence as to its safety. 

"My plan is simply to anaesthetize the patient with the smallest amount of Chloroform 
possible ; and as Oxygen is the Antidote to the anaesthetic I exclude all air that is not 
impregnated with the anesthetic. 

" In this manner a very few inspirations will produce immediate anaesthesia without 
the muscular struggling which always follows when pure air is admitted with the chloro- 
form. I always measure my dose with the same care as if I were administering Arsenic, 
Strychnine, Corrosive Sublimate, or any other potent agent; and then I know what I am 
doing. If by accident there should be some peculiarity about the patient, making him 
unduly susceptible, a few artificial respirations would soon remove the influence of the few 
drops which had been inhaled, and thus all danger can be avoided. Five, ten, or twenty 
drops of Chloroform administered in this manner is all that is requisite to produce imme- 
diate and profound anaesthesia. I have explained my method hundreds of times at my 
clinical lectures in Bellevue Hospital, many of which have been published at different 
times in different medical journals by various persons who have made stenographic re- 
ports of my lectures. In the 'Transactions of the International Medical Congress,' held 
in Philadelphia in 1876, is a verbatim report of my remarks on this subject made while 
I was performing an exsection of the hip-joint in the hospital before the Congress." 

The writer can add his testimony to that of the above letter respecting 
the thorough anaesthetic effect and freedom from unpleasant symptoms 
observed in a large number of cases in which Chloroform was administered 
in the manner described under his observation during several years past. 
As to the safety of this method over the ordinary way no conclusion can 
be reached without the results of many thousands of examples in the 
hands of many different observers. 



CHLORUM, Chlorine, CI, — is a greenish-yellow gas having a 
suffocating odor, and belonging to the group of Halogen elements, so 
named (from a'A?, the sea) because its most important members, Chlorine, 
Bromine and Iodine, are derived from the ocean, Chlorine being obtained 
from sea-salt, Bromine from sea-water, and Iodine from sea-weed. Chlo- 
rine itself is not official, but is represented in medicine by 2 Chlorates 
and 8 Chlorides (of Potassium, Sodium, Ammonium, Calcium, Iron, 
Gold, Zinc and Mercury), which are described under the titles of their 
respective bases; also by Hydrochloric Acid, Chloral, Chloroform, etc., 
and by the following preparations which furnish it. 

Preparations. 
Aqua Chlori, Chlorine Water, — is an aqueous solution of Chlorine, containing at least 
0.4 per cent, of the gas; and is prepared by heating together Manganese Dioxide 10 



CHLORUM. I89 

parts and Hydrochloric Acid 35 parts, then saturating 400 of distilled Water with the gas 
so obtained. It is a clear, greenish-yellow liquid, of suffocating odor and disagreeable 
taste. Dose, gj-^ss, well diluted, as a lotion or spray; internally, ITLx-xx, in water. 

Chlorine Water may be extemporaneously prepared by mixing in a mortar Chlorate of 
Potassium 40 grains and Hydrochloric Acid y 2 ounce, and adding a pint of distilled 
water by agitation during the evolution of the vapors. If done in a closed vessel danger 
may arise from the explosive gas, C1 2 Q 4 , which is liberated at the same time. It should 
be quickly bottled. 

Calx Chlorata Chlorinated Lime, (" Chloride of Lime"}, — is a compound resulting 
from the action of Chlorine upon Calcium Hydrate, and containing at least 35 per cent, 
of available Chlorine. It is obtained by exposing slaked Lime to the action of Chlorine 
gas as long as the latter is absorbed, and should not be confounded with Calcium Chloride 
(see ante, page 160). It occurs as a whitish, dry powder or friable lumps, gradually 
decomposing in the air, of saline, disagreeable taste and a feeble Chlorine odor, partially 
soluble in water and in alcohol, and when dissolved in dilute Hydrochloric acid gives off 
Chlorine gas. Dose, gr. iij-vj in water; for external use a I to 3 per cent, solution. 
Liquor Calcis Chloratce, B. P., is a solution of I pound in I gallon of water. 

Liquor Sodae Chloratae, Solution of Chlorinated Soda, Labarraque' 's Solution, — a 
pale-greenish liquid, of faint Chlorine odor, and alkaline taste and reaction ; prepared by 
adding together watery solutions of Sodium Carbonate 150, and Calx Chlorata, 75, each 
in water, then adding Water up to 1000. Is an aqueous solution of several chlorine- 
compounds of sodium, containing at least 2.6 per cent., by weight, of available chlorine. 
Dose, Ti\x- g j in 20 parts of water. 

Physiological Action. 
Chlorine is actively irritant to the skin and mucous membranes. Locally 
applied it produces heat, burning and even vesication. Inhaled in any 
quantity it causes cough, sneezing and spasm of the glottis, also inflam- 
mation of the air-passages and of the lungs. It is the most powerful of 
all disinfectants and deodorants, also an antiseptic and antifermentative 
agent of the highest activity. Its power in all these respects is due to its 
affinity for hydrogen, decomposing all bodies in which hydrogen enters 
as a molecular constituent, forming chlorhydric acid and setting oxygen 
free in its nascent form (ozone). Used internally it has the same local 
action on the parts with which it comes in contact, and on reaching the 
stomach in dilute solution it is converted into hydrochloric acid and 
chlorides, losing all further action on the body in its own character. 

Antidotes. 

Ammoniacal Vapors inhaled after Chlorine to form Ammonium Chloride. Ammonium 
Sulphide has a similar reaction, but should be inhaled in great moderation. Albumen 
is the antidote if Chlorine preparations have been taken into the stomach, and a little 
Aqua Ammonia;, sufficiently diluted, may also be administered with advantage. 

Therapeutics. 
The Chlorinated preparations are used as disinfectants and deodorizers 
of rooms, drains and discharges from the body. They are rarely used 
about the person or clothing of patients by reason of the irritation pro- 
duced by them when inhaled, and their power to destroy the color of 
fabrics. In dilute solution they are well employed as local applications 
in aphthae, gangrene, scarlet fever and diphtheria, in which their princi- 
pal action is to destroy fetor. The same may be said of their use in 



I9O CHONDRUS — CHRYSAROBINUM. 

sloughing ulcers and gangrenous wounds, foul discharges, etc., as they are 
rarely employed about the person in sufficient strength to have any de- 
structive effect on disease-germs. A strong solution of Chlorinated Soda 
is a good application to bites of serpents and insects, to prevent infection 
by the syphilitic poison, and to wash the hands after contact with infec- 
tious material. 

A combination of Potassium Chlorate and Tinctura Ferri Chloridi, 
makes a solution of Chlorine, Euchlorine, Potassium Chloride and Ferric 
Chloride, when diluted with water, and gives one of the best and most 
innocuous solutions of antiseptics. It makes an excellent gargle for sore 
throats, simple or diphtheritic. Glycerin should never be added to it, as 
the resulting mixture will be liable to explode violently. 

These preparations have been administered internally in septic diseases, 
low fevers, etc., but without producing any marked beneficial results. 

To disinfect unoccupied rooms all means of exit should be stopped up, 
then a pound of Chlorinated Lime sewed loosely in a strong canvas bag 
is immersed in a mixture of a pint and a half of common Muriatic Acid 
with 4.3^ pints of water, and left 24 hours. 



CHONDRUS, Irish Moss, Carragheen, — consists of two sea-algre, Chondrus 
crispus and Gigartina mannnilosa, dried and bleached. Is horny, translucent, pale 
yellowish-while, swelling in water, of sea-weed odor and mucilaginous, saline taste. On 
boiling with 30 parts of water for ten minutes it yields a solution which gelatinizes on 
cooling. It contains 90 per cent, of mucilage with traces of Iodine and Bromine, also 
I per cent, of Nitrogen. There are no official preparations. A jelly or blanc mange 
may be prepared by boiling ^ ij in ^ xxxiv of water for an hour, straining and adding 
^iij of sugar while hot. Dose, indefinite. 

Irish Moss is a demulcent and nutrient substance of some slight value in bronchial and 
catarrhal affections. Having no starch in its composition it is not so valuable as Iceland 
moss (Cetraria) as an article of food for the sick. 



CHRYSAROBINUM, Chrysarobin, — is a mixture of proximate principles ex- 
tracted from Goa-powder, a substance found in cavities formed by decay in the wood of 
the trunk of Andira Araroba, a Brazilian tree of the nat. ord. Leguminosse. It is com- 
monly misnamed " Chrysophanic Acid" (which is one of the constituents of Rheum) — 
though easily converted into that substance. Occurs as an orange-yellow powder, odor- 
less and tasteless, nearly insoluble in water and alcohol, but readily soluble in ether, solu- 
tions of alkalies and sulphuric acid. Dose, gr. *^-gr. xx. 

Preparation. 
Unguentum Chrysarobini, Chrysarobin Ointment, — Chrysarobin 5, Benzoinated 
Lard 95 parts. Should be diluted for average use from I to 3 times. 

Physiological Action and Therapeutics. 
In 20-grain doses Chrysarobin is a gastro-intestinal irritant, producing large, watery, 
bilious stools, with repeated vomiting but not much nausea. Locally it produces diffuse 
dermatitis ofien followed by follicular and furuncular inflammation. It stains the skin a 
dark yellowish-brown color, which may be removed by a weak solution of chlorinated 
lime. Ttie use of this remedy is confined to superficial parasitic skin diseases of vegetable 
origin, and for psoriasis, in the latter affection being the best remedy known. It may be 
used in weak ointment locally, and internally in l A -grain doses. 



CIMICIFUGA. I9I 

CIMICIFUGA, Black Snake-root, Black Cohosh,— is the rhizome 
and roots of Cimicifuga racemosa, a plant of the nat. ord. Ranunculaceae, 
native in the United States. Rhizome horizontal, 2 inches long or more, 
about 1 inch thick, with numerous upright or curved branches. Rootlets 
numerous, containing a ligneous cord which branches into four or five 
rays. Contains a Volatile Oil when fresh, resin, tannic and gallic acids, 
also an acrid, crystallizable, neutral principle. Cimicifugin or Macrotin 
is an impure resin obtained by precipitation from a concentrated tincture 
by the addition of water. The active principle has not been isolated. 

Preparations. 

Extractum Cimicifugae, Extract of Cimicifuga. — Dose, gr. j-v. 

Extractum Cimicifugae Fluidum, Flitid Extract of Cimicifuga, — alcoholic. Dose, 
TTLv-xx. 

Tinctura Cimicifugae, Tincture of Cimicifuga, — 20 per cent. Dose, rr^ x-3 j. 
Macrotinum, Macrotin, (Unofficial). — Dose, gr. ss-ij. 

Physiological Action. 
Cimicifuga is stomachic, antispasmodic, aphrodisiac, diaphoretic, diu- 
retic and expectorant. Its taste is bitter and nauseous, resembling that 
of Opium. It acts on the heart and circulation similarly to Digitalis, and 
on unstriped muscular fibre like Ergot, but is much feebler in activity 
than either of these agents. Small doses stimulate digestion and secre- 
tion, the generative function and the menstrual flow, and especially the 
secretions of the bronchial mucous membrane and the kidneys. Full 
doses slow the heart while increasing its force, raise arterial tension and 
stimulate uterine contraction. Large doses dilate the pupils and produce 
dimness of vision, vertigo, intense headache, nausea, vomiting, and in 
some persons soporific and anodyne effects. 

Therapeutics. 

Cimicifuga closely resembles Digitalis in action, but it is safer, and 
should be more frequently used when the latter drug is indicated. In 
cardiac diseases it is very efficient, especially in weak or fatty heart where 
Digitalis would be dangerous. It is a good stomachic tonic, particularly 
in the irritable dyspepsia of alcoholism. As an expectorant it is used in 
acute and chronic bronchitis. It is a good nerve-tonic in delirium tre- 
mens, and in functional impotence it is remarkably efficient. In rheuma- 
tism of the localized muscular variety, as lumbago, torticollis, pleuro- 
dynia", intercostal rheumatism, etc., it is one of the most efficacious 
remedies, having a strong affinity for the muscular system. Neuralgias of 
various kinds are benefited by it, particularly ovarian neuralgia. Chorea 
about the age of puberty is one of the affections in which it is most effi- 
cient, and the same may be said of the hysterical form of this disease. 

Many uterine disorders are remarkably benefited by Cimicifuga, such 



I92 CINCHONA. 

as amenorrhcea, neuralgic and congestive dysmenorrhcea, subinvolution, 
spinal irritation due to some obscure sympathetic or neuralgic affection 
of the womb, sympathetic pains and neuralgise arising from the so-called 
irritable womb, passive menorrhagia, etc. In obstetrics it gives excel- 
lent results when used to initiate uterine contractions, to check hemor- 
rhage, and to allay afterpains and nervousness after delivery. In puer- 
peral mania and peritonitis its good effects are frequently remarkable, 
and in puerperal hypochondriasis it is strongly recommended by very 
high authority. 



CINCHONA, Peruvian Bark.— The Cinchona tree belongs to 
the nat. ord. Rubiaceae and is a native of the eastern slope of the Andes, 
but has been largely planted in India, Ceylon, Java and Burmah, with the 
result of improving the quinine-yielding value of many species by culti- 
vation. In late years the test of appearance has given way to that of 
assay in judging of the various barks of commerce, and only those are 
official which yield 5 per cent, of total alkaloids of which at least 2}^ per 
cent, must be Quinine. Yellow bark contains most Quinine (as high as 
9 per cent, having been obtained from one specimen), pale bark contains 
most Cinchonine and least Quinine, while red bark contains these, alka- 
loids in about equal proportions. The Columbian varieties afford the 
largest percentage of Cinchonidine. 

The principal varieties of the sub-order Cinchoneae, the barks of 
which are found in commerce and used by manufacturers of the alka- 
loids, are — 

Cinchona Calisaya, Yellow Bark, — from Peru, Bolivia and India. 
Cinchona Succirubra, Red Bark, — from Ecuador, Java and Ceylon. 
Cinchona Condaminea, Pale Bark, — from Ecuador and Peru. 
Cinchona Pitayensis, Pilaya Bark, — from New Granada. 
Cinchona Micrantha, Gray Bark, — from Peru and Bolivia. 

Altogether there are some 31 species acknowledged by botanists, and 
the list is constantly increasing, from the tendency of the different trees 
to hybridize. Several trees formerly acknowledged as Cinchonas are now 
placed in the genus Cascariila, but their barks are to be found on the 
market. Cuprea bark is from trees of the genus Remijia, growing in 
Columbia; it contains Quinine and a peculiar alkaloid, Cinchonamine , 
but no Cinchonidine. 

Official Species. 
Cinchona, Cinchona, — is the bark of Cinchona Calisaya, Cinchona 
officinalis, and of hybrids of these and of other species of Cinchona, 
yielding, when assayed by a prescribed process, not less than 5 per cent. 
of total alkaloids, and at least 2^ per cent, of Quinine. 



CINCHONA. I93 

Cinchona Rubra, Red Cinchona, — is the bark of Cinchona Succi- 
rubra, containing not less than 5 per cent, of its peculiar alkaloids. 
From it is prepared the Compound Tincture of Cinchona. Occurs in 
brown-red quills and flat pieces of various sizes, with ridges and warts on 
outer surface, coarsely striated on inner surface. 

Cinchona Flava, Yellow Cinchona, Calisaya Bark, — is the bark of Cinchona Cali- 
saya. Occurs in tawny-yellow, flat pieces or quills, ridged exteriorly, finely striated on 
inner surface, breaking with a transverse fracture showing numerous rigid fibres in bundles 
or radial rows. 

Bark may be administered in doses of gr. x-3j, but it is never used 
now in substance, being too bulky and disagreeable. 

Composition of Cinchona. 
The bark contains 21 natural alkaloids (of which 4 are official), 8 arti- 
ficial alkaloids, 2 simple acids, 2 tannic acids, a resinoid and coloring- 
matter, as follows: — 

Quinine, C 20 H 24 N 2 O 2 , — a strong base, fluorescent, the most valuable of all the alka- 
loids; heated with glycerin to 374 F., it is converted into the isomeric base Quinicine. 

Quinidine, C 20 H 24 N 2 O 2 , — isomeric with Quinine, fluorescent, probably the most power- 
ful as an antiperiodic, but existing in very small quantity. 

Cinchonine, C 20 H 24 N 2 O, — the least active of the official four, having about half the 
therapeutic power of Quinine. Not fluorescent. 

Cinchonidine, G^H^NjO, — isomeric with Cinchonine, not fluorescent, one of the 
most powerful of the alkaloids. 

Kinic and Kinovic Acids, — are combined in the bark with the alkaloids. The for- 
mer is used to make a Kinate of Quinine, and the latter occurs in non-official pharmacy 
as Kinovate of Lime, an ingredient in Deloudre's Extract, which is used in Europe and 
India for dysentery. 

Kino-tannic and Kinovo-tannic Acids, — give to bark its peculiar and powerful 
astringent qualities. They have not been fully studied. 

Kinovin,— is a bitter amorphous resinoid, which is resolvable into Kinovic Acid and 
sugar. It is soluble in alcohol, but not in water. 

Cinchona Red, — a reddish-brown, insipid, inodorous substance. 

[The other alkaloids are of no interest medicinally.] 

Preparations of the Bark. 

Extractum Cinchonae, Extract of Cinchona. — Dose, gr. j-v. 

Extractum Cinchonae Fluidum, Fluid Extract of Cinchona. — Dose, TTLx-^j. 

Tinctura Cinchonae, Tincture of Cinchona, — 20 per cent. Dose, gss-ij. 

Tinctura Cinchonae Composita, Compound Tincture of Cinchona, — made from 
Red Cinchona — strength 10 per cent. Contains Bitter Orange-peel 8,' and Serpentaria 
2 per cent. Dose, gj-iv. 

Infusum Cinchonae, Infusion of Cinchona, — has of Cinchona 6, Aromatic Sulphuric 
Acid I, Water to loo. Is the only official infusion containing this acid. Dose, -jj-^j, 
or more. 

Huxham's Tincture of Bark, 1788 (Unofficial), is still used. Red Cinchona ^iv, 
Orange peel ^iij, Serpentaria gr. lxxx, Spanish Saffron gr. clx, Cochineal gr. lxxx, 
Brandy ^xl, digested for 4 days, expressed and filtered. Dose, gss-ij. 

Quinine and its Salts. 
Quinina, Quinine, C 20 H 24 N 2 O 2 -|- 3H 2 0, — a white, amorphous or minutely crystalline 
powder, of alkaline reaction and very bitter taste, soluble in 1670 of water and 6 of alco- 
hol at 59 F., in 23 of ether, 5 of chloroform, and readily in dilute acids. Dose. gr. j-xx, 
or xl in special cases. Is insoluble in saliva. 

13 



194 CINCHONA. 

Quininae Sulphas, Quinine Sulphate, (C 20 H 24 N 2 O 2 ) 2 .H 2 SO 4 + 7H 2 0, — very light, 
snow white, fragile crystals, of very bitter, persistent taste, soluble in 740 of water and 
65 of alcohol at 59 F., in 30 of boiling water, 3 of boiling alcohol, also in acidulated 
water. Dose, gr. j-xx, or even gr. xl in special cases. 

Quininae Bisulphas, Quinine Bisulphate, C 20 H 24 N 2 O 2 .H 2 SO 4 -f- 7H 2 0, — clear, color- 
less, efflorescent crystals or small needles, of very bitter taste and strongly acid reaction, 
soluble in 10 of water with blue efflorescence, and in 32 of alcohol, at 59 F. Dose, gr. 
j-xxx, or even gr. lx in special cases. 

Quininae Hydrobromas, Quinine Hydrobromate, C 20 H 24 N 2 O 2 HBr -f- H 2 0, — color- 
less needles, of very bitter taste, soluble in 54 of water and in 0.6 of alcohol at 59 F., 
very soluble in boiling water and in boiling alcohol. Dose, gr. j-xx. 

Quininae Hydrochloras, Quinine Hydrochlorate, C 20 H 24 N 2 O 2 HCl -f- 2H 2 0, — white 
needles in tufts, of very bitter taste, soluble in 34 of water and 3 of alcohol at 59 F., in 
I of boiling water or alcohol. Is used hypodermically. Dose, gr. j-xx. An excellent 
salt which should be more generally used ; 5 to 10 gr. doses are antipyretic. 

Quininae Valerianas, Quinine Valeria7iate, C 20 H 24 N 2 O 2 C 5 H 10 O 2 -j- H 2 0, — white, 
pearly crystals, of valerianic odor and bitter taste, soluble in 100 of water and in 5 of 
alcohol at 59 F. Dose, gr. j-iij. It is the only salt of Quinine supposed to be affected 
by the constituent acid. 

Quininae Hydrochloras Carbamidata, Quinine Carbamide Hydrochlorate (Unoffi- 
cial), — is a new compound salt of Quinine and Urea, soluble in equal parts of water and 
therefore admirably adapted for hypodermic administration in a 50 per cent, solution. It is 
almost unirritating to the tissues, and is given subcutaneously in doses of gr. j-iij. 

Chininum Amorphum Boricum, Amorphous Quinine Borate (Unofficial), — is a 
new preparation, soluble in an equal quantity of water, and claimed by its introducers to 
be equally as satisfactory as any other Quinine salt, and much better borne by the stomach 
than any other one. It is also said to cause little or no congestion of the membrana tym- 
pani. 

Tinctura Pyrexialis, Warburg's Tincture (Unofficial), — is a celebrated preparation, 
formerly secret, but published in 1875 by the originator, whose formula is as follows: — 
& . Aloes soc. lb j ; Rad. rhei (chinens), Sem. angelicae, Confec. Damocratis,* aa ^iv ; 
Rad. helenii (s. enulae), Croci sativi, Sem. fceniculi, Cretae prep., aa ^ ij ; Rad. gentianae, 
Rad. zedoariae, Pip. cubebae, Myrrhae elect., Camphorae, Bolet. laricis, aa ^j. Digest the 
whole with 500 oz. of proof spirit in a water-bath for 12 hours, express, add ^x Bisul- 
phate of Quinine, dissolve by aid of a water-bath, cool, and filter. Dose, ( ^j, in two 
doses 3 hours apart. Hager's modification of the original formula is — r£ . Quininae sulph. 
part, j, Spt. camphorae, part, ij, Elix. proprietatis (Tinct. aloes etmyrrhae) part, xxij, Alco- 
hoiis part. xvj. The evidence published in favor of this preparation goes to show that its 
power does not wholly lie in the quinine, camphor, aloes or rhubarb, but in some of the 
aromatic plants contained in it. 

Other Official Alkaloids and their Preparations. 

Cinchonina, Ci?ichonine, C 19 H 22 N 2 0, — white, lustrous prisms or needles, of bitter 
after-taste, almost insoluble in water, readily so in dilute acids and 116 of alcohol at 59 
F. Dose, gr. j-xxx or more. 

Cinchoninae Sulphas, Cinchonine Sulphate (C 19 H 22 N 2 0) 2 H 2 S0 4 -f- 2H 2 0, — white, 
shining prisms, of very bitter taste, soluble in 66 of water and in 10 of alcohol at 59 F., 
and readily soluble in dilute acids. Dose, gr. v-xxx or more. 

Cinchonidiriae Sulphas, Cinchonidine Sulphate (C 19 H 22 N 2 0) 2 H 2 S0 4 -j- 3H 2 0, — 
white, silky crystals, of bitter taste, soluble in 70 of water and in 66 of alcohol at 59 
F., freely soluble in acidulated water. Dose, gr. j-xx or more. 

Quinidinae Sulphas, Quinidine Sulphate (C 20 H 24 N 2 O 2 ) 2 H 2 SO 4 -f- 2H 2 0, — white, 
silky needles, of bitter taste, soluble in 100 of water and in 8 of alcohol, readily in acidu- 
lated water, at 59 F. Dose, gr. j-xx or more. It is not so bitter as Quinine, is less 
expensive, and is a valuable antipyretic and antiperiodic. 

Non- Official Preparations. 
Chinoidinum, Chinoidin, Quinoidin, — a mixture of alkaloids, mostly amorphous, 
obtained as a by-product in the manufacture of the crystallizable alkaloids from Cinchona. 

* For the formula for this ingredient see the article on Confections in the section on 
Extemporaneous Pharmacy, Pait II. 



CINCHONA. I95 

A black solid when cold, plastic when warmed, of bitter taste, almost insoluble in water, 
freely soluble in alcohol and in dilute acids. It contains the 4 alkaloids in amorphous 
condition, and has about ]/ z the therapeutic power of Quinine. Dose, gr. v-xxx or more. 

Quinquinina, Quinetnm, — is an Indian preparation containing the total alkaloids 
extracted from bark by acidulated water, then precipitated by soda and dried. In India 
it is called " febrifuge." 

Cinchonidinae Salicylas, Cinchonidine Salicylate, — has anti-malarial power only 
inferior to the salts of Quinine. 

Substitutes for Quinine. 
The synthetical production of Quinine has been the "philosopher's 
stone " of the modern chemists, who have prosecuted with untiring energy 
the search for an artificial product possessing all its properties. Though 
in this they have as yet been unsuccessful, they have discovered several 
organic bodies, which closely resemble each other and also quinine, both 
in chemical constitution and physiological action. These substances 
belong to the aromatic series of carbon compounds, all of which are de- 
rivatives of Benzene or Benzol, C 6 H 6 , the Hydride of the organic radical 
Phenyl, C 6 H 5 . The distinctive action of the lower members of this series 
is their antiseptic and antipyretic powers, — as that of the fatty series of 
carbon compounds is stimulant and ancesthetic (Brunton). Many of these 
agents are obtained from coal-tar oil (petroleum) by fractional distilla- 
tion, etc., — and they are all derivatives of Benzene (Benzol), either 
directly or from some of the products formed therefrom, by substitution ; 
various radicals replacing the different constituent atoms of H and C. 



Thus by the ring-arrangement of atoms peculiar to this series, there are formed from 
Benzene (C 6 H 6 ), the following substances, viz. — 

Phenol, or Carbolic Acid, C 6 H-OH — by replacing H by OH, (hydroxyl). 

Pyrocatechin, or Or t ho- \ C 6 H 4 (OHj 2 . 

Resorcin, or Mela- V dioxybenzol, — by replacing 2H by 2OH. 

Hydroqainone, or Para- J C 6 H 4 (OH) 2 . 

Pyrogallol, Pyrogallic Acid, Tri- hydroxy benzene C 6 H 3 (OH) 3 , — 3H by 3OH. 

Amido-benzene, or Anilin, C 6 H 5 .NH 2 — by replacing H by IN'H 2 (^amidogen). 

Nitro-benzene, C 6 H 5 .N0 2 — by replacing H by N0 2 (nitroxyl). 

Benzoic Acid, C 6 H 5 CO.OH— by replacing H by CO.OH (carboxyl). 

Salicylic Acid, HC 7 H 5 3 — by replacing 2H by OH and CO.OH. 

Naphthalin, C 10 H 8 — by uniting iwo Benzenes in an over-lapping ring. 

Pyridin, C 5 H 5 N — by replacing tetrad C by triad N. 

Chinolin, C 9 H 7 N — uniting Benzene (C 6 H 6 ) and Pyridine (C 5 H 5 N). 
Derived from Chinolin is the hypothetical base — 

Chinicin, or Quinicin, C 9 H 9 N 2 , — represented in Antipyrin. 

Also Kairin, Thallin, and other compounds. 

The most important of these are Antipyrin, Acetanilid, Resorcin, 
Chinolin and Naphthalin, which are respectively described in separate 
articles. Others of the same class are the following, viz. — 

Some Unofficial Antipyretics. 

Kairinum, Kairin (Hydrochlorate of Oxy-ethyl chinolin-hydride), C 10 H 13 NO.HC1. 
H 2 0, — is an artificial alkaloid prepared from Chinolin, belonging to the phenol group 
of carbon compounds, and a powerful antipyretic in 8-grain doses hourly. It stains the 
urine a deep green, and has not proven fatal though 220 doses have been administered 



I96 CINCHONA. 

in one case. In some cases of typhus it has caused cyanosis and collapse. It produces 
profuse sweating and vomiting, and the subsequent rise of temperature after its antipyretic 
influence has worn off is generally ushered in by a severe rigor. It is by many authorities 
considered to be the most certain, most powerful and most rapid antipyretic drug we 
possess, though this claim is now disputed by the advocates of Antipyrin. It occurs in 
white crystals, which are freely soluble in water, but is best given in wafer, paper or cap- 
sules. Dose,gr. iij-xxx. 

Kairolinum, Kairolin {Sulphate of Telra-hydromethyl-chinolin), — is antipyretic, but 
much less efficient than Kairin. 

Thallin (Parachinanisols), — is a synthetically prepared alkaloid, having the chemical 
name Tetra-hydro-paramethyl-oxy-chinolin. It occurs as a colorless powder which is 
soluble in water, and enters into combination with acids, forming salts, of which the 
tartrate and sulphate are the most eligible, especially the latter. The dose of Thallin or 
its Sulphate ranges from gr. ij to gr. xv, a mean average dose being about 5 grains, given 
in the form of compressed tablets. Thallin is an antipyretic of very great power, closes 
of 5 to 12 grains lowering the temperature in typhoid fever 4 to 5 in 2 hours' time, the 
effect lasting nearly 3 hours. In tuberculosis similar results were obtained. Large doses, 
however, produce very profuse sweating and a dangerous degree of depression ; so that 
this agent is not a favorite remedy for hyperpyrexia. 

Hydroquinone (Para-di-hydroxy-benzene) C 6 H 4 (OH) 2 , — is isomeric with Resorcin 
(see ante, page 195). It crystallizes in rhombic, colorless prisms which are slightly 
soluble in water, readily so in alcohol and in ether, and is obtained from Arbutin, a glu- 
coside constituent of Uva Ursi and other Ericaceae. It is an efficient antipyretic, without 
injurious effects so far as observed, but its influence is only temporary. The action of 
this drug on animals is summarized in the N. Y. Medical Record for August 15th, 1885, 
and its influence on pyrexia elucidated in the same journal for May 3016,1885. Dose, 
as an antipyretic, gr. xv-xx, best given in alcohol. Gr. xl have been given without dis- 
agreeable effects. 

Pyrocatechin, Catechol (Ortho-di-hydroxy benzene), C 6 H 4 (OH) 2 , — is also isomeric 
with Resorcin, and is one of the acid constituents of coal tar, also obtained from wood-tar 
and from kinic acid. It is a good antipyretic, but much inferior to Quinine or Resorcin. 

Phenacetin {Acetphenetidiii), — a white and glossy, crystalline powder, in chemical 
constituent analogous to Acetanilid. It is tasteless, and but slightly soluble in water, 
more so in glycerin, and still more so in alcohol and in lactic acid. It is a very efficient 
antipyretic and antineuralgic, with no disagreeable after effects. The dose is about one- 
half that of Antipyrin or gr. x-xx. See under Phenacetinum. 

Pheno-resorcin, — is a mixture of Carbolic Acid 67 with Resorcin 33 and Water 10, 
forming a liquid which mixes readily with water. It is supposed to combine the virtues 
of both its ingredients. 

Physiological Action. 

The action of Cinchona in sufficient dose is generally that of its alka- 
loid Quinine, except that bark is decidedly astringent, more of a gastric 
irritant, and by reason of its bulk its active principles are more slowly 
absorbed. In large doses Q^ij) the powdered bark has produced flatu- 
lence and eructation, and in many]well-authenticated instances has appar- 
ently produced a well-marked febrile paroxysm, beginning with chill, then 
fever and headache, which gradually subsided in slight perspiration. So 
also, Quinine, while incapable of producing intermittent fever in a healthy 
person, may, if taken in large doses unnecessarily, throw the nervous 
system into high commotion, and if untimely used by a malarial subject 
may reproduce the paroxysm with greater or less severity. 

Cinchona is an astringent bitter and a stomachic tonic. At first it 
promotes appetite, digestion, the flow of saliva and of gastric juice ; 
long-continued it sets up a gastric catarrh, impeding digestion and caus- 
ing constipation. 



CINCHONA. I97 

Quinine is a bitter tonic, antiseptic, antiperiodic, antimiasmatic and 
antipyretic, a diminisher of reflex action, a protoplasmic poison, a cardiac 
depressant and perhaps an oxytocic. It is rapidly diffused and slowly 
excreted, being found in the urine in 15 minutes after its administration 
and for two or three days afterwards. Its action on the stomach is simi- 
lar to that of cinchona. It arrests the movements of the white blood- 
corpuscles though increasing their number, and prevents acetification and 
decay of the blood. It is actively destructive of lowly organized life, a 
solution of 1 to 500 being fatal to infusoria and fungi, while one of double 
this strength prevents alcoholic fermentation and checks putrefactive de- 
composition. The heart and arterial tension are somewhat stimulated 
by small doses, but depressed by large ones (gr. xl-lxxx), which slow and 
enfeeble the pulse by direct action on the cardiac ganglia. The brain is 
rendered hyperaemic and exhilarated by small or moderate doses, but 
large ones produce a sense of fulness and constriction in the head, cere- 
bral anaemia, pallor, tinnitus aurium, vertigo, staggering gait, amaurosis, 
and deafness, great headache, dilated pupils, delirium, coma, and in 
animals convulsions. The eyes and ears are very rarely injured perma- 
nently. These symptoms collectively are termed Cinchonism. It reduces 
the size of the spleen when enlarged, and lowers the temperature of 
pyrexia, though it does not depress the body temperature in health. 
Large doses lower the reflex function of the spinal cord. In some sub- 
jects it produces sexual excitement, in others cutaneous eruptions some- 
times followed by desquamation. It lessens the excretion of uric acid, 
but not that of urea, and is a uterine stimulant in labor, but its power 
to initiate uterine contractions is a much debated question. 

Quinidine and Cinchonidine correspond in action with Quinine both 
qualitatively and quantitatively, the latter however producing less severe 
head symptoms. 

Cinchonine also corresponds in effect, but is much the least active of 
the four alkaloids. It is said to produce greater headache, and much 
precordial pain and muscular weakness, but to have little effect on sight 
or hearing. 

Antagonists and Incompatibles. 

Morphine antagonizes its cerebral action. Atropine its nervous, cardiac and anti- 
pyretic powers. Free Tannic Acid is incompatible with the Infusion of Cinchona. 
Iodine preparations, Alkalies, Alkaline Carbonates and Earths, are incompatible with 
solutions of the alkaloids, the first-named forming insoluble compounds, the latter pre- 
cipitating them. 

Therapeutics. 
Cinchona is used as a tonic, and has many applications. The Infusion 
or Compound Tincture with a mineral acid is extremely serviceable in 
atonic dyspepsia, gastric catarrh of alcoholics, adynamia, convalescence, 



I98 CINCHONA. 

asthma, chronic bronchitis, and generally in weak subjects of flabby flesh 
and perspiring skin. 

Quinine finds its principal field of action in the malarial diseases, over 
which its power is that of a specific. In intermittents, a ten-grain dose 
of the sulphate should be given in the sweating stage and again 5 hours 
before the expected time of the next paroxysm. In the intervals Arsenic 
is better used, as Quinine may cause a daily exacerbation "of temperature 
if long continued. In remittents 20- to 30-grain doses should be admin- 
istered once or twice a day until the temperature is reduced to the normal 
point. In pernicious remittents large doses (gr. xxx to lx) are necessary 
to the safety of the patient. In chronic malarial poisoning Quinine has 
considerable power, but Chinoidin is more effective. Small doses of 
Quinine (gr. ij-iij per diem) are efficient as a prophylactic against malaria. 

As an antipyretic Quinine is used with the best results, especially in 
typhus, typhoid, variola, pneumonia and acute rheumatism. Inflamma- 
tions may, at their inception, be aborted by 15- or 20-grain doses, com- 
bined with Morphine, which in this respect is synergistic to Quinine. 
Acute tonsillitis and acute catarrh may sometimes be aborted by a full 
dose. In surgical fevers, pyaemia and exhausting suppurative conditions, 
also in septicaemia, hectic fever, and before surgical operations, Quinine 
is much employed. Neuralgias of malarial origin are amenable to it, as 
also neuralgia of the ophthalmic division of the fifth nerve. In eruptive 
fevers, especially scarlet fever, erysipelas and measles, it is advantageously 
administered throughout their course. In some skin diseases particularly 
erythema nodosum, it is quite efficient, also in whooping-cough and hay- 
fever. In the latter affection a solution of gr. vj to the g of the neutral 
hydrochlorate is a very useful local application. 

Antipyresis has of late received considerable attention, particularly in 
the German hospitals. The most certain and safe of all antipyretics is 
undoubtedly the cold bath, but it is not always the most practicable, 
especially in private practice. Internal antipyretics are therefore of great 
value, and of these the safest and best is Quinine, next in order being 
Phenacetin. 

Warburg's Tincture has obtained a very high reputation in the 
hands of Indian army-surgeons in the treatment of remittent and other 
malarial fevers of the most malignant types, in malarial neuralgias, acute 
nervous exhaustion and sudden collapse without organic disease. The 
most pronounced testimony to its value is that of Dr. Maclean {Med. Times 
and Gazette, Nov., 1875), whose authority will not be questioned by the 
most captious. He affirms that the influence of this combination to arrest 
an exacerbation of remittent fever is far more powerful than that of Qui- 
nine alone. The remedy has become much less of a favorite since its 
originator was induced to make public the secret of its composition. 



CINNAMOMUM COCA. 1 99 

A dm inistration . 

The persistently bitter taste of Quinine and its salts is best obviated by administering 
them in pill form, made with glycerin as an excipient, or by using Liquorice, Eriodyction 
or Chocolate to cover the taste if given in solution or powder. The taste is extremely 
well covered by using as a vehicle a combination of Glycyrrhizin and Fluid Extract of 
Eriodyction, named " Velatine" but the Quinine must be suspended therein by the aid 
of mucilage, for when an acid is used to dissolve it the bitter taste cannot be disguised. 

For hypodermic use the best salt is the Carbamide Hydrochlorate, by reason of its 
ready solubility and freedom from irritant quality. 



CINNAMOMUM, Cinnamon, — is official under the three following titles, viz. — 

Cinnamomum Cassia, Cassia Cinnamon, — is the bark of the shoots of one or more 
undetermined species of Cinnamomum, (nat. ord. Laurinese), grown in China. Is a con- 
stituent of the compound tinctures of Cardamon, Catechu and Lavender. 

Cinnamomum Saigonicum, Saigon Cinnamon, — the bark of an undetermined 
species of Cinnamomum. 

Cinnamomum Zeylanicum, Ceylon Cinnamon, — the inner bark of the shoots o 
Cinnamomum Zeylanicum. 

The latter occurs in light, yellowish-brown quills, consisting of several pieces rolled 
together, each very thin, while the Chinese variety comes in single quills of irregular 
form and rougher texture. The taste is warm and aromatic, and the odor very fragrant. 
The active principle is a Volatile Oil, and they also contain a resin, and tannic and cin- 
namic acids. Dose, gr. x-xx. 

Preparations. 

Oleum Cinnamomi, Oil of Cinnamon, Oil of Cassia, — a volatile oil distilled from 
Cassia Cinnamon. A yellowish-colored liquid, of sp. gr. 1.055 to I -°65; soluble in an 
equal part of alcohol or of glacial acetic acid. Becomes darker and thicker by age and 
exposure to air. Dose, gtt. j-v. 

Aqua Cinnamomi, Cinnamon Water, — has of the Oil 2, triturated with Precipitated 
Calcium Phosphate 4, and Distilled Water to 1000. Dose, indefinite. 

Spiritus Cinnamomi, Spirit of Cinnamon, — has 10 per cent, of the oil in Alcohol to 
100. Dose, m^v-xxx. 

Tinctura Cinnamomi, Tincture of Cinnamon, — has of Ceylon Cinnamon 10, 
Glycerin 5, Alcohol and Water to 100. Dose, 5 ss— ij . 

Pulvis Aromaticus, Aromatic Powder, — has of Ceylon Cinnamon 35, Ginger 35, 
Cardamom 15, Nutmeg 15, triturated together to a fine powder. Dose, gr. x-xxx. 

Extractum Aromaticum Fluidum, Aromatic Fluid Extract, — has of Aromatic 
Powder 100 per cent, in Alcohol. Dose, Tt^x-xxx. 

Cinnamon is an agreeable carminative, somewhat astringent and stimulant, also highly 
aromatic and antiseptic. The oil is not astringent but is a pleasant stimulant to the nerv- 
ous and vascular systems, and is by some believed to exercise a specific action on the 
uterus, particularly as a hemostatic. 

The various preparations are in general use as flavoring excipients, and the Aqua -is a 
pleasant vehicle for extemporaneous prescriptions. The Bark and its preparations are 
used to check diarrhoea in combination with opium, chalk, or some vegetable infusion. 
The Oil is a good stimulant in flatulence, paralysis of the tongue, cramp of the stomach, 
enteralgia, etc., and is sometimes used to check nausea and vomiting. Cinnamon was 
formerly used with success in uterine hemorrhage, generally in combination with sulphuric 
acid, which of itself is an efficient uterine hemostatic. It has lately been employed in 
France as an internal germicide, with great satisfaction ; and has given particularly good 
results in the treatment of typhoid fever, against the supposed bacillus of which disease 
it is believed, by its advocates, to have specific and destructive powers. 



COCA, Coca, Cuca, — the leaves of Erythroxylon Coca, a small shrub 
of the nat. ord. Lineae, indigenous to the mountains of Peru and Bolivia, 
and extensively cultivated in those and other S, American states. It has 



200 COCA. 

numerous purplish-brown branches; small, yellowish, 5-petalous flowers, 
and a scarlet- red, oblong fruit, containing a single seed. The leaf resem- 
bles a large tea-leaf, being 2 to 3 inches long, oval-shaped, obtuse at the 
apex, reticulate on both sides, with a prominent midrib, on either side of 
which is seen a curved line on the leaf from base to apex ; odor tea-like, 
taste slightly bitter and aromatic. It contains a crystalline alkaloid Co- 
caine. C 17 H 2 iN0 4 , which when heated with HC1 is split up into Benzoic 
Acid, Methylic Alcohol and another alkaloid Ecgonine. Other constitu- 
ents are a volatile, liquid alkaloid of herring-brine odor, alkaline reaction 
and burning taste, named Hygrine, an aromatic Oil, and Coca-tannic 
Acid. Coca should not be confounded with Cocoa, the seed of the 
chocolate-tree, Theobroma Cacao. Dose of the leaves, 3j~iv. 

Preparations. 

Extractum Cocae Fluidum, Fluid Extract of Coca, — Dose, 3 ss-ij. Leaves of good 
quality are often so difficult to be obtained that Dr. Squibb, the well-known pharmaceu- 
tist has more than once omitted the fluid extract from his trade list, with the explanation 
that " it is impossible to get Coca of proper quality for medical use." 

Cocaina, Cocaine, C 17 H 21 N0 4 (Unofficial), — crystalline, colorless and of bitter taste, 
very soluble in ether, almost insoluble in water or alcohol, and of decided basic proper- 
ties, combining with acids to form salts. It exists in the leaves in very small quantity, 
viz. — from 0.02 to 0.04 per cent. Dose, gr. y%-'}. 

Cocainae Hydrochloras, Cocaine Hydro chlorate, C 17 H 21 N0 4 HC1, — also called Co- 
caine Muriate, but is more properly Cocaine Chloride, — occurs in colorless, transparent 
crystals, odorless, of saline, slightly bitter taste, producing on the tongue a tingling sen- 
sation followed by numbness. Soluble in 0.48 of water, and in 3^ of alcohol. Is used 
in aqueous solutions of 2 to 10 or more per cent, hypodermically or locally to mucous 
surfaces as a local anaesthetic. Dose, internallv, gr. y%-] ; by hypodermic injection, gr. 

Cocainas Oleas, Oleate of Cocaine { Unofficial), — a 10 per cent, solution of the alka- 
loid in Oleic Acid, for external use. 

Wines, Lozenges, Elixirs, Glyceroles, Pastes, etc., of Coca are being manufactured and 
marketed in great variety. The Citrate and Salicylate of Cocaine are recent products of 
the laboratory and may be obtained in the shops. 

Physiological Action. 

Coca is an aromatic bitter tonic, a diuretic and a cerebral and nervous 
stimulant, though locally used one of the most efficient nerve sedatives. 
Small doses improve digestion, stimulate respiration, increase the heart's 
action after a brief depression, raise the arterial tension, and increase the 
excitability of the sensory nerves. It stimulates the brain by increasing 
its blood-supply, producing wakefulness, a sense of well-being, and a 
marked diminution of the senses of fatigue, hunger and thirst. Under 
its daily use a considerable amount of labor and want of sleep can be 
borne without suffering. Though diuretic, it lessens the quantity of urea 
eliminated by checking the processes of waste. Large doses produce 
impaired coordination, hallucinations and delirium. 

Cocaine acts upon the lower animals similarly to Caffeine. It tetanizes 
frogs, and in large doses paralyzes their sensory nerves and the posterior 
columns of the spinal cord. It kills rabbits and dogs by paralysis of the 



COCA. 201 

respiratory centre. In proper doses it raises arterial tension by stimulat- 
ing the vaso-motor centres and the cardiac motor system. 

On man, in small doses Cocaine is a cerebral, cardiac, respiratory and 
nervous stimulant, and a diuretic. It improves digestion, stimulates 
respiration, increases the heart's action, raises the arterial tension, and 
exalts the irritability of the sensory nerves. It stimulates the brain by 
increasing its blood-supply, producing wakefulness and marked diminu- 
tion of the senses of fatigue and hunger. Though decidedly diuretic, 
it lessens the quantity of urea, by checking the processes of waste, thus 
acting as an indirect nutrient, and enabling the body to maintain its 
energy on a lessened supply of food. It increases the cutaneous circula- 
tion, flushing the surface, exciting perspiration, and a sense of heat, and 
does actually raise the body-temperature. It dilates the pupil, both when 
locally applied and when taken systematically, — and stimulates intestinal 
peristalsis as well as the evacuation of the bladder in a few minutes after 
its ingestion. 

An overdose produces symptoms of cardiac and respiratory embarrass- 
ment in a very short time. The pulse, at first quick and forcible, becomes 
small, rapid and intermitting ; — the heart apparently standing still in 
systole once in every 10 or 12 beats. Respiration is slow and shallow, 
and a sense of "tightness" about the chest is very marked ; — the skin 
grows cold and clammy, and the subject is seized with a sense of impend- 
ing dissolution. Death occurs in animals by paralysis of respiration, — 
but in man a tetanoid spasm of the cardiac muscle seems to occur, which 
is equally dangerous to life. Other symptoms are impairment of coordi- 
nation, hallucinations and delirium. Lethal doses paralyze the intra- 
cardiac motor ganglia, the posterior columns of the cord, the sensory 
nerves, and the respiratory centre. 

Nearly three years ago, Satterwhite, as a result of the study of one hundred cases of 
poisoning by this alkaloid, called attention to the clangers attending the use of even very 
small doses, and at about the same time another author, after summarizing the records of 
fifty cases, made a similar announcement. A case is reported by Broughton in which 
unconsciousness, an irregular, slow respiration, and a slow pulse, followed the application 
of three minims of a twenty per cent, solution within the cavity of a tooth. Whistler, 
after the application of a four per cent, solution to the nasal cavity, noted vertigo and 
threatening syncope. In a case of glossitis, Ricket states, that the patient became mori- 
bund after the use of a similar solution. Myrtyle dropped three minims of a three per 
cent, solution in each eye, which immediately caused a sense of numbness in the back of 
the tongue and throat, palpitation, threatened syncope and nausea. Bettleheim records 
that in one case the hypodermatic injection of one-sixth of a grain induced alarming 
symptoms; and in another, one-eighth of a grain similarly injected caused unconscious- 
ness, congestion of the face, irregular breathing and trismus. 

As a Local Ancestheiic the power of Cocaine is very great over a limited 
area. Applied to such structures as the Schneiderian membrane, and the 
mucous covering of the glans penis ; or injected hypodermically in other 
locations, it blanches the structures and causes a profound but temporary 



202 COCA. 

anaesthesia throughout a small space. Applied to the tongue it tempor- 
arily destroys both taste and tactile sensibility ; — to the ocular conjunctiva, 
it produces profound anaesthesia of that membrane, together with dilata- 
tion of the pupil, partial paralysis of accommodation, enlargement of the 
palpebral fissure, slight lachrymation, and sometimes temporary ptosis. 
This profound degree of anaesthesia is thought by some to be caused by 
its paralyzing the terminal twigs of the sensory nerves, — by others to be 
due to vaso-motor stimulation rendering the nerves bloodless and there- 
fore unable to transmit sensory impressions. It produces mydriasis by 
stimulation of the ends of the sympathetic in the iris, and does not affect 
the third nerve or the sympathetic centre. 

In general action, Cocaine resembles Atropine very closely, especially 
in its influence upon the pulse and blood-pressure, the respiration, pupils, 
salivary- and sweat-glands and intestinal peristalsis. In its symptoms, 
both from large and small doses, it exactly parallels Sparteine, another 
cardio-inhibitory depressant. 

Antagonists. 
Amyl Nitrite combats the earliest symptoms of cardiac depression, — then Alcohol and 
Opium as stimulants to the heart, also Artificial Respiration. The most direct antago- 
nist is Chloral, so also are Chloroform and Ether. Morphine is also directly antagonistic 
at almost all points. 

The Cocaine-Habit. 

Cocainism, the Cocaine-habit, is now presenting itself to observation, numerous 
instances of persons addicted to its excessive use being met with. Loss of digestive power, 
absolute insomnia, enfeeblement of the intellect, great emaciation, ascites, general maras- 
mus, nausea, decay of the teeth, an excessively fetid breath, amblyopia, visual hallucina- 
tions and complete anorexia, form a consensus of symptoms which rival the worst effects 
of the opium habit. Some observers report the most extraordinary mental changes result- 
ing from Cocainism, and exceeding those produced by any other drug. The most intense 
selfishness, utter disregard of all social and- domestic duties, the most debasing habits, 
complete destruction of all noble qualities, and a general condition of depravity, are some 
of the results which are charged to this drug. The author's experience of a large number 
of such cases convinces him that a cocaine habitue who has used the drug daily for three 
months is practically an insane individual while under the influence of the drug; but 
that the mind soon resumes its normal condition after withdrawal thereof, which can be 
done, in nearly all cases, at once, without involving any serious suffering. 

The Cocaine- habit is acquired, in most of the cases, by persons previously addicted to 
the use of Morphine, who go to Cocaine in the hope of finding help in their struggle 
against the tyranny of the former drug. In this hope, however, they are always disap- 
pointed when the drugs are in their own hands. The victim soon finds that one of these 
agents antagonizes the other to a great extent, while, at the same time, it sets up peculiar 
troubles of its own : and that there is a constant need of more Morphine to counteract 
the Cocaine-symptoms, and of more Cocaine to antagonize the symptoms due to the 
increased amount of Morphine. The result of any such attempt will be that one who is 
only using a moderate daily amount of Morphine, will, if Cocaine be added, soon be 
using a very great amount of Morphine, as well as of Cocaine, and " the last state of that 
man is worse than the first." 

As the stimulant effect of a single hypodermic injection passes off very quickly, within 
about 15 or 20 minutes, the cocaine habitue is under the necessity of constantly injecting 
the drug, so that, as one such expressed it, " I had no time to go home, — no time to do 
anything except to prepare and take one 'shot' after another." The effect of such 
repeated puncturing of the skin is very disastrous to that tissue, causing great induration, 
and numerous sloughing sores. 



COCA. 203 

Therapeutics. 

Coca-leaves are chewed by the Peruvians for the purpose of sustaining 
them during arduous labors and long journeys, and were so highly 
esteemed as to have been represented on the coat-of-arms of that nation, 
by whom they are used much as we do tea, coffee or tobacco. This 
example was imitated by Weston the pedestrian, who is said to have been 
detected chewing the coca-leaf during one of his protracted walks. 
Cocaine is a useful stimulant to the brain and the nervous system in 
many morbid conditions, particularly cerebral and spinal anaemia, neu- 
rasthenia, melancholia, hysterical and hypochondriacal insanity, and in 
protracted mental depression with suicidal tendency. It may be employed 
with benefit in wasting diseases to retard waste and to stimulate digestion, 
in convalescence from fevers and other acute maladies, and in migraine 
and neuralgia due to depression of the nervous system. It is very bene- 
ficial in some cases of the vomiting of pregnancy, in stomatitis and 
gastralgia, and in functional impotence due to general atony of the system. 

A wine of the leaves is thought by singers and speakers to relieve hoarse- 
ness, to tense the vocal cords and improve the timbre of the voice. Coca- 
leaves may be smoked in cigars or cigarettes to obtain the exhilarating 
effects of the drug, and for the relief of asthma, hay-fever and many 
irritable throat affections. The Oleate of Cocaine is an efficient palliative 
application to painful hemorrhoids, fissures of the anus, burns, boils, and 
irritable ulcers ; also in pruritus pudendi et ani and skin diseases attended 
with intolerable itching. 

Cocaine Hydrochlorate has achieved notoriety as a local anaesthetic, 
and promises to be of the greatest value in many operations on the eye 
and ear, nasal passages, uterus and urethra. A 2 to 4 per cent, solution 
is brushed lightly over the mucous surface or injected into the urethral 
canal, the application being repeated within 5 or 10 minutes if profound 
local anaesthesia is required. After about fifteen minutes any superficial 
operation may be performed without giving the slightest pain. Its anaes- 
thetic action is so entirely local and generally free from unpleasant after- 
effects that it is considered the most efficient and desirable agent of the 
kind which is known. It has been used in the same manner with decided 
benefit in congestion of the nasal passages from acute catarrh and hay- 
fever ; and has been applied to the cervix uteri to relieve the first pains 
of labor, to the ear for tinnitus aurium, and by inhalation to strengthen 
the vocal cords, relieve hoarseness and cough, and to improve the quality 
of the voice. It is injected hypodermically around the prepuce to pre- 
vent pain during circumcision, into the vicinity of the supra-orbital and 
infra-orbital foramina to cut short neuralgia of those nerves, and into 
hemorrhoids previous to their ligation. It may be injected into the 
bladder before lithotrity, into the urethra before the passage of sounds or 



204 coccus. 

catheters or to relieve chordee, and it is an excellent application to the 
gums of teething infants. To be efficient it must reach the terminal fila- 
ments of the sensory nerves in sufficient concentration. Rhus poisoning, 
by either the oak or ivy, is promptly controlled by the application of a 5 
per cent, solution or oleate, freely over the affected surface. It gives 
instant relief from the burning and itching, and speedily reduces the 
dermatitis. 

The rapid accumulation of cases in which alarming symptoms followed the local appli- 
cation of small quantities of cocaine, together with the fact that these untoward effects 
are due to individual idiosyncrasy and do not invariably occur immediately, is a positive 
warning to the profession that this powerful substance should not be used in any case for 
the first time without proper antidotes directly at hand and the patient being kept under 
surveillance for at least a half hour. There seems to be no doubt that cocaine is absorbed 
with extraordinary rapidity and that the stronger the solution which is locally applied, the 
greater the danger of toxic symptoms, but whether the latter are to be attributed merely 
to the larger dose or to some obscure action, is not apparent. Falk has found that the 
rapidity of absorption varies in the different tissues — absorption taking place most rapidly 
through the conjunctiva, then in the following order : nose, larynx, mouth, and ear. It is 
generally conceded that a 5 per cent, solution is sufficiently strong for most purposes, 
besides being free from many of the dangers attending the use of stronger ones. 

As a Mydriatic for ophthalmological use, Cocaine has peculiar qualities 
which make it the most serviceable of the class. The dilatation produced 
by it is great, is quickly attained, lasts only 12 to 20 hours, is promptly 
overcome by the application of Eserine, and is not accompanied by much 
photophobia. The latter is due to the fact that the cocainized pupil is 
not rigidly dilated (as with Atropine), but reacts to light. The accom- 
modation, moreover, is greatly reduced, but not entirely paralyzed, and 
is quickly regained. 

As an Antagonist Cocaine is of especial value in narcotic poisoning by 
Chloral or Opiates, where depression of the cardiac and respiratory cen- 
tres exists. It is also indicated in chronic depressant poisoning from the 
Bromides, and in spinal paralyses. In these cases it has all the advantages 
of Strychnine without its poisonous character. It has no value in the 
proper treatment of Morphinism except to antagonize certain heart 
symptoms, for which purpose it should be administered only by the phy- 
sician in charge of the case ; but never as a regular remedy, at regular 
intervals of time, even by him. 



COCCUS, Cochineal, — is the dried female of Coccus cacti, an insect of the order 
Hemiptera, which feeds on the cactus plants of Mexico and Central America. Occurs 
in ovate, plano-convex form, of a purple gray or purple-black color, yielding when 
crushed a dark-red powder, which contains Carminic Acid, or Car7nine, the red coloring- 
matter, which is soluble in water and alcohol, but not in oils. Cochineal is an ingredient 
of Tinctura Cardamomi Composita, and is used in pharmacy solely as a coloring material. 

The only therapeutic use of Cochineal is in whooping-cough and neuralgia, in which 
affections it is supposed to have considerable influence, especially in the former. Its dose 
to an infant is about gr. y£ thrice daily. 



COLCHICUM. 205 

COLCHICUM, Meadow Saffron, — is the corra and seed of the 
Colchicum autumnale, a European plant of the nat. ord. Liliaceae. It 
contains an intensely bitter, poisonous alkaloid, Colchicine, C n H 19 N0 5 , 
which by the action of acetic and mineral acids is converted into Col- 
chicine and a resin, — also tannic and gallic acids, resin, starch, sugar, 
etc. It is official in two forms, namely — 

Colchici Radix, Colchicum Root, — the corm, about 1 inch long, 
white internally, grooved on one side, inodorous, taste sweetish, bitter 
and acrid. Is less active than the seed. Dose, gr. ij-viij. Contains of 
Colchicine, 0.45 per 1000. 

Colchici Semen, Colchicum Seed, — about yL inch thick, sub-globular, 
resembling black mustard seed but larger, very hard and tough, inodor- 
ous, of bitter and acrid taste. Dose, gr. j-v. Contains of Colchicine, 
3.35 per 1000. 

Preparations. 

Extractum Colchici Radicis, Extract of Colchicum Root, — made with Acetic Acid 
35 parts to 100 of the root, and sufficient water. Dose, gr. ^-ij. 

Extractum Colchici Radicis Fluidum, Fluid Extract of Colchicum Hoot. — Dose, 
TTVij-x. 

Extractum Colchici Seminis Fluidum, Fluid Extract of Colchicum Seed. — Dose, 
ttVJ-v. 

Vinum Colchici Radicis, Wine of Colchicum Root, — strength 40 per cent. Dose, 
TT\, v-xv. 

Vinum Colchici Seminis, Wine of Colchicum Seed, — strength 15 per cent. Dose, 
tr^ x-xxx. 

Tinctura Colchici Seminis, Tincture of Colchicum Seed, — from the seed, strength 
15 per cent. Dose, rr^ x-xxx. 

Colchicina, Colchicine, C 17 H 19 N0 5 (Unofficial), a white or yellowish, amorphous 
powder, of saffron-like odor and bitter taste, soluble in water and in alcohol. Dose, gr. 
xlo-sV ^ s su i ta hle for hypodermic injection. 

Laborde and Houde condemn all preparations made with acetic acid, also those made 
from the tubers and all wines. The best preparation is Colchicine, in granules or in a 
wine; or a strong tincture made from fresh seed with the shell on, the latter containing a 
very volatile but active oil. Of this seed ^ j to l / z pint of highest proof alcohol, standing 
for 2 weeks. Of this 3 v to water q. s. ad 0y 2 > of which the dose is ^ ss every 4 hours 
night and day, avoiding acids, until nausea, vomiting and purging set in. 

Physiological Action. 
Colchicum is emetic, diuretic and diaphoretic, a drastic purgative, a 
gastro-intestinal irritant and a cardiac depressant. In small doses it 
increases secretion, especially the urine and the sweat. In full doses its 
action is emeto-cathartic, producing profuse watery discharges, great 
nausea and extreme muscular feebleness. In large doses it is a powerful 
irritant of the gastro-intestinal tract, causing severe griping, choleraic 
flischarges, lowered arterial tension and depression of the heart by reflex 
action over the distribution of the pneumogastric, — then great prostration, 
convulsions and collapse, death occurring from exhaustion, with con- 
sciousness preserved until carbonic acid narcosis sets in. On the excretion 
of uric acid and urea its influence is very much disputed, but it probably 
increases the flow of bile, and certainly unloads the portal circulation. 



206 COLOCYNTHIS. 

Antagonistics and Incompatibles. 
Tannic Acid to retard absorption. Emetics and cathartics, also warm demulcent drinks 
freely. Morphine hypodermically to antagonize the cardiac depression, also Alcohol. 

Therapeutics. 
Colchicum is a specific palliative in gout of acute form, in which it 
should be given with an alkali, and kept short of emeto-catharsis. It 
does not prevent relapses, and its power in this disorder is weakened by 
repetition. In ascites from obstructive disease of the liver it is most 
effective, given in full doses to establish a profuse drain, with opium to 
sustain the heart. In acute cerebral congestion and in portal congestions 
it is well given as a drastic purgative. It is often used with marked 
success in acute rheumatism, but frequently fails, and in no ease should 
it be continued long in this affection. It has been used with good results 
in the treatment of gonorrhoea and chordee. The alkaloid is probably 
the best preparation for general use, and is admittedly superior to the 
other preparations in acute gout. 

COLOCYNTHIS, Colocynth,— is the fruit of Citrullus Colocyn- 
this, deprived of its rind. The plant is a native of Spain and Asiatic 
Turkey and belongs to the nat. ord. Cucurbitacese, the fruit being of the 
size of a small orange, white, light, spongy, inodorous, very bitter, con- 
taining many flat, brown seeds which should be rejected before the pulp 
is used. Its active principle is Colocynthin, C 56 H 84 2 3, an amorphous but 
crystallizable bitter glucoside, readily soluble in water. It also contains 
Colocynthein, a resin, and Colocynthitin, which is a tasteless, crystalline 
powder, soluble in ether but not in water, and devoid of purgative 
action. 

Preparations. 

Extractum Colocynthidis, Extract of Colocynth. — Dose, gr. ^-ij. 

Extractum Colocynthidis Compositum, Compound Extract of Colocynth, — con- 
tains of the preceding 16 parts, Aloes 50, Cardamom 6, Resin of Scammony 14, Soap 14, 
Alcohol 10. Dose, gr. v-xx. 

Pilulae Catharticae Compositae, Compound Cathartic Pills, — have of the preceding 
8, Calomel 6, Extract of Jalap 3, Gamboge \V 2 , Water to make 100 pills. Dose, j-iij 
pills. 

Pilulae Catharticae Vegetabiles, Vegetable Cathartic Pills —have of Compound 
Extract of Colocynth 6, Extract of Hyoscyamus 3, Extract of Jalap 3, Extract of Lep- 
tandra 1^, Resin of Podophyllum i l / 2 , Oil of Peppermint 0.8, Water to make 100 pills. 
Dose, j-iij pills. 

Laville's Anti-Gout Remedy, — is a proprietary medicine prepared in France and 
purporting to be " a mixture of prepared Kino-colocynthine." The published formula 
is as follows: Active principle of Colocynth 2^, Quinine and Cinchonine 5, Spanish 
Wine 800, Alcohol 100, Water to 1000 parts; but there is good reason for believing that 
it contains Colchicine instead of Colocynthin. 

Physiological Action and Therapeutics. 
Colocynth is classed among the tonic-astringent and resin-bearing pur- 
gatives. In moderate doses it increases peristalsis and the intestinal 



C0N1UM. 207 

glandular secretions, producing bilious, watery evacuations with much 
colicky, griping pain. Its purgative action is specific, and may be 
obtained by its application to the skin over the abdomen. In large 
doses it is a violent irritant of the gastro-intestinal tract, and has fre- 
quently produced fatal gastro-enteritis. It is popularly supposed to be 
abortifacient, but this is only true of quantities sufficient to endanger 
life. It is an indirect diuretic. 

Colocynth is too severe an agent to be administered alone for consti- 
pation, but it makes a useful factor in compound purgatives, as the com- 
pound cathartic pills. In cerebral congestion it may be used to produce 
rapid derivation, and in ascites to set up a profuse drain from the intes- 
tinal canal. In certain cases of chlorotic amenorrhcea it stimulates the 
pelvic nerves and vessels with excellent results. There seems to be 
abundant evidence that in very small doses (wIyVtV °f a tincture) Colo- 
cynth is an efficient remedy in colic, sciatica, ovarian and other neural- 
gias, as well as in the pain of glaucoma. These actions may be due to 
its two non-purgative principles, which may prove to possess powers not 
heretofore suspected, an example of which is seen in the recently-discov- 
ered cardiac influence of Convallaria, a drug until recently only known 
as a purgative and a diuretic. 



CONIUM, Hemlock, — is the full-grown fruit, gathered while green, 
of Conium maculatum, the spotted hemlock (nat. ord. Umbelliferae). It 
is smaller than anise-fruit, of a gray-green color, slight odor and taste, 
and contains 3 alkaloids, namely, — Confine, C 8 H ]5 N, liquid and volatile, 
Methyl-confine, C 8 H U NCH 3 , and Conhydrine, C 8 H 17 NQ, solid and vola- 
tilizable ; — also Coniic Acid and a volatile oil. Paraconi'ine is an artifi- 
cial substance produced by the reaction between Butyric Aldehyd and 
an alcoholic solution of Ammonia, and isomeric with Coniine but not 
identical with it. The leaves of Conium are no longer official. 

Preparations. 

Extractum Conii, Extract of Conium, — each grain represents a grain of the crude 
drug. Dose, gr. ij— v-xl. 

Extractum Conii Fluidum, Fluid Extract of Conium, — has the same strength as 
the extract. Dose, rnjj-v-xl. 

Conii'na, Coniine, C 8 H 15 N (Unofficial), — an oily, limpid, volatile liquid, of acrid taste, 
alkaline reaction, and an odor compared to that of the urine of mice. It is quickly 
.decomposed by heat, and if exposed to the air soon becomes inert. Dose, gr. ^"To* or 
in minim doses, TTLj^-ij. Is too irritant for hypodermic use, unless carefully neutralized 
by acetic acid. The Hydrobromate in watery solution of gr. viij to the % , of this tr^x = gr. 
i/6, is a good form for subcutaneous or stomachal administration, and may be given in 
doses of gr. ^ to gr. j, as it is not actively toxic. 

All the preparations of Conium are uncertain in action, particularly the extract, as 
the active principle is very volatile. Any specimen must be carefully tested before 
deciding on its dosage, and if the powerful mouse-like odor of the drug be absent, it is 
probably worthless. 



208 CONIUM. 

Physiological Action. 

The special action of Conium and Coniine is the production of motor 
paralysis without loss of consciousness or sensation. It paralyzes the 
motor nerves, the action commencing at the peripheral end-organs and 
extending upwards, involving the nerve-trunks and finally the centres, 
but the muscular irritability remains unaffected. Methyl- Coniine acts 
similarly but reversely, affecting first the motor columns of the cord. 
The sensory nerves are not affected, but the general sensibility is, a feel- 
ing of numbness being experienced in the extremities. 

Gastric irritation is usually the first sensation produced by a full dose 
of Conium, nausea and vomiting being its symptoms. Then weakness 
of the legs, numbness and fatigue, drooping eyelids, diplopia, slightly 
dilated pupils, vertigo, impaired utterance, slow and labored breathing, 
and if the dose be a lethal one, paralysis of the voluntary muscles, those 
of the lower limbs being first affected, speech and vision are lost, and 
finally death occurs from paralysis of the muscles of respiration. The 
heart is not affected and the mind remains clear, but torpid and indiffer- 
ent, until carbonic acid narcosis sets in. Muscular movement counter- 
acts the effects of the drug to a very great extent. 

Conium is believed to have been the state poison of the Athenians, by 
the juice of which Socrates and Phocion died. 

An/agonists and Inco?npatibles. 

Nux Vomica and its alkaloids, Picrotoxin and other tetanizers are antagonistic. 
Tannic acid and caustic alkalies are chemically incompatible. 

Therapeutics. 
Conium is especially indicated in diseases characterized by excessive 
motor activity. Large doses are required, as some physiological action is 
necessary. Children bear it well, their constant activity preventing its 
full action. In chorea and paralysis agitans it palliates, by depressing the 
motor nervous system. In acute mania and delirium tremens to quiet 
motor excitement and prevent exhaustion, it is remarkably efficient, 
especially when given conjointly with Morphine. When pain and spasm 
are present, it will prove a useful agent ; and in tetanus, blepharospasm, 
asthma, whooping-cough, and other spasmodic affections it is frequently 
used with great benefit. The pain of cancer seems to be especially 
amenable to its influence when locally applied, and Conii'ne-vapor is an 
admirable palliative of the tickling cough of phthisis and the irritability 
of the air-passages in acute bronchitis. In pneumonia and pleurisy the 
hypodermic use of Coniine to afford the organs rest by inducing a paretic 
state of the respiratory muscles has been followed by a marked decrease 
in the temperature and pulse-rate. 



CONVALLARIA. 200, 

CONVALLARIA, — is the rhizome and roots of Convallaria majalis ; 
Lily of the Valley, a stemless perennial of the nat. ord. Liliacese, indig- 
enous to Europe, Northern Asia and the Southeastern portion of the 
United States. The preparations in the market vary in action, according 
to the quantity of the Resin present, it being emeto-cathartic. Conval- 
laria contains two glucosides, namely, Convallamarin, on which the 
cardiac action depends, and Convallarin, a crystalline, purgative prin- 
ciple, insoluble in water ; — also an acrid Resin which probably contains 
the latter glucoside. 

Preparations. 

Extractum Convallarise Fluidum, Fluid Extract of Convallaria, — is the only offi- 
cial preparation, and probably contains Convallarin, which is not present in aqueous 
preparations, being insoluble in water. Dose, TT^ij-x. 

Extractum Convallarise (Unofficial), — prepared from the flowers and stalks with )/ z 
of the leaves and root; is a black solid, freely soluble in water and alcohol. Dose, 
gr- ij-x. 

Infusum Convallarias (Unofficial), — prepared from the flowers, leaves and stems 25, 
in water 75. Dose, ^ss-ij. 

Convallamarinum, Convallamarin, C 23 H 44 0i 2 (Unofficial), — an amorphous, white, 
bitter powder, freely soluble in water and in alcohol, but insoluble in ether. Dose, gr. 
X-iJ- 

Physiological Action. 

Convallaria has long been known as a decided cathartic and a prompt 
and powerful diuretic, but its cardiac action has only lately excited atten- 
tion, and it is now considered a close analogue of Digitalis, while free 
from the cumulative action which makes the latter drug so frequently a 
dangerous remedy. 

Preparations of the root have a powerful emeto-cathartic action, prob- 
ably due to a preponderance of the resin. Those freed from this ingre- 
dient correspond in action with Convallamarin, stimulate the appetite, 
without impairing digestion, increase peristalsis without producing 
catharsis, slow the heart and raise the arterial tension, also slowing and 
deepening respiration. Lethal doses at first produce irregularity of the 
cardiac action and spasm of the respiratory muscles, high arterial tension 
and a very rapid pulse, — followed by lowered blood-pressure, very slow 
and deep breathing, and finally arrest of the heart in systole. Its mode 
of action is by direct stimulation of the pneumogastric, the motor and 
sensory nerves retain their irritability, the muscles preserve their contrac- 
tility, and the cerebral functions and the pupil are unaffected. 

Convallarin is a drastic purgative in 3-grain doses. Convalla- 
marin is an emetic even in small quantity, and the powdered root is 
sternutatory. 

Therapeutics. 

Convallaria is a heart-tonic like Digitalis, and is indicated in the same 
class of cases as is that drug, with the advantage that having no cumula- 
tive action it is not dangerous to the heart in medicinal doses, and does 
14 



2IO COPAIBA. 

not disturb the stomach or the functions of the cerebro-spinal axis. In 
doses of gr. xv-xxv of the extract it slows the action of the heart and 
increases the force of its contractions, raises arterial tension, augments 
the force and volume of the respiration, and produces prompt diuresis 
without altering the composition of the urine. It is often a valuable 
remedy in mitral stenosis or insufficiency with venous stasis, dilatation of 
the heart, palpitation, vehement cardiac action or disordered rhythm, 
and in all valvular affections accompanied by dropsy and a weak heart. 
It has also been used with benefit in pneumonia, typhoid fever and renal 
dropsy. Its action is maintained for several days after its use has been 
suspended. 



COPAIBA, Copaiba, Balsam of Copaiba, — is the oleoresin, of 
Copaifera Langsdorffii, and other species of Copaifera, a S. American 
tree of the nat. ord. Leguminosae, growing chiefly in the valley of the 
Amazon. It is a translucent, viscid liquid, of yellow color, aromatic 
odor, acrid and bitter taste, not fluorescent, soluble in alcohol and benzol. 
It is not a balsam as it contains no cinnamic acid. Its constituents are 
a Volatile Oil and a Resin in about equal proportions, the latter contain- 
ing nearly 99 per cent, of Copaibic Acid. Dose, rr^x-^j. 

Preparations. 

Oleum Copaibae, Oii of Copaiba, C 10 H 16 , — the volatile oil, a pale yellow liquid, of sp. 
gr. 0.890, of bitter taste and neutral reaction, soluble in 10 volumes of alcohol. Dose, 
ttpc-xv. 

Resina Copaibae, Resin of Copaiba, — is the residue left after distilling off the vola- 
tile oil from Copaiba ; a yellowish, brittle body, of acid reaction, soluble in alcohol, 
benzol or amylic alcohol. Consists mainly of Copaibic Acid, which is crystallizable, also 
I y z per cent, of a viscid resin. Dose, gr. j-v. 

Massa Copaibae, Mass of Copaiba, Solidified Copaiba, — consists of Copaiba 94, fresh 
Magnesia 6, triturated with water and set aside to concrete into a pilular mass. Dose, 

Mistura Copaibae Composita, Conipound Mixture of Copaiba, Lafayette's Mixture 
(Unofficial), — & . Copaibae gvij, Ol. Cubebse gj, Glyceriti Vitelli gvij. Triturate and 
add gradually while triturating Syrupi Aq. Menth. Piperitse 3 ijss. Then add with con- 
stant stirring Liq. Potassae ^ ss, Tr. Cardamomi Co. ^ij, Spt. Etheris Nitrosi ^ss, Aq. 
Menthse Pip. q. s. ad § viij. Dose, ^j-^ss. 

Physiological Action and Therapeutics. 
Copaiba is a stimulant diuretic, diaphoretic, expectorant, and a gastro- 
intestinal irritant. Its taste is bitter and nauseous. In the stomach it 
causes heat, unpleasant eructations, heaviness, frequently anorexia and 
diarrhoea, and if continued for any length of time gastro-intestinal 
catarrh and desquamative nephritis may result. The oil and resin diffuse 
into the blood and are excreted by the bronchial mucous membrane, 
skin and kidneys, producing increased secretion at the points of elimi- 
nation. The various secretions have the odor of the drug, especially the 



CORIANDRUM — CORNUS — COTO. 2 I I 

urine. In medium doses it increases the quantity of urine and its solid 
constituents, but large doses will cause scanty urine, containing albumen, 
casts and blood, with pain in the loins and other signs of renal conges- 
tion. On the skin it often produces itching and several forms of erup- 
tion. 

Copaiba has been largely used in gonorrhoea after the acute symptoms 
have subsided, also in chronic cystitis, acute and chronic bronchitis, and 
in dropsies, particularly ascites. In all these affections it is a useful 
remedy, but its nauseous taste and irritant effects on the stomach are 
driving it out of fashion, especially in private practice. One eminent 
surgeon declares that not only is it useless in gonorrhoea but that it does 
more harm than good, often prolonging the disease beyond its natural 
limit. In psoriasis and urticaria, and in cutaneous affections character- 
ized by torpid peripheral circulation, this drug has been administered 
internally with excellent results. In long-standing cystitis in the female 
Copaiba has been injected into the bladder with great benefit. The 
resin is the most active ingredient, especially for diuretic purposes. 



CORIANDRUM, Coriander, — is the fruit of Coriandrum sativum, a European 
plant of the nat. ord. Umbelliferae. It is a minute, globular, brownish-yellow body, 
finely ribbed, of aromatic odor and taste, and contains a volatile and a fixed oil. Dose, 
gr. x-xx. 

Oleum Coriandri, Oil of Coriander, — a volatile oil distilled from Coriander. A 
colorless, or pale yellowish liquid, of aromatic, bitter and pungent taste; soluble in io 
volumes of alcohol, forming a slightly turbid liquid, neutral to litmus paper. Dose, 

Coriander is stimulant, aromatic and carminative. It is used almost wholly as a 
flavoring to other remedies, or as a corrective against the griping effects of certain purga- 
tives. Its flavor covers the taste of Senna and Rhubarb, and it is an ingredient of the 
official Confectio Sennse. 



CORNUS, Dog-wood (Unofficial), — is the bark of the root of Cormisjlorida, a small 
tree of the nat. ord. Cornacese, indigenous in the U. S. Occurs in reddish-brown, 
curved pieces, of astringent, bitter taste, and contains a bitter principle named Cornin, 
which is crystallizable and soluble in water and alcohol ; also a resin and tannic acid. 

Cornus is a simple bitter, having stomachic and other qualities similar to those of 
Calumba (which see). In addition it is possessed of considerable antiperiodic power, 
and has a good deal of reputation in the Southern States as a remedy in malarial fever, 
the physicians of that section considering it as next to quinine in efficiency. Heat 
destroys its active principle, consequently a decoction is a useless preparation. A fluid 
extract is on the market, the dose of which is Tujc-3 j. 



COTO, Coto Bark (Unofficial), — is the bark of some unknown tree growing in 
Bolivia, from whence it comes in brownish pieces of aromatic odor and acrid, bitter 
taste. It contains an acrid, bitter principle, of yellow color, crystalline and soluble in 
hot water and alcohol, named Cotoin, C 22 H 18 € ; also Piperonylic Acid, C 8 H 6 4 , and a 
volatile oil, resin, etc., but no tannin. Dose, gr. j-xv. 

Paracoto Bark, or False Coto, — is thicker than the true bark, has a fainter odor 
and taste, and is marked by whitish furrows on its surface. Its principle, Paracotoin, 
C 19 H 12 6 , has a strong similarity to Cotoin therapeutically, but is less active. 

A fluid extract of the official strength is prepared, also a tincture (10 per cent.), which 



212 CREOSOTUM. 

may be administered in doses of from n\ j-xx. Cotoin is used in doses of gr. j-iv, and 
Paracotoin in somewhat larger quantities. 

The physiological action of Coto has not been studied, all that is known about it 
being that it is decidedly irritant to the skin and mucous membranes. After its internal 
administration the urine takes a dark- red color with Nitric Acid. Ferric Chloride 
blackens a dilute solution of Cotoin, but has no reaction with Paracotoin. 

The bark and both principles are highly recommended in diarrhceas of various forms, 
especially those of phthisis, typhoid fever, and cholera. In Asiatic cholera Paracotoin 
has been used hypodermicalJy in 3-grain doses with success. Where there is any ten- 
dency to acute inflammation of the gastro-intestinal tract this agent must be used with 
caution. Small doses of the tincture (Tt\J-v) are said to be very effective in the diar- 
rhoea of children. 



CREOSOTUM, Creosote, — is a mixture of phenols, chiefly Guaia- 
col and Creosol (also Methylcreosol and Phlorol), obtained during the 
distillation of wood-tar, preferably of that derived from the Beech. It 
'occurs as an almost colorless, or pinkish, inflammable, oily liquid, of 
smoky odor, caustic taste, and neutral reaction; soluble in about 150 of 
water at 59 F., and in all proportions, in absolute alcohol, ether, chloro- 
form, benzin, carbon disulphide, acetic acid, and fixed and volatile oils. 
It does not coagulate albumen (?) or collodion, Carbolic Acid does. It 
was named from its remarkably preservative power over meat (creas, 
flesh, sohzoh, preserve). Much of the commercial Creosote is an impure 
Carbolic Acid, or a heavy oil distilled from coal-tar and containing Car- 
bolic and Cresylic Acids. Dose, rnj-iij, well diluted. 

Preparations. 

Aqua Creosoti, Creosote Water, — a I per cent, solution, containing nearly 5 minims 
of Creosote in each fluidounce. Dose, gj-iv. 

Morson's Beechwood Creosote, — is best for internal use. Dose, Tr^ j every 3 hours, 
in wine or whiskey, well diluted. 

Guaiacolum, Guaiacol, Methyl Pyrocatechin, C 6 H 4 OHOCH g , (Unofficial), — is the 
most active ingredient of Creosote, of which it constitutes from 60 to 90 per cent. It 
occurs as a colorless liquid, highly inflammable, of a powerfully aromatic odor, and sp. 
gr. 1.1 17: very slightly soluble in water, readily soluble in alcohol. Dose, TT\J-xv, in 
capsules, pills, or alcoholic solution. 

Guaiacoli Carbonas, Guaiacol Carbonate, (Unofficial), — is a tasteless and odorless, 
crystalline powder, insoluble in water. Dose, gr. ^3-j, gradually increased to a maxi- 
mum of 90 grains. 

Benzosolum, Benzosol, Benzoyl Guaiacol, (Unofficial), — is prepared by heating 
Guaiacol with Benzoic acid, and occurs in small, colorless, odorless, and almost tasteless 
crystals, practically insoluble in water. Contains 54 per cent, of Guaiacol. Dose, gr. v-xv. 

Physiological Action and Therapeutics. 
Creosote is expectorant, astringent, antiseptic, styptic, escharotic, an- 
aesthetic and narcotic. Its action is practically the same as that of Car- 
bolic Acid (see ante, page 64), especially upon the heart, respiration and 
nervous system, but differs from that of the latter in not causing convul- 
sions, and in increasing the coagulability of the blood. It is eliminated 
by the kidneys and bronchial mucous membrane, which it stimulates, 
being quite a good expectorant. In small doses it seems to have a selec- 



CREOSOTUM. 213 

tive sedative influence on the terminal nerve-filaments in the gastric 
mucous membrane. In large doses it is a powerful poison, resembling 
Carbolic Acid in its symptoms, except that its nervous effects are even 
more marked. It explodes when combined with Oxide of Silver in pill, 
unless previously diluted with an inert powder. 

Being a very complex substance of varying composition Creosote has 
been almost entirely supplanted in therapeutics by Carbolic Acid for 
external use, and by Guaiacol for internal administration. As an astrin- 
gent it has been employed in intestinal hemorrhage, gonorrhoea and 
gleet, and generally in the same affections as Carbolic Acid. Externally 
it is a good application in eczema, pruritus, ulcers and scaly skin diseases, 
and it effectually relieves the pain of an exposed dental nerve if applied 
thereto. It is a good agent by inhalation in chronic bronchitis and 
gangrene of the lung, and it has been administered internally with 
decided benefit in abnormal fermentative processes in the stomach and 
intestines, in reflex nausea and vomiting, (as from sea-sickness, pregnancy, 
etc.) : — also as an aseptic expectorant in chronic basilar cavity, in which 
it seems to have greater efficacy than any other remedy ; and in bronchitis, 
pulmonary gangrene, carcinoma of the stomach and diabetes. 

In pulmonary tuberculosis, when well borne by the stomach, and con- 
tinued over a long period of time, it has proved more efficient than any 
other remedy. Its employment in this disease is based on the statement 
of Guttmann, that tubercle bacilli are destroyed by blood which contains 
x / 2 per 1000 of Creosote, while even one-half that proportion arrests their 
growth. The commencing daily dose, of Creosote (or Guaiacol), is 2 or 
3 minims, largely diluted to prevent irritation, taken after meals, and 
increased by the addition of one minim daily until a maximum daily 
dosage Of 15 to 18 minims is reached, at which rate it should be continued 
for several months. Under this treatment cough is relieved, expectoration 
diminished, night-sweats are stopped, the fever lowered ; while body- 
weight and appetite are increased in most cases; and in many even the 
local conditions are decidedly improved, as evinced by the physical 
signs. Recent researches indicate that the good effects of this treatment 
are due to the formation of soluble compounds between the remedy and 
the toxic albuminous by-products of the tubercle bacillus, which products 
are then eliminated from the blood. 

Guaiacol is preferred by many, for internal administration, instead of 
Creosote, being the principal ingredient of the latter, and of more definite 
chemical composition, though nearly or quite as irritant to the stomach. 
It may be given in mixture with wine or brandy, in capsules, or in com- 
bination with cod-liver oil. When neither of these agents agree with the 
patient, a useful and efficient substitute therefor is Guaiacol Carbonate, 
in doses of 6 to 8 grains, gradually increased to gjss daily. This prepa- 



214 CROCUS CUBEBA. 

ration is well borne, as it does not irritate the gastric mucous membrane 
nor disturb the digestion. 

Benzosol contains Guaiacol in the proportion of 54 per cent. In the 
intestinal canal the latter is probably set free by the action of the alkaline 
secretions, as Benzosol is excreted by the urine in the form of guaiacol 
and benzoic acid combinations. Compared with guaiacol, this agent has 
the advantage of being almost tasteless ; hence it can be given in large 
doses without the digestive disturbance and disagreeable eructations pro- 
duced by the parent substance when administered in liquids, and without 
the local irritant effect caused by the latter in capsules. In doses of 4 
grains, gradually increased to 12 grains thrice daily, results have been 
obtained from this agent, in the treatment of phthisis, equal, if not 
superior, to those produced by Creosote. 



CROCUS, Saffron, — the stigmas of Crocus sativus, a plant of the nat. ord. Iridese, 
cultivated in Europe, containing a volatile oil and coloring matter. Occurs as separate 
stigmas or three attached to the style, of orange-brown color, peculiar, aromatic odor, 
and bitter taste. So called American Saffron is not Crocus but the flowers of Carthamus 
tinctorius. True Saffron is expensive, as it requires about 60,000 flowers to furnish one 
pound of the stigmas. Dose, gr. v-xx, in infusion. 

Tinctura Croci, Tincture of Saffron, — 10 per cent. Dose, sjj-ij. 

Saffron Tea, so much used in domestic practice, is an infusion of Carthamus tinc- 
torius, the Safflower. 

Crocus is a stimulant aromatic, having some antispasmodic and anodyne qualities. 
The hot infusion produces diaphoresis, probably by virtue of the hot water alone. It is 
said to have caused death with narcotic symptoms. On the continent of Europe it is 
employed as a stimulant and emmenagogue, but in this country its only use is as a color- 
ing agent. The miscalled Saffron Tea noted above is used in domestic practice for 
measles and other exanthemata. 



CUBEBA, Cubeb, — is the unripe fruit of Piper Cubeba, a plant of 
the nat. ord. Piperaceae, cultivated in Java. Occurs as a blackish-gray, 
wrinkled, globular body, about the size and shape of black pepper, of 
strong, spicy odor, and aromatic, pungent taste. Contains a Volatile 
Oil, which is official, an acrid resin composed in part of Cubebic Acid, 
also a fatty oil, gum, and Cubebin, which is an insoluble, neutral, odor- 
less and tasteless body. The volatile oil may be separated into Cubebene 
a camphor, and Cubeben a liquid portion. The active principles are the 
volatile oil and the cubebic acid, both of which are contained in the 
oleoresin. Cubeb should be kept whole and not pulverized until wanted 
for use. Dose of the powdered drug, gr. x-^ij. 

Preparations. 

Extractum Cubebae Fluidum, Fluid Extract of Cubeb, — Alcoholic. Dose, ff\v- 
xxx. 

Tinctura Cubebae, Tincture of Cubeb, — 20 per cent. Dose, TTLx-^iij. 
Oleoresina Cubebae, Oleoresin of Cubeb, — extracted by ether. Dose, TT^v-xxx. 



CUPRUM. 215 

Trochisci Cubebae, Troches of Cubeb, — each contains of the Oleoresin 4, Oil of Sas- 
safras I, Extract of Glycyrrhiza 25, Acacia 12, and Syrup of Tolu q. s. to form 100 
troches. Dose, j-iij. 

Oleum Cubebae, Oil of Cubeb, C 15 H 24 , — is the volatile oil, a colorless or pale green- 
ish-yellow liquid, of sp. gr. 0.920, warm, aromatic taste, odor of cubeb and neutral 
reaction. Is soluble in an equal volume of alcohol. Dose, TT^v-xx. 

Cubeb belongs to the pepper family, and like black pepper is an 
aromatic stomachic and a stimulant diuretic in small or medium doses, 
but large doses derange digestion and may act as a gastro-intestinal irri- 
tant. Its constituents are eliminated by the bronchial mucous mem- 
brane, the skin and the kidneys, stimulating and disinfecting the genito- 
urinary passages, increasing the bronchial mucus, sweat and urine, and 
frequently causing an urticarial or vesicular eruption. It increases the 
action of the heart and of the vascular system, stimulates the venereal 
appetite, and promotes the menstrual discharge. 

Cubeb is particularly useful in affections of the bladder and urethra. 
It is used in the acute, stage of gonorrhoea, in chronic cystitis, prostator- 
rhcea and chronic bronchitis with excellent results. The powder is a 
good application in hay-fever, chronic nasal catarrh and follicular pharyn- 
gitis, blown on to the mucous membrane by an insufflator. It may also 
be smoked in cigarettes with temporary relief in cases of acute nasal 
catarrh with " stuffed " nasal passages. In some subjects the continued 
use of cubeb produces nausea, hemorrhoids, hematuria and severe head- 
ache. The troches are a useful preparation in chronic irritability of the 
fauces, pharynx and air-passages, and are much employed by singers and 
public speakers for their tonic effect on these parts and for the relief or 
prevention of hoarseness. 



CUPRUM, Copper, Cu, — is not official, but one of its salts is, the 
Sulphate. The metal itself is inert, but in combination it is actively 
poisonous. Copper has been found in the normal human blood in very 
minute quantity. 

Salts and Preparations of Copper. 

Cupri Sulphas, Copper Sulphate, CuS0 4 -4- 5H 2 0, — blue, translucent crystals, efflor- 
escent, of nauseous, metallic taste and acid reaction, very soluble in water, insoluble in 
alcohol. Its solution is blue by transmitted light, green by reflected light. Dose, as an 
emetic, gr. ij-v, every 10 or 15 minutes, — as a tonic, gr. ]/&-%• 

Alkaline Cupric Tartrate Volumetric Solution, Fehling's Solution, — the official 
reagent for glucose, is prepared as follows. (1) Dissolve 34.64 grammes of pure Cupric 
Sulphate, in water to measure exactly 500 cubic centimeters. (2) Dissolve 173 grammes 
of Potassium and Sodium Tartrate and 125 grammes of Potassium Hydrate in water to 
measure exactly 500 cubic centimeters. Keep the two solutions in small, rubber-stop- 
pered bottles, separate; and for use, mix exactly equal volumes of the two at the time 
required. One cubic centimeter of the mixed solution is the equivalent of — 

Cupric Sulphate, crystallized, CuS0 4 -j- 5 H 2 0, Gramme, 0.03464 

Cupric Tartrate, CuC 4 H 4 6 -f 3H 2 0, " 0.03685 

Glucose, anhydrous, C 6 H 12 O e , " 0.00500 



2l6 CUPRUM. 

Cuprum Ammoniatum, Ammoniated Copper (Unofficial), — is made by triturating 3 
parts of Ammonium Carbonate with 4 of Cupric Sulphate until effervescence has ceased, 
then drying. A deep azure blue powder, of ammoniacal odor, a styptic, metallic taste, 
and alkaline reaction, soluble in water. Dose, gr. ]/(,-)• 

Cupri Arsenis, Copper Arsenite. See ante, page 132. 

Physiological Action. 

The salts of Copper are gastro-intestinal irritants, producing a metallic 
taste, nausea with greenish vomited matter, purging of blood and mucus, 
constricted fauces, depressed heart action, hurried respiration and fever. 
Or, as with Arsenic, gastro-enteritis may not occur, but instead profound 
nervous symptoms, as headache, defective coordination, coma and con- 
vulsions. The symptoms of chronic poisoning are bronchial irritation 
and catarrh, gastro-intestinal catarrh, colic with diarrhoea [Lead produces 
colic with constipation], dysentery, nausea, emaciation, anaemia, saliva- 
tion, and a green line (sulphide) along the margin of the gums in those 
who do not clean their teeth. The nervous symptoms above mentioned 
are also usually well marked. The liver becomes atrophied from irrita- 
tion of its connective tissue and fatty degeneration of the hepatic cells. 
The lungs are congested, even pneumonic consolidation may be set up, 
the metal seeming to have affinity for the parenchyma of these organs. 
These effects are often produced by the inhalation of cuprous fumes, and 
by eating acid fruits cooked in a copper vessel. 

Copper Sulphate is a simple, irritant emetic, producing prompt and 
continued vomiting with but little nausea or depression. In small doses 
it is a nerve-fonic, and is astringent to the gastro-intestinal tract. Ex- 
ternally applied in solution it is a useful stimulant and astringent to 
diseased mucous surfaces, and is mildly caustic if used in substance. The 
Acetate is possessed of the same general action as above described. Its 
local action is stimulant and escharotic. The impure acetate (verdigris) 
is a violent irritant poison. Ammoniated Copper has no special action 
other than above noted. 

Antagonists and Antidotes. 

Potassium Ferrocyanide is the antidote to Copper salts, but Albumen or Magnesia 
may be used. Any chemical antidote should be followed by prompt evacuation of the 
stomach, then Opium and demulcents for gastro-enteritis, and Potassium Iodide even to 
saturation of the system. Alkalies andtheir Carbonates, Lime-water, Iodides, and Min- 
eral Salts (except the sulphates), are all incompatible. 

Therapeutics. 
The Sulphate is a prompt and efficient emetic, and is so used in croup 
and narcotic poisoning. In phosphorus poisoning it forms a compara- 
tively insoluble phosphide of copper besides producing emesis. Fifteen 
or twenty grains may be dissolved in ^iv of water, and a teaspoonful or 
more, according to age, given every ten minutes until vomiting is pro- 
duced. In acute diarrhoea and chronic dysentery it is the best metallic 



CURARE. 217 

astringent in doses of gr. y 1 ^ to y 1 ^ with Opium, and in gastro-intestinal 
catarrh it is equally efficient. Locally, it is used with benefit in throat 
affections, gonorrhoea, granular lids and corneal ulcers, indolent granula- 
tions and chronic inflammations of mucous membranes. In most of these 
affections weak solutions (gr. ^ to ^ to the ^) are best, but in granular 
conjunctivitis the smooth crystal may be rubbed quickly over the surface 
once daily. 

In various nervous diseases, as epilepsy, chorea, hysteria, etc., the salts 
of copper are sometimes beneficial, the Ammoniated Copper being con- 
sidered the most efficient preparation in these cases. In Germany a tinc- 
ture of the Acetate was official and has been used successfully in the 
treatment of pneumonia. Ammoniated Copper has lately been highly 
recommended for facial neuralgia, but requires pushing to the production 
of some physiological action. 

Ointments or lotions of the Acetate are useful applications in eczema, 
herpes, tinea sycosis, mentagra and herpes circinatus. 

Villaie' s Solution has been successfully used as a local injection for the 
cure of caries. It is composed of Copper Sulphate, Zinc Sulphate, of 
each 15 parts, Liquor Plumbi Subacetatis 30, Vinegar 200. The solution 
is thoroughly injected into the sinuses leading to the carious bone. 



CURARE, Woorara (Unofficial), is a vegetable extract obtained 
from various members of the Strychnos family, also from Paulinia curare 
and other plants. It is used in S. America as an arrow-poison under 
various names, as Caroval, Vao, etc. Its active principle is the crystal- 
lizable alkaloid Curartne, which contains no oxygen. 

The dose of Curare is gr. ^o - !" hypodermically, — of Curarine, gr. Yoo - rinr hypoder- 
mically, or gr. y^-^o D y the stomach, but as the samples vary greatly in activity they 
should first be tried on some inferior animal before being administered to man. 

Physiological Action. 
Curare is a paralyzer of the voluntary muscles, affecting them through 
the end-organs of the motor nerves. It does not at first act upon the 
brain or spinal cord, but if life be prolonged by artificial respiration the 
cord, sensory nerves and even the muscular tissue all become affected. 
The heart, at first quickened, becomes depressed, and the blood-pressure 
is lowered, the eyelids droop, the eye-balls protrude, vision is disordered, 
intestinal peristalsis and sensibility to stimuli are greatly increased, and 
an artificial glycosuria (curare-diabetes) is set up. The limbs are paralyzed 
first, death occurring by paralysis of respiration. The absorption of the 
drug by the stomach is very slow, as its active principle passes with diffi- 
culty through animal membranes, and its elimination, which takes place 



2l8 CUSSO — CYDONIUM. 

by the kidneys, being more rapid and complete than that of any other 
agent, no marked effect may be produced when administered internally. 
When hypodermically injected its action is very prompt. The urine of a 
curarized animal will poison another, and that of the second will paralyze 
a third. 

As compared with other motor depressants Curarine and Coni'ine 
paralyze the end-organs of the motor nerves, Gelsemine and Methyl- 
coniine paralyze the motor centres. 

Antagonists and Incompatible*. 

Strychnine, though from a member of the same family, is antagonistic as to the action 
on the heart and respiration. So also is Atropine. Artificial respiration is the most 
efficient antagonist, maintaining life until elimination occurs. Evacuation of the bladder 
repeatedly is important to prevent reabsorption. The caustic alkalies destroy Curarine 
as they do all other alkaloids. 

Therapeutics. 
Curare is chiefly used for experimental purposes on the lower animals. 
It has an historical interest from its having been the means by which 
Bernard demonstrated the existence of muscular contractility as an essen- 
tial endowment of that tissue. It has been used with some success in 
spasmodic nervous affections, particularly in tetanus, both idiopathic and 
traumatic, in hydrophobia, chorea and epilepsy. It does not promise 
well as a therapeutic agent, but undoubted cases of hydrophobia are 
reported by high authority as cured by this drug. 



CUSSO, Kousso, Brayera, — is the female inflorescence of Hagenia abyssinica, an 
Abyssinian tree of the nat. ord. Rosaceae. It occurs in bundles or rolls, of fragrant, 
tea-like odor, and bitter, nauseous taste, and contains tannic acid, a volatile oil, and a 
crystalline principle named Koussin, which by itself is apparently inert. Dose, of Cusso, 

Extractum Cusso Fluidum, Fluid Extract of Kousso. — Dose, gij-^j. 

Cusso has little or no effect except the nausea, vomiting, colic and slight diarrhoea pro- 
duced by large doses. Its chief action is anthelmintic against both varieties of tape- 
worm, but it rarely expels the head of the parasite, and is very nauseous to the taste and 
difficult of retention by the stomach in the large doses necessary to efficiency. 3 ij to t ^ j 
of the flowers infused in ?* iv of boiling water is the usual dose, and should be taken on 
an empty stomach and followed by a castor-oil or saline purge after 3 or 4 hours. An 
emulsion of a 6 per cent, infusion with castor-oil, yolk of egg, a few drops of ether and 
oil of anise with 10 to 20 drops of Oleoresin of Male-fern, is more agreeable and effi- 
cient than the infusion alone. 



CYDONIUM, Quince Seed (Unofficial), — is the seed of Cydonia vulgaris, a tree 
of the nat. ord. Rosacea, native in Crete and Austria, and cultivated elsewhere. The 
seeds are about ]^. inch long, triangularly compressed, covered with a whitish epithelium, 
and in wa'er they swell up forming a mucilaginous mass. The mucilage is the only con- 
stituent of importance and is contained in the epithelial cells. It has been named 
Cydonin, and considered to be a compound of gum and cellulose. 

Mucilago Cydonii, Mucilage of Cydonium (Unofficial), — is prepared by macerating 
2 parts of Cydonium in 100 of Distilled Water. Dose, indefinite. 



CYPRIPEDIUM DAMIANA DATURA DIGITALIS. 2 I9 

Cydonium is of value for its mucilage, which is used as a bland, demulcent application 
in conjunctivitis, abrasions of the skin, and fissures of the mucous membranes, and as a 
vehicle for injections in gonorrhoea. Internally it may be used as a soothing remedy for 
the throat, stomach, or intestines. The preparation known as Bandoline, used as a hair- 
dressing, is identical with mucilage of Cydonium. 



CYPRIPEDIUM, Ladies' Slipper, — is the rhizome and roots of Cypripedium 
pubescens, and of C. parviflorum, the Moccasin-plant, or American Valerian (nat. ord. 
Orchideae). Is dark or orange-brown in color, of strong, heavy odor, and bitter, pungent 
taste. It contains a volatile oil, a volatile acid, resins, and tannin. 

Extractum Cypripedii Fluidum, Fluid Extract of Cypripedium. — Dose, tt\x-xxx. 

Cypripedin (Unofficial), — is an impure alcoholic extract. Dose, gr. ss-iij. 

Cypripedium is antispasmodic, tonic, stimulant and diaphoretic, possessing the same 
general properties as Valerian, whence one of its common names, American Valerian. 
It is a popular remedy in some parts of the U. S. for nervous hypersesthesia unaccompa- 
nied by organic lesion, especially morbid sensibility of the eye. It is reported to have 
even cured epilepsy, and to be highly useful in neuralgia, hysteria, nervous headache and 
insomnia. 



DAMIANA (Unofficial), — the leaves of Turnera aphrodisiaca, a plant of the nat. 
ord. Turneraceas, growing in Mexico and Lower California. Several varieties of so-called 
Damiana are in the market, but the true leaf is of a light-green color, small, lanceolate, 
and dentate along the margin. It contains a volatile oil and a resin. Dose, ^j daily. 

Extractum Damianae, Extract of Damiana (Unofficial). — Dose, gr. ij-x. 

Extractum Damianae Fluidum, Fluid Extract of Da??iiana (Unofficial). — 
Dose, rrrx— 3 j. 

Damiana is said to be a powerful aphrodisiac in cases of sexual atony, but the pub- 
lished, reports of its use since its introduction vary greatly as to its efficacy. It is probably 
a stimulant diuretic, a bitter tonic, and a purgative in sufficient doses. 

Besides its use as an aphrodisiac Damiana has been administered with benefit in some 
forms of cerebral exhaustion and general atony of the nervous system, also in sick head- 
aches and in some few cases of paralysis. It forms the chief stock in trade of the 
numerous charlatans who fill the daily papers with advertisements of " manhood- 
restorers." 



DATURA TATULA (Unofficial),— is an indigenous plant of the nat. ord. Solana- 
cese, resembling Stramonium very closely, with which it generally agrees in its physio- 
logical action and therapeutics. It is distinguished by its purple stem, purple flowers and 
anthers, and the darker green of its leaves. It probably contains the alkaloid Daturine 
(see Stramonium), — and has been smoked in asthma, in a few cases giving continued 
relief when Stramonium had failed to render any service. 



DIGITALIS, Foxglove, — Digitalis consists of the leaves, col- 
lected from plants of the second year's growth, of Digitalis purpurea, 
the Purple Foxglove, a plant of the nat. ord. Scrophularinese, which 
grows wild in Europe, and is cultivated in this country, often in private 
gardens for its beautiful spike of purple flowers, and largely by the Shakers 
for the drug market. 

The British Phar. directs that the official drug shall consist of "the dried leaf, collected 
from the wild, indigenous plant, when about two-thirds of the flowers are expanded." 
Much of the leaf found in our shops is of very poor quality, a large proportion being 



220 DIGITALIS. 

inert; but whether this is due to our Phar. not restricting the official drug to the wild 
plant, or to careless treatment in gathering and drying, is not definitely known. When, 
however, the leaves are imperfectly dried, a process of decomposition sets in, which 
destroys the active principles, and may produce new and poisonous ones. A similar 
decomposition is said to occur whenever the tincture of Digitalis is mixed with watery 
or syrupy solutions. Certain it is, at any rate, that Digitalis is one of the most unreliable 
drugs, in respect to the physiological activity of any particular sample or preparation. 
The seeds are known to contain the active principle in much greater proportion than the 
leaves, but they are never used. 

Constituents. 

The active principle of Digitalis was first designated by the term Digi- 
talinum (Digitalin), under which name a substance was official in the 
U. S. Phar. and a process was given therein for its extraction, until the 
revision of 1880, when it was omitted. It was an amorphous product, of 
complex composition, and did not represent Digitalis. 

In 1871 Nativelle received the Orfila prize from the French Academy for the discovery 
of a crystalline principle in Digitalis, which he named Digitaline. This was supposed 
to be the active principle of the plant, until Roucher, (1872) and Schmiedeberg, (1875) 
found it to be a complex body, consisting of a mixture of Digitoxin and Digitalin. 
Schmiedeberg's latest analysis is now accepted as the most accurate determination yet 
obtained of this vexed question. He enumerates five principles at least as contained in 
Digitalis, viz. : — (1) Digitalin, amorphous, insoluble in water, but readily soluble in 
alcohol; the active ingredient of Homolle's French Digitaline and the Digitalin of the 
U. S. and Br. Pharmacopoeias ; — (2) Digitoxin, insoluble in water and sparingly soluble 
in alcohol ; the most active of all, and the principal constituent of Nativelle's prize Digi- 
taline ; — (3) Digitalein, soluble in both water and alcohol ; — (4) Digitonin, readily soluble 
in water, sparingly so in alcohol ; — active, but acts like Saponin, forming a solution which 
froths easily and antagonizes the other three; — (5) Digilin, which seems to be entirely 
inert. The first three are active cardiac stimulants and highly poisonous. The fourth is 
a direct depressant of the heart, antagonizing the stimulant action of the others. All five 
are non-nitrogenous, and, except Digitin, are glucosides. Digitalis contains no alkaloid. 

Preparations. 

Digitalis, Digitalis, — the powdered leaves. Dose, gr. ss-iij. 

Extractum Digitalis, Extract of Digitalis, — By maceration and percolation in Alco- 
hol 2, Water 1, distilling off the alcohol, and evaporating the residue. Dose, gr. %-). 

Extractum Digitalis Fluidum, Fluid Extract of Digitalis, — By maceration and 
percolation in Alcohol 2, Water 1, and evaporation to the required strength. Dose, 
X\ ss-iij. 

Tinctura Digitalis, Tincture of Digitalis, — digitalis 15, Diluted Alcohol to 100. 
By maceration and percolation. Dose, TT^v-xxx. 

Infusum Digitalis, Infusion of Digitalis, — Digitalis \y z , Alcohol 10, Cinnamon 
Water 15, Boiling Water 50, Water to 100. By maceration in boiling water. Dose, 
5jj-iv. Notice that the dose is in drachms, not in ounces. 

Digitalinum, Digitalin, — is the complex product of the process formerly official in 
the U. S. and Br. Phar. Dose, gr. ^WV- 

Homolle's (or Quevenne's) Digitalin (Unofficial), — is much used in France in 
form of granules. Consists chiefly of Digitalin with a little Digitoxin, and possesses the 
action of the leaves. An amorphous, yellowish-white powder or small scales, intensely 
bitter, inodorous, but irritant to the nostrils. Dose, gr. J^, equal to about gr. jss of the 
powdered leaves. 

Nativelle's Digitalin, — consists largely of Digitoxin, and is cumulative in action. 
Light, white, crystalline tufts of needles, of very bitter taste ; soluble in alcohol, insoluble 
in water. Dose, gr. ^V^o * n P^- 

Note on the Preparations. The Tincture and Fluid Extract, 
being alcoholic preparations, contain a large proportion of Digitalin 



DIGITALIS. 221 

and Digitalein, with a small proportion of Digitoxin and Digitonin. On 
the addition of water thereto, the Digitoxin is precipitated to the bottom. 
The Infusion contains a large proportion of Digitonin, some Digitalein, 
and little or no Digitalin or Digitoxin. The Infusion is the best prepar- 
ation for diuretic purposes, the Tincture for cardiac action ; but to obtain 
the action of the plant itself the powdered leaves must be used in pill or 
capsule. To obtain the best action of the Tincture on the heart, it 
should be administered without admixture, or at least, with water alone, 
the latter being added immediately before ingestion and any precipitate 
being also swallowed. 

Physiological Action. 

Digitalis is a cardiac tonic, a vascular stimulant, and an excito-motor, 
also emetic, diuretic, hemostatic,, anaphrodisiac, and paralyzant. In 
over-doses it irritates the mucous membranes, causing sneezing, severe 
gastric disturbances, nausea, vomiting, colic and purging, the discharges 
being of a grass-green color. It lowers temperature, probably by lessen- 
ing the blood-supply to the tissues, produces headache, irregularity of the 
heart's action, vertigo and an appearance of vibratory fringes of color 
around objects. 

The Heart is slowed by Digitalis, but its force is at the same time 
increased. The drug stimulates the cardiac muscle and its inhibitory 
apparatus ; also the vaso-motor centres, contracting the arterioles, and 
thereby greatly raising the arterial tension. Full doses continued exhaust 
the irritability of the motor ganglia and paralyze the cardiac muscle itself.. 
The recumbent posture must be maintained when Digitalis is given for its 
full cardiac effects. Its final effect on striped muscular tissue is to lessen 
the contractile power, causing great weakness and languor. Under it, 
the excretion of urea is at first increased, but soon decidedly diminished. 
It lessens the sexual appetite and impairs the venereal function. 

It has been conclusively shown that in many cases of pneumonia 
Digitalis failed to influence the pulse, the result probably of the partial 
paralyzant influence of high body temperature upon the vagus centre and 
endings in the heart, thus weakening the inhibitory apparatus to such a 
degree that the drug awakens no responsive increase of inhibition. In 
cases with but moderately high pyrexia the characteristic action of the 
drug is not interfered with. . 

The Diuretic Action of Digitalis is due to its peculiar influence upon 
the general and renal circulation, it increasing the force of the ventricular 
contractions, while at the same time one of its constituents, Digitalin, 
contracts the blood-vessels of the body, and two others, Digitoxin and 
Digitalein, dilate the renal arteries. The effect of this combined action is 
to greatly raise the arterial tension and the blood-pressure in the glomeruli, 
their afferent vessels being contracted ; — while the rapidity of the renal 



222 DIGITALIS. 

circulation is increased and its volume augmented by the greater force of 
the heart-beat and the dilatation of the afferent vessels. No other drug 
known has this double power, and therefore, so far as vascular action is 
concerned, Digitalis is the ideal diuretic. Still, while its power to pro- 
duce diuresis in cardiac disease is unquestioned, most observers deny that 
it has any such power in health. 

Lethal doses lessen the reflexes by stimulation of Setschenow's centre, 
and paralyze the muscles and the peripheral nerves, motor and sensory. 
Respiration, at first slowed, becomes rapid and feeble; cyanosis, coma 
and convulsions follow, and death by sudden paralysis of the heart, 
which is arrested in systole. 

Compared with Aconite, both it and Digitalis slow the heart, but 
otherwise their actions are antagonistic. Aconite at first stimulates and 
soon relaxes inhibition and depresses the cardiac motor ganglia, — Digi- 
talis increases inhibition and stimulates the cardiac muscle. Both drugs 
finally paralyze the heart, Aconite by direct depression of its motor 
ganglia, Digitalis by over-stimulation of the cardiac muscle. Under 
Aconite the heart is arrested in diastole, under Digitalis in systole. The 
arterial tension is lowered by Aconite, raised by Digitalis. Aconite acts 
quickly, Digitalis very slowly, — a fact which makes the latter drug of 
little value in poisoning by the former. 

During the use of this drug for any length of time the muscle of the 
heart is so nearly paralyzed by over-stimulation that on suddenly assum- 
ing the erect position the cardiac energy may fail, more especially if the 
doses are administered too closely together to admit of the elimination 
of one before the ingestion of the next. This is the explanation of the 
so-called cumulative action of Digitalis, which is not now generally 
recognized in the sense in which the term was formerly applied. Another 
explanation is that it may stop its own excretion, by arresting the renal 
circulation and the secretion of urine through extreme contraction of the 
renal vessels, and thus may really accumulate in the blood. 

Antidotes, Antagonists and Inco?)ipaiibles. 

Tannic Acid is the chemical antidote, but as the tannate is not inert the stomach 
should be evacuated. Aconite is the best antagonist to the effects of large doses, Opium 
to those of its long continued use. Saponin and Senegin are considered to be its most 
complete physiological antagonists, lncompatibles are Cinchona, Iron Sulphate, Tinc- 
ture of Ferric Chloride, and Lead Acetate, also syrupy and watery solutions which may 
decompose the active principles of the plant. 

Therapeutics. 

The employment of Digitalis in disease is chiefly based on its action as 

a cardiac tonic and a diuretic. The forms of heart disease in which it is 

indicated are the affections of the two auriculo-ventricular orifices, i. e., 

mitral and tricuspid disease, whether regurgitant or obstructive in char- 



DIGITALIS. 223 

acter. It is contra-indicated in aortic disease, except for special symp- 
toms, and in fatty degeneration of the cardiac muscle. Its greatest sphere 
of usefulness is Mitral Regurgitation, especially when accompanied by 
venous engorgement and oedema of the lungs, the right heart, the liver, 
kidneys and subcutaneous tissues. In such cases its action is shown to 
striking advantage, ameliorating all the symptoms by assisting the flow of 
blood in the veins. By prolonging the diastole, it gives time for the 
dilated auricle to empty itself through the incompetent orifice; and by 
strengthening the contraction of the left ventricle, it causes the better 
approximation of the mitral flaps, consequently less regurgitation, less 
venous engorgement, and the propulsion of more blood into the arterial 
system. If it also acts as a diuretic, as it usually does in these cases, the 
diuresis will tend to remove the oedema ; and the general improvement 
in the circulation produced by it will relieve the cardiac pain and dis- 
tress, the dyspnoea and cyanosis. The less a case of mitral regurgitation 
approaches the cedematous type, the less good will Digitalis do, as a 
rule. 

In Mitral Constriction Digitalis is usually of great assistance, the 
lengthened diastole giving more time for the blood to pass through the 
narrowed orifice, and the increased force of the auricular contraction 
helping in the same direction. 

In Tricuspid Regurgitatio7i or Constriction, Digitalis is beneficial in the 
same manner as in disease of the mitral valve. It is particularly useful in 
dilatation of the right side of the heart with incompetence of the 
tricuspid. The rational symptoms which indicate its use are — rapid and 
feeble cardiac action, low arterial tension, cough, dyspnoea, pulsating 
jugulars, a dusky face, scanty and high-colored urine and general dropsy. 

In Aortic Regurgitation, Digitalis is generally injurious; the prolonged 
diastole giving more time for the blood to regurgitate through the im- 
perfectly closed orifice, and thus increasing the danger of fatal syncope. 
It may do good, if compensatory hypertrophy has not set in, if the heart 
is feeble and its action rapid, or when there is but little blood regurgitat- 
ing, or when there are reasons, such as the coincident presence of aortic 
obstruction, for wishing to strengthen and regulate the contraction. In 
any case, the dose must be a small one, and its effects must be carefully 
watched. 

In Aortic Constriction, Digitalis is generally contra-indicated, especially 
when, as is usually the case, this lesion is accompanied by aortic regurgi- 
tation. It may be of service, however, when the force of the heart-beat 
requires strengthening; or when, as a result of the obstruction, mitral 
dilatation has set in, with much regurgitation, and the consequent venous 
and pulmonary engorgement. It should not be used in aortic stenosis 
with compensatory hypertrophy, in simple hypertrophy when compen- 



224 DIGITALIS. 

sated, in pericarditis or in fatty degeneration of the heart, except tem- 
porarily for some special indication. 

In the irritable heart of soldiers Digitalis is often curative, and palpita- 
tion, cardiac failure and venous engorgement are well treated by it. In 
exophthalmic goitre it has apparently benefited some cases, when used 
over a long course of treatment ; but, as a rule, this affection is not 
amenable to its influence. 

When the cardiac action of Digitalis is desired, the tincture should be 
employed, given on sugar or bread, prohibiting the ingestion of any 
aqueous fluid within 20 minutes either before or after swallowing it. If 
the diuretic action is required, the proper preparation is the infusion, 
which contains a much larger proportion of Digitonin than of the other 
principles. This agent, acting upon the renal apparatus and antagoniz- 
ing the action of the other three, is freely soluble in water, but sparingly 
so in alcohol. On the other hand, Digitalin, to which the cardiac action 
of the drug is chiefly due, is almost insoluble in water, but readily solu- 
ble in alcohol ; and Digitoxin, the most active constituent, is insoluble 
in water, though somewhat soluble in alcohol. 

In Bright 's Disease. Digitalis is not a suitable diuretic. It has been 
used in the early stage of the acute form, but it is very questionable practice 
to dilate the vessels of any acutely inflamed organ. Moreover, in such 
cases the arterial tension is always somewhat raised, and this drug only 
aggravates that condition. In chronic Bright's disease it is still more 
injurious, for the same reason, the arterial tension being very high therein. 
It may be of service, however, in cases of renal cirrhosis, when the car- 
diac hypertrophy has failed to overcome the peripheral resistance, and 
consequently there is dilatation of the left ventricle and the left auriculo- 
ventricular orifice, with the resulting mitral regurgitation. In such cases, 
a diuretic pill is frequently of service, consisting of Digitalis leaves in 
powder, Calomel and Squill, a grain of each, made into pill with extract 
of Hyoscyamus. 

Digitalis is always an uncertain diuretic unless the heart is diseased ; 
yet it has rendered good service in renal dropsy as well as in the cardiac 
form. Its contractile power over the arteries may so predominate as to 
arrest the renal circulation completely, and stop the secretion of urine 
(Brunton.) On this account it is well to administer at the same time an 
agent which causes dilatation of the renal vessels, as Sodium Nitrite. It has 
been employed with benefit in the early stage of scarlet fever, and when 
the kidneys strike work in that disease. As a hemostatic it may be used 
in hemorrhage from a large surface, in the hemorrhagic diathesis, hemop- 
tysis, and menorrhagia. As an antipyretic it has been much used in 
fevers, in the first stage of pneumonia, and in other inflammations, but a 
reaction is setting in against this employment of so powerful a heart- 



DIOSCOREA — DITA DROSERA— DUBOISIA. 22$ 

depressant. In rheumatic fever it lowers the temperature, shortens the 
duration of the disease, and is particularly indicated for any cardiac 
complications. It was formerly much used in delirium tremens, in con- 
gestive headaches, acute mania and other congestive conditions of the 
brain, but generally without much benefit. In spermatorrhoea of the 
plethoric it may be well combined with Potassium Bromide, and when 
this affection is complicated with an atonic condition, shown by feeble 
erections, frequent emissions and cold feet and hands, it is a serviceable 
anaphrodisiac. Finally, Digitalis is said by high authority to be particu- 
larly adapted to blondes and persons of sanguine and indolent tempera- 
ment. Sometimes the vomiting caused by it is so severe as to prevent 
its use. 



DIOSCOREA, Wild Yam, Colic-root (Unofficial), — is the rhizome of Dioscorea 
villosa, a creeping plant of the nat. ord. Dioscoraceae, indigenous to the eastern U. S. 
It contains an acrid resin, and is reported to be expectorant and diaphoretic in action, as 
well as stimulating to the intestinal canal, and in large doses to cause general neuralgic 
pains with erotic excitement. It is used with great success in bilious colic; and in the 
cramps cf cholera morbus, spasmodic hiccough, dysmenorrhcea and nocturnal emissions 
of sthenic type it is said to be very efficient. A powdered extract named Dioscorein is on 
the market, of which the dose is gr. j-iv. A fluid extract made according to the pharma- 
copceial rule may be administered in doses of TTl, xv— xxx. 



DITA BARK (Unofficial), — is the bark of Alstonia scholaris, a tree of the nat. ord. 
Apocynaceae, growing in the Philippine Islands. It contains two active alkaloids, 
Ditaine and Ditamine, the former of which has an action identical with that of Curare. 
The bark is considered tonic and antiperiodic, and is used in the East as a remedy for 
intermittents. It may be given in doses of ^j-iv, in powder or as fluid extract. 



DROSERA, Sundew (Unofficial), — A fluid extract of Drosera rotundifolia, the 
round-leaved Sundew, is said to have been successfully used in phthisis pulmonalis. It 
is certainly a most useful agent in whooping-cough and other spasmodic coughs ; especially 
when marked by violent paroxysms, the cough being loud and harsh, and followed by 
bleeding from the nose or mouth, and perhaps by vomiting of the contents of the 
stomach. The expressed juice has been applied to warts and corns, for the purpose of 
curing them. Dose df the fluid extract, TT^v-xx. 



DUBOISIA (Unofficial), — is the leaf of Duboisia myoporoides, an Australian tree of 
the order Solanacese. It contains a poisonous alkaloid, Duboisine, which is believed to 
be identical with Hyoscyamine, and strongly resembles Atropine. 

Preparations. 
Extractum Duboisise, Extract of Duboisia (Unofficial), — Dose, gr. Ye-%- 
Tinctura Duboisiae, Tincture of Duboisia (Unofficial), — Dose, TT^v-xx. 
Duboisinse Sulphas, Duboisine Sulphate (Langenberg's), Unofficial, — Dose, gr. 



Physiological Action and Therapeutics. 

The actions of Duboisia are in all respects similar to those of its congener, Belladonna, 
except that Duboisine is more soluble in water than Atropine, is less irritating to mucous 
membranes, and more prompt in mydriatic action, but its effects are of shorter duration. 

15 



226 DULCAMARA. 

It is also less of a cerebral excitant and more of a calmative and hypnotic. On man its 
action is said by some authorities to be more powerful than that of Atropine, but less 
powerful on frogs. 

Duboisine has not been much used except by ophthalmologists, who employ it as a mild 
mydriatic. Its advantages over Atropine in ocular therapeutics are its more rapid action 
in paralyzing accommodation and effecting mydriasis, the shorter duration of its effects 
and its slight irritation of the conjunctiva. It has been well employed in puerperal 
mania, and may be used in place of Atropine in many conditions, especially the night- 
sweats of phthisis, respiratory neuroses and cardiac failure. It is an efficient antagonist 
to Morphine. Its antagonists and incompatibles are the same as for Belladonna, which 
see, ante, page 143. 



DULCAMARA, Bittersweet, — the young branches of Solatium 
Dulcamara, or Woody Night-shade, a shrub of the nat. ord. Solanacese, 
growing in Europe and N. America. Occurs in short sections % inch 
thick, covered with a pale green bark, of slight odor, and taste at first 
bitter, afterwards sweet. It contains the glucoside Dulcamarin, a peculiar 
principle named Picroglycion, and the alkaloid Solanine, which exists in 
the steins of other species of Solan um, viz.- — S. tuberosum (potato), S. 
Lycopersicum (tomato), and S. nigrum (black nightshade). Solanine is 
of bitter taste, alkaline reaction, crystalline in minute prisms soluble in 
125 of boiling alcohol but very insoluble in water. It is a narcotic 
poison, but exists in very small quantity in the plant. 

Preparations. 

Extractum Dulcamarse Fluidum, Fluid Extract of Dulcamara, — Dose, 3). 
Decoctum Dulcamarse, Decoction of Dtilcamara (Unofficial), — may be made of 
10 per cent, strength and given in doses of ^j-ij. 

Physiological Action and Therapeutics. 

Dulcamara is but imperfectly understood. In overdoses it has pro- 
duced nausea and vomiting, vertigo, convulsive muscular movements, 
pruritus and erythematous eruptions on the skin, languid circulation with 
a dusky color of the face and hands. In children who have eaten the 
berries there have been observed signs of severe enteValgia, abdominal 
tenderness, nausea, thirst, heat in the throat and chest, great prostration, 
rapid pulse, quick and painful respiration. In very large doses it is a 
narcotic poison, causing paralysis by depression of the central nervous 
system, with lowered activity of the heart and respiration. It is believed 
by some authorities to be anaphrodisiac, diaphoretic and diuretic. 

Dulcamara was formerly used in a variety of affections, as herpetic 
diseases, chronic rheumatism, gout, jaundice, etc. It is now chiefly 
employed in obstinate scaly skin diseases, as psoriasis and pityriasis, in 
which it is unquestionably serviceable. It is also serviceable in the 
diarrhoea of children when produced by exposure to cold and damp, in 
mania with strong venereal propensities, chronic bronchitis and whoop- 
ing-cough. As a diaphoretic it has been used with benefit in rheumatic 



ELASTICA ELATERINUM. 227 

and venereal disorders, and is often beneficial in nasal, pulmonary and 
vesical catarrhs. It is said to be particularly useful in affections of a 
rheumatic or catarrhal nature when caused by exposure to damp weather. 



ELASTICA, India-rubber (Caoutchouc), — is the prepared milk- 
juice of various species of Hevea (nat. ord. Euphorbiaceae), growing in 
S. America, and being known in commerce as Para Rubber. It is very 
elastic, insoluble in water, diluted acids, or diluted solutions of alkalies, 
soluble in chloroform, carbon disulphide, oil of turpentine, benzin and 
benzol. When pure, or nearly pure, it floats on water. 

India-rubber is a carbohydrogen, and may be combined with sulphur 
by the aid of heat (vulcanized), which process, long continued, converts 
it into hard rubber. It is used in the fabrication of catheters, bougies, 
pessaries, court plaster, bandages, elastic stockings, tubing, etc. An 
analogous substance is Gutta-percha, which was official in the U. S. 
Phar., 1880. 

Gutta-percha (Unofficial), — is the concrete exudation of Isonandra gutta, a large 
tree of the nat. ord. Sapotaceae, growing in the Malay peninsula and adjoining islands. 
Occurs in tough but somewhat flexible pieces, of grayish or yellowish color, plastic 
above 140 F., soft at 212 F., insoluble in water or alochol, soluble in chloroform, 
oil of turpentine, carbon disulphide, benzin and benzol. It contains a hydrocarbon, 
Gutta, C 10 H 16 (80 per cent.), two Resins named Fluavil and Albau, also a volatile oil, 
salts, fat and coloring matter. 

Preparations. 

Liquor Gutta-perchae, Solution of Guttapercha (Unofficial), — Gutta-percha 9, Car- 
bonate of Lead 10, in Chloroform 91. Used as a protective application to eruptions and 
slight wounds, the evaporation of the menstruum leaving behind a thin adhesive and non- 
irritating pellicle. 

Traumaticin (Unofficial), — is the name given to a 10 per cent, solution of Gutta- 
percha in Chloroform, which forms on drying a permanent, unirritating, adhesive, flexible 
and non-contractile skin for the treatment of skin affections and slight wounds. It forms 
an excellent basis for the application of Chrysarobin to psoriasis. 

Gutta-percha has neither physiological action nor therapeutics, being used for its 
physical qualities alone. In surgical practice it has several applications, making a good 
material for splints, as it can be softened in hot water and adapted to any surface while 
pliable. From it are manufactured pessaries, specula, stethoscopes and other instruments. 
The solution may be used as a protective covering for excoriations and slight wounds, to 
prevent pitting in small-pox, and to paint over the line of suture after post-mortem 
examinations. 



ELATERINUM, Elaterin, C 20 H 28 O 5 ,— is a neutral principle ex- 
tracted from Elaterium, a substance deposited by the juice of the fruit of 
Ecballium Elaterium, or Squirting Cucumber, a cultivated European 
plant of the nat. ord. Cucurbitacese. Elaterium is no longer official 
by reason of its variable quality. Elaterin occurs in small, colorless 
scales or prisms, of bitter taste and neutral reaction, insoluble in water, 



228 ERGOTA. 

soluble in 337 of alcohol and in solutions of the alkalies. Dose, gr. 

Preparation. 

Trituratio Elaterini, Trituration of Elaterin, — Elaterin 10, Sugar of Milk 90, 
thoroughly mixed by trituration. Dose, gr. ss-j. 

Physiological Action and Therapeutics. 

Elaterin is the most powerful of the hydragogue cathartics, causing 
profuse, watery stools, and when given in large doses great prostration 
and gastro-intestinal irritation, nausea and vomiting. On the lower ani- 
mals it does not produce purgation, but profoundly impresses the nervous 
system, causing irregular breathing, convulsions and death. 

Its chief use is to produce free watery discharges in ascites, anasarca, 
uraemia and cerebral disorders, but while the most efficient agent we 
possess for this purpose it must be used with great caution in the aged and 
feeble, as it is very depressant. 



ERGOTA, Ergot, Ergot of Rye, — is the sclerotium (compact 
mycelium or spawn, intermediate fibrous stage) of Claviceps purpurea 
(class Fungi), growing within the flower and replacing the grain of Rye, 
Secale cereale, (nat. ord. Gramineae). It occurs in fusiform, curved, 
grain-like bodies, about an inch long, three-furrowed, obtuse at the ends, 
of purplish-black color, peculiar and heavy odor, and oily, disagreeable 
taste. It should be only moderately dried, and should be preserved in a 
close vessel, and have a few drops of chloroform dropped upon it from 
time to time, to prevent the development of insects. When more than 
one year old it is unfit for use. Dose, gr. x-^j. 

Composition of Ergot. 
The composition of Ergot and the nomenclature of its supposed con- 
stituents is a subject upon which there exists a great diversity of opinion, 
and about which there is nothing settled. The following synopsis gives 
the views of the different persons who have examined into the matter. 

Wenzell (1864) named two alkaloids, Ecboline and Ergotine, which he claimed to 
be the active principles, and to be combined with Ergolic Acid, a volatile body yielding 
crystallizable salts. He also claimed the presence of Trimethylamine as a Phosphate. 

Tanret (1877) isolated a crystallized alkaloid, which he named Ergolinine, C 35 H 40 - 
N 4 6 (dose, gr. •gV'TV)' a ^ so a volatile camphoraceous substance. 

■ Dragendorf and his pupils (1875-1879) stated the active principles to be two in 
number, Sclerotic or Sclerotinic Acid, a very powerful body, yellow-brown, amorphous, 
tasteless and well adapted for hypodermic use in doses of gr. sV"tV> anc ^ Scleromucin, a 
colloid substance, also quite active. Besides these they held that Ergot contained various 
coloring matters (Sclererythrin, Scleroxanthin, etc.), also a non-drying Oil, a peculiar 
sugar (MykOse), a number of alkaloids (Trimethylamine, etc.), and other principles, all 
inert. 



ERGOTA. 229 

Kobert (1885) announces that Ergot contains three active principles, viz., (1) Ergo- 
tinic Acid, a glucoside, and the chief constituent of Sclerotinic Acid; having no ecbolic 
action, but affecting the nervous system, the heart and the respiration; — (2) Sphacelinic 
Acid, non-nitrogenous, unstable, soluble in alcohol, insoluble in water, stimulates the 
vaso-motor centre, and is believed to be the active agent in contracting the blood-vessels, 
and producing gangrenous ergotism ; — (3) Cornutine, an alkaloid, believed to be the 
agent which contracts the uterus. It produces convulsions and peristaltic contractions 
of the uterus, and is the active agent in convulsive ergotism. 

Tanret's Ergotinine has been proven to have no action on the uterus. 
The Ergotin of Bonjean, Wiggers and Tanret is not a fixed compound, 
but a mixture. The Ecboline of Wiggers is also a mixture. Sclerotinic 
Acid is said by many authorities to act on the uterus, but this is positively 
denied by many others. It is probably a very uncertain preparation, and 
is said to be really a mixture of Sphacelinic acid and Cornutine. For 
the Ergotin of commerce see below. Ergot also contains Trymethylamine^ 
to which its odor is due, a fixed oil, (30 per cent.) and tannin. 

Preparations. 

Extractum Ergotae Fluidum, Fluid Extract of Ergot, — prepared with Acetic Acid 
and Diluted Alcohol. Dose, ^ss-ij. 

Extractum Ergotae, Extract of Ergot, commonly called Ergotin, — is prepared by 
evaporating the fluid extract at a temperature not above 122° F., until reduced to a pilu- 
lar consistence. Dose, gr. ij-xx. 

Vinum Ergotae, Wine of Ergot, — strength 15 per cent. Dose, J5J-^j. Is made by 
an improved method and is more reliable than that formerly official. 

Ergotin (Unofficial), is the name of several watery extracts found on the market, and 
varying much in action both from each other and from the parent drug. That made by 
Squibb has about the same strength as the official extract, and represents the general 
powers of Ergot. It may be used hypodermically in doses of gr. %-gv. v. The Ergotin 
of Bonjean is also an aqueous extract, but is very variable in quality and frequently inert. 
Wiggers' Ergotin is ins'oluble in the ordinary menstrua, and inert on the vascular appa- 
ratus, but causes colic and gastro-enteritis. 

Physiological Action. 

Ergot is an excito-motor and a hemostatic, chiefly affecting the spinal 
cord, circulation, respiration, intestinal and uterine muscular fibres. Its 
principal action is the production of an* artificial anaemia, and tetanic 
contraction of unstriped muscular fibre. Its phenomena are divided into 
two sets, named respectively Acute and Chronic Ergotism, according as 
the drug is administered in large doses, or in small quantity for a consid- 
erable length of time. 

Acute Ergotism. In large doses Ergot acts as a gastro-intestinal irri- 
tant, causing nausea and vomiting, gastralgia, colic, thirst, difficult 
micturition and purging. It slows the heart, raises the arterial tension 
greatly, dilates the pupils and produces pallor, vertigo and frontal head- 
ache. Its action on the circulation is due to its inducing arterial anaemia, 
but whether this is done by contraction of the arterioles through direct 
action on their muscular fibres or by central stimulation of the vaso- 
motor system, or by producing active venous dilatation, thus draining 



23O ERGOTA. 

the arterial system, is a much disputed question. It certainly stimulates 
the contraction of unstriped muscular fibre, especially affecting the 
sphincters and the uterus, causing continuous labor pains and tonic con- 
traction of the sphincter vesicae, making micturition difficult if not im- 
possible. It also produces cerebral and spinal anaemia, coldness of the 
surface, tetanic spasms and violent convulsions, but very large doses 
(several ounces) are necessary to such results. As much as giij of the 
fluid extract has been given daily for a week or more, without producing 
any marked effect. 

Chronic Ergotism occurs in two forms, the Convulsive, and the Gan- 
grenous, — either usually excluding the other. The convulsions are 
tetanoid spasms of the flexor muscles, the uterus, the intestinal fibres, 
and the muscles of respiration, ending in coma and death by asphyxia. 
The gangrenous form begins with coldness and numbness of the limbs, 
formication of the skin all over the body, loss of sensibility and abolish- 
ment of the special senses, bullae of blood and ichor, followed by dry or 
moist gangrene of the lower extremities, buttocks and other parts, epi- 
leptiform convulsions, coma and death. Autopsies show changes in the 
posterior columns of the cord, resulting probably from the spinal 
anaemia. 

Experiments with the various derivatives of Ergot show that no one 
of its constituents represents the power of the drug itself. Those which 
probably come nearest to it in action are the Ergotinine of Tanret and 
Sclerotinic Acid. 

Analogues of Ergot are Ustilago (see under Zea), Gossypii Radicis 
Cortex (Cotton-root Bark), and Caulophyllum (Blue Cohosh). They are 
each described under their respective titles. 

Antagonists and Incompatibles. 

Amyl Nitrite, Aconite, Veratrum Viride, Tobacco and Lobelia antagonize its action 
on the circulation. Caustic alkalies and metallic salts are chemically incompatible. 

Therapeutics. 
Ergot has a wide field of application. Its most familiar use is to pro- 
mote uterine contraction in labor, but as the contractions produced by 
it are continuous instead of the natural intermittent ones, it is highly 
dangerous when there is any obstacle in front of the child, the probable 
results being rupture of the uterus, paralysis of the fcetal heart, and severe 
laceration of the perineum. At the end of the second stage, when the 
head is born, is the best time for its use (if employed in labor at all), in 
order to promote firm uterine contraction, thereby guarding against 
post-partum hemorrhage, and promoting the expulsion of the placenta. 
The tendency, however, of obstetrical teaching, is against its employ- 
ment at all in labor; while, in practice, the teaspoonful of Ergot is 



ERIGERON ERIODICTYON. 23 1 

almost invariably administered as soon as possible after the child is born. 
In many uterine affections, as chronic metritis, subinvolution, congestive 
dysmenorrhea, menorrhagia, fibroids and polypi, Ergot is well employed, 
producing firm contraction of the womb and promoting absorption of 
inflammatory products. It is extremely useful in amenorrhoea due to 
plethora, and in the atonic form of spermatorrhoea. In conjunctivitis, 
gonorrhoea, and inflammations of mucous membranes generally, it is of 
striking benefit, if used both locally and internally. It is also an excel- 
lent remedy in acute and chronic dysentery, chronic diarrhoea, atonic 
hemorrhages of arterial type, mania due to cerebral hyperaemia, head- 
ache and migraine of congestive form, myelitis, spinal congestion, 
cerebro-spinal meningitis, splenic enlargement, lax sphincters of the 
rectum and bladder, and in incontinence of urine from paralysis of the 
sphincter vesicae. Hemorrhoids are well treated by its local application, 
but here it should not be used internally as it promotes venous conges- 
tion. In aneurism it aids coagulation by slowing the blood- current, and 
in cardiac hypertrophy without valvular lesion it acts well by slowing the 
heart. In diabetes insipidus full doses of Ergot are often curative, and 
it has been used with benefit in diabetes mellitus. 

Hypodermically, the aqueous extract dissolved in water and free from 
alcohol or any other irritating substance, is in many cases much more 
prompt in action than when given per orem, especially if injected near 
to the seat of the affection. This is particularly true in postpartum and 
other hemorrhages, prolapse of the rectum, chronic metritis and subin- 
volution of the womb, uterine fibroids, varicocele and varicose veins. 
When so administered it will frequently so contract the sphincter of the 
bladder as to produce retention of urine, and require the use of the 
catheter. 



ERIGERON, Fleabane (Unofficial), — is the flowering plant Erigeron canadense, a 
weed of the nat. ord. Composite, growing in N. America. It contains a Volatile Oil, 
which is official, also tannic acid and a bitter extractive. 

Oleum Erigerontis, Oil of Fleabane, — a pale yellow liquid, of sp. gr. about 0.850, 
becoming darker by age and exposure to air, of peculiar and persistent odor, pungent 
taste and neutral reaction, readily soluble in alcohol. Dose, m^x-i^ss. 

Oil of Erigeron has the same action as Oil of Turpentine but is less irritant and less 
efficient. It has considerable reputation as a hemostatic, especially in menorrhagia and 
intestinal hemorrhage of passive form, as in typhoid fever. It is also used with benefit 
in diarrhoea and dysentery, and in hemoptysis without fever or other evidence of irritation 
it is a very valuable remedy. 



ERIODICTYON, — the leaves of Eriodictyon glutinosum, Yerba Santa, a Californian 
shrub of the nat. ord. Hydrophyllacese. They are from 2 to 4 inches long, shining green 
as if varnished on the upper surface, white and hairy beneath, of fragrant odor, aromatic 
taste, and contain an acrid Resin and an aromatic Volatile Oil. 

Extractum Eriodictyi Fluidum, Fluid Extract of Eriodictyon, — Dose tt\xv-3J. 



232 EUCALYPTUS. 

Extractum Eriodictyi, Extract of Eriodictyon (Unofficial), — Dose, gr. ij-x. 

Eriodictyon is expectorant, and covers the taste of Quinine in a remarkable manner, 
for which purpose it is combined in mixture with Glycyrrhizin, under the title " Veld- 
tine" as a proprietary preparation (see ante, page 199). It is used with fair success in 
bronchial and laryngeal affections, also in asthma. Combined in syrup with Grindelia it 
is very efficient for coughs. 



EUCALYPTUS,— the leaves collected from the older parts of the 
tree, of Eucalyptus globulus, or Blue Gum-tree (nat. ord. Myrtaceae), a 
native of Australia, now grown in California, Italy, etc. The leaves are 
6 to 12 inches long, gray-green, lanceolately scythe-shaped, studded with 
oil-glands ; of camphoraceous odor and bitter, aromatic taste. They 
contain tannic acid, a resin, a fatty acid and a Volatile Oil. The latter 
consists of three different oils which distil over at different temperatures, 
the first product being the official substance named Eucalyptol, C 10 H 18 O, 
which by the action of Phosphoric Acid is converted into Eucalyptene, 
a substance allied to Cymene, and Eucalyptolen. 

Preparations. 

Extractum Eucalypti Fluidum, Fluid Extract of Eucalyptus, — is three-fourths 
alcohol. Dose, n\x~3J. 

Oleum Eucalypti, Oil of Eucalyptus, — the volatile oil, is distilled from the fresh 
leaves of various species of Eucalyptus, that from E. amygdalina being considered 
wanting in Eucalyptol. Is soluble, in all proportions, in alcohol, carbon disulphide, or 
glacial acetic acid. Dose, mv-xxx, in emulsion or capsules. 

Eucalyptol, C ]0 H 18 O, — is a neutral body obtained from the volatile oil ; a colorless 
liquid, of aromatic, camphoraceous odor, and pungent, cooling taste ; soluble in all pro- 
portions in alcohol, carbon disulphide and glacial acetic acid. Dose, mjij-x. 

Physiological Action. 

The taste of Eucalyptus is warm, aromatic, bitter and camphoraceous. 
It increases the flow of saliva, the gastric juice and the intestinal secre- 
tions, and in small doses promotes appetite and digestion, increases the 
heart's action and lowers arterial tension. In large doses it produces 
eructations, indigestion, diarrhoea, nausea and vomiting, lowered temper- 
ature, great muscular weakness, and if continued will irritate and congest 
the kidneys, and induce a feverish state with symptoms of cerebral con- 
gestion, and great constitutional disturbance. Toxic doses are fatal by 
paralysis of respiration through direct action on the spinal cord. 

It is powerfully antiseptic, and destructive to low forms of life, a stimu- 
lating expectorant and an efficient diaphoretic. By some authorities it is 
believed to reduce the size of an enlarged spleen, and to possess anti- 
malarial properties by absorbing noxious germs as well as by draining the 
soil of its water, and by its aseptic emanations purifying the atmosphere 
in its vicinity. It is largely cultivated in malarial districts for these 
properties, and is reported to have rendered habitable a portion of the 
deadly Roman Campagna. 



EUONYMUS EUPATORIUM. 233 

Eucalyptus is eliminated by the skin, bronchial mucous membrane 
and the kidneys, imparts its odor to the breath and the urine, and is more 
or less irritant at the points of its elimination. 

Therapeutics. 
Eucalpytus is an efficient stomachic in atonic dyspepsia, chronic gastric 
and intestinal catarrh, and in conditions of the intestinal canal which 
favor the development of worms. In chronic catarrhal conditions of the 
genito-urinary organs, the broncho-pulmonary mucous membrane, and 
especially the bladder, it is very useful, acting as a stimulant and disinfec- 
tant to the mucous membranes. It is equally beneficial in chronic bron- 
chitis and bronchorrhcea, in cachectic states generally, and in convales- 
cence from acute diseases. In epidemic influenza (grippe) the oil has 
been used internally with good results, and sprinkled on blotting-paper 
placed in offices and stores has seemed to act as a prophylactic on persons 
employed therein. In hysteria, chorea and asthma it is beneficial, in the 
latter affection being advantageously smoked in cigarettes with Stramo- 
nium or Belladonna leaves. In malaria as a reconstructant it is better 
than Quinine, and it has considerable utility in obstinate intermittents 
where it is desirable to stop the use of Cinchona preparations. As an 
antiseptic it is highly valuable in dilute solution for application to ulcers, 
and as a substitute for Carbolic Acid on gauze in the antiseptic treatment 
of wounds. It is also used in dilute solution locally, as a stimulating dis- 
infectant in stomatitis, and in the subacute stages of pharyngitis and ton- 
sillitis. An aqueous preparation is highly recommended as a vehicle for 
alkaloids in solution for hypodermic use, to prevent the development of 
the penicillium, which rapidly destroys the alkaloid present. 



EUONYMUS, Wahoo, — is the bark of Euonymtts atropurpureus, a shrub of the 
nat. ord. Celastrineae, growing in the U. S. Occurs in quills or curved pieces, about -^fl- 
inch thick, of ashy-gray color and acrid, sweetish taste. It contains an amorphous, 
bitter principle named Euonymin, also Resins, Euonic Acid, and Asparagin, fixed oil, 
etc. 

Extractum Euonymi, Extract of Euonymus, — Dose, gr. j-v. 

Euonymin (Unofficial), — the eclectic preparation, consists of the fixed oil and resin, 
and is given in doses of gr. ss-v. 

Euonymus is classed with Rhubarb, Jalap, Aloes, etc., as a tonic-astringent and resin- 
bearing purgative. It is said to be also diuretic and expectorant, and a very efficient 
cholagogue. Its cathartic action is similar to that of Rhubarb, but milder. It has been 
employed with benefit in some cases of dropsy, also in habitual constipation, torpid liver, 
and pulmonary affections. In overdoses it will set up considerable gastro-intestinal 
irritation. 



EUPATORIUM, Thorough-wort (Boneset),— the leaves and flowering tops of 
Eupatorium perfoliatum, an American plant of the nat. ord. Compositse, having lanceo- 
late leaves, two united at the base, each 4 to 6 inches long, of weak, aromatic odor and 
bitter, astringent taste. It contains a neutral, bitter principle, named Eupatorin, tannic 
acid, a volatile oil, etc. 



234 EUPHRASIA FEL BOVIS FERRUM. 

Extractum Eupatorii Fluidum, Fluid Extract of Eupatorium, — Dose, n\x-3j. 

Eupatorium is a bitter tonic and efficient diaphoretic, also in full doses emetic and 
aperient. It has been supposed to have antiperiodic and tseniafuge powers. A warm 
infusion (Boneset tea) is a popular diaphoretic in remittent and typhoid fevers, and at the 
onset of an attack of acute catarrh or general cold. As a bitter tonic it may be used with 
advantage in dyspepsia and general debility. Its common name is derived from its sup- 
posed power to relieve ihe bone pains of dengue or the " break-bone fever." 

Another variety of Eupatorium, E. purpureum, or Gravel-root, is reputed to have 
decided power over the uric acid diathesis. 



EUPHRASIA, Eye-bright (Unofficial),— is a small annual plant of the nat. ord. 
Strophulariacere, growing in Europe and the U. S., odorless, of astringent taste, and con- 
taining Euphrastic Acid, tannin, etc. It was formerly of great repute in various eye- 
affections, and may be of utility as a mild astringent in catarrhal conjunctivitis. Its chief 
value, however, is to abort an attack of acute nasal catarrh with lachrymation, for which 
purpose a few drops of the tincture every two hours is remarkably efficient. _ In hay-fever 
also it is of decided utility in mitigating the catarrhal symptoms, and in the acute coryza 
of measles it will be found an excellent remedy. A tincture (i to 9) of the fresh plant 
should be used, and given in doses of rr^ j-v. 



FEL BOVIS, Ox-gall {Eel Tauri)— the fresh gall or bile of Bos Taurus, is a 
dark-green, viscid liquid, of peculiar odor, bitter taste, and neutral or faintly alkaline 
reaction. Sp. gr. 1.018 to 1.028. It contains Sodium Glycocholate, Sodium Tauro- 
cholate, Cholesterin and coloring matter. 

Fel Bovis Purificatum, Purified Ox-gall, — 3 of Ox-gall and 1 of Alcohol evapor- 
ated to pilular consistence, after standing 24 hours, decanting, filtering, etc. Dose, gr. 
v-xv. 

Bile is tonic, antiseptic and purgative. It assists in the emulsification of fats, and 
stimulates the absorbent powers of the mucous membrane. In the stomach it neutralizes 
the gastric juice, precipitating the pepsin, and is apt to cause nausea and vomiting. 
Recently it is found to act well in stimulating the resolution of hypertrophies when locally 
applied to the part, as the mammae, tonsils, pannus, etc. It is used as a laxative in con- 
stipation when the natural secretion of bile is deficient, but has no advantage over other 
purgatives. 



FERRUM, Iron, Fe, — is metallic Iron in the form of fine, bright, 
and non-elastic wire. 

Ferrum Reductum, Reduced Iron, — consists of metallic Iron in fine 
powder, obtained by reducing the Sesquioxide by hydrogen at a dull red 
heat. It is a very fine, gray-black, lustreless powder, odorless, tasteless, 
and insoluble in water and alcohol, but soluble in dilute sulphuric acid 
with the evolution of nearly odorless hydrogen gas. Dose, gr. j-v, aft 
meals. 

Salts of Iron and their Preparations. 

Liquor Ferri Acetatis, Solution of Ferric Acetate, — is an aqueous solution, containing 
about 31 per cent, of the anhydrous salt, and corresponding to about 7^ per cent, of 
metallic iron. A dark, red brown, transparent liquid of acetous odor, sweetish and faintly 
styptic taste, reaction slightly acid. Dose, TT^ij-x. Used chiefly for pharmaceutical pur- 
poses. 

Ferri Carbonas Saccharatus, Saccharated Ferrous Carbonate, — has at least 15 per 
cent, of ferrous carbonate. A greenish-gray powder, of sweetish taste at first, changing 
to ferruginous. Partially soluble in water, but soluble in dilute hydrochloric acid with 



FERRUM. 



235 



evolution of C0 2 . Action, — slightly stimulant to digestive tract. Dose, gr. ij-x with 
food. 

Massa Ferri Carbonatis, Mass of Ferrous Carbonate, Vallels Mass, — Ferrous Sul- 
phate 100, Sodium Carbonate 100, Honey 38, Sugar 25, Syrup and Distilled Water each, 
to make 100. Prepared by solution, precipitation and evaporation. Has 42 per cent, of 
Ferrous Carbonate. An astringent, non-irritant, ferruginous tonic. Dose, gr. j-v, after 
food. 

Pilulae Ferri Carbonatis, Pills of Carbonate of Iron, Ferruginotis Pills, Chalybeate 
Pills, Bland's Pills, — made by mixing Ferrous Sulphate, about 2 x / 2 grains for each pill, 
with Potassium Carbonate, Sugar, Tragacanth, Althaea, Glycerin and Water. Dose, j-ij 
pills, after food. 

Mistura Ferri Composita, Compound Iron Mixture, Griffith 1 s Mixture, — has ot 
Ferrous Sulphate 6, Myrrh 18, Sugar 18, Potassium Carbonate 8, Spirit of Lavender 60, 
Rosewater to 1000. Is really a solution of the Carbonate formed by reaction between the 
two principle constituents. Is an excellent chalybeate, but disagreeable to the taste. 
Dose, gij-iv. 

Ferri Chloridum, Ferric Chloride, Per chloride of Iron, Fe 2 Cl B -(-i2H v O, — orange- 
yellow, deliquescent, crystalline pieces, of styptic taste and acid reaction, freely soluble in 
water, alcohol or ether. Action, — strongly astringent, hemostatic. Never used in- 
ternally. 

Liquor Ferri Chloridi, Solution of Ferric Chloride, — an aqueous solution of the 
preceding, containing 37.8 per cent, of the anh\drous salt, with some free HC1 acid. 
Action, — strongly astringent and styptic. Rarely used internally. Dose, Tt^ij-x, well 
diluted. 

Tinctura Ferri Chloridi, Tincture of Ferric Chloride, — a hydro-alcoholic solution of 
Ferric Chloride, containing about 13.6 per cent, of the anhydrous salt, conesponding to 
about 4.7 per cent, of metallic iron. Has of the preceding solution 25 in Alcohol to 
make loo. A bright, brownish liquid, of ethereal odor, styptic taste and acid reaction. 
Is used in Mistura Ferri et Ammonii Acetatis. One of the best preparations of Iron. 
Action, — ferruginous tonic. Dose, TT^v-xx, in water, syrup or glycerin. 

Ferri Citras, Ferric Citrate, Fe. 2 (C 6 H 5 7 ^ 2 +6H 2 0, — garnet-red, transparent scales, 
slowly soluble in water, not in alcohol. Action, — mildly stimulant. Dose, gr. ij-v. 
Formed by evaporating the following : — 

Liquor Ferri Citratis, Solution of Ferric Citrate, — an aqueous solution, containing 
about 35 ]/ z per cent, of the anhydrous salt, corresponding to about 1 l / 2 per cent, of 
metallic iron. Solution of Ferric Sulphate 105, Citric Acid 30, Ammonia Water 88, 
Water to 100. A dark-brown liquid, of slightly ferruginous taste and acid reaction. 
Dose, tt\v-xv. 

Vinum Ferri Citratis, Wine of Ferric Citrate, — made from Iron and Ammonium 
Citrate 4, Tincture of Sweet Orange Peel 15, Syrup 10, White Wine to 100. An Elixir 
of Iron. Dose, 3 j-ij. 

Ferri Hypophosphis, Ferric Hypophosphite, Fe 2 (H 2 P0 2 ) 6 , — a white or grayish-white 
powder, odorless, tasteless, slightly soluble in water, freely so in HC1 acid or in a solu- 
tion of sodium citrate. Action, ferruginous tonic. Dose, gr. v-x. 

Ferri Iodidum Saccharatum, Sacchamted Ferrous Iodide, — a yellowish-white 
powder, very hygroscopic, odorless, of sweetish, ferruginous taste, and slightly acid reac- 
tion, soluble in 7 of water, insoluble in alcohol. Action, — ferruginous tonic. Dose, gr. 
v— xxv in pill or elixir. 

Pilulae Ferri Iodidi, Pills of Ferrous Iodide, — made with Reduced Iron, Iodine, 
Licorice, Sugar. Acacia and Water, covered with a coating of Balsam of Tolu in Ether. 
" Blancard's Pills" only differ from these by being covered with a coating of reduced 
iron to protect the interior from oxidation, but it also protects them from the solvent 
action of the gastric juice. Dose, 1 or 2 pills ter in die. 

Syrupus Ferri Iodidi, Syrup of F&rrous Iodide, — is a syrupy liquid containing 10 
per cent, of ferrous iodide. A transparent, pale green liquid, of sweet, ferruginous taste 
and neutral reaction. Action, — ferruginous tonic. Dose, rr\,v-xxx. 

Ferri Lactas, Ferrous Lactate, Fe(C 3 H 5 3 > ) 2 -|-3F[ 2 0, — pale, greenish -white, crystal- 
line grains, soluble in 40 of water, freely in solution of an alkali citrate, yielding a green 
solution, almost insoluble in alcohol. Action that of a feeble ferruginous tonic. Is a 
constituent of Syrupus Hypophosphitum cum Ferro. Dose, gr. j— iij, in pill or syrup. 

Liquor Ferri Nitratis, Solution of Ferric A r itrate, — an aqueous solution of Fe 2 - 
(N0 3 ) 6 , containing about 6.2 per cent, of the anhydrous salt, corresponding to about 1.4 
per cent, of metallic iron. A transparent, amber-colored liquid, of acid, styptic taste and 



236 FERRUM. 

acid reaction. Action, — medium as to irritation, astringent and hemostatic. Dose, 
n\v-xv, well diluted. 

Ferri Oxidum Hydratum, Ferric Hydrate, Ferric Hydroxide, Hydrated Oxide of 
Iron, Fe 2 (OH) 6 , — a brown-red magma, wholly soluble in HC1 without effervescence. 
Should be freshly prepared by mixing together Solution of Ferric Sulphate 100, Ammonia 
Water no, and Water to 250. The two solutions aforesaid should be kept in separate 
bottles, on hand, ready for mixing, in quantity of 200 cubic centimeters of the first and 
220 of the latter, and when required the precipitate may be washed by pressing in a 
wet muslin strainer, until no more liquid passes, then diluting as directed. It is the 
chemical antidote for Arsenic. Dose, 3 j in water, frequently repeated. 

Ferri Oxidum Hydratum cum Magnesia, Ferric Hydrate iviih Magnesia {Arsenic 
Antidote}, — is a more convenient and more efficient antidote for Arsenic than the preced- 
ing, as the excess of the alkaline precipitant is non-irritant, and is itself an Arsenic anti- 
dote. The two following solutions should be kept ready: (1) Solution of Ferric Sulphate 
50 Cc. in Water 100 Cc. (2) Magnesia, 10 grammes rubbed up with Water 750 Cc. in 
a bottle of 1000 Cc. capacity. When wanted, shake the latter to a homogeneous magma, 
add it gradually to the former, and shake them together to a uniform, smooth mixture. 
Should be given in large doses (j§j) and frequently repeated. 

Emplastrum Ferri, Iron Plaster, Strengthening Plaster, — has of Ferric Hydrate, 
dried, 9, Olive Oil 5, Burgundy Pitch 14, Lead Plaster 72. 

Trochisci Ferri, Troches of Iron, — each troche has of Ferric Hydrate gr. v, with 
Vanilla, Sugar and Tragacanth. Dose, j-iij troches, thrice daily. 

Ferri Phosphas Solubilis, Soluble Ferric Phosphate, — bright-green, transparent 
scales, of acidulous, saline taste, soluble in water, not in alcohol. Used as an adjuvant 
to laxative pills to prevent the after reactionary constipation. Dose, gr. v-x. Made by 
reaction between Ferric Citrate and Sodium Phosphate. 

Ferri Pyrophosphas Solubilis, Soluble Ferric Pyrophosphate, — green, transparent 
scales, of acidulous taste, soluble in water but not in alcohol. Is almost tasteless and 
unirritating, and non-constipative. Dose, gr. ij-v. Made by reaction between Ferric 
Citrate and Sodium Pyrophosphate. 

Ferri Sulphas, Ferrous Sulphate, FeS0 4 -\- 7H 2 0, — large, pale bluish-green prisms, 
efflorescent, of saline, styptic taste, and acid reaction, soluble in 1.8 of water at 59 F., 
insoluble in alcohol. Is chiefly used to make the Dried Sulphate and other preparations. 

Ferri Sulphas Exsiccatus, Dried Ferrous Sulphate, 2FeS0 4 -j- 3H 2 0, — a grayish- 
white powder, nearly soluble in water, consisting of the preceding salt, heated gradually 
to 300 F., until it ceases to lose weight. The most astringent and irritating ferrous salt, 
but an excellent one in small doses. Is a constituent of Pil. Aloes et Ferri. Dose, gr. 
ss-ij in pill. 

Ferri Sulphas Granulatus, Granulated Ferrous Sulphate, FeS0 4 -j- 7H 2 0, — is the 
same salt as above described, precipitated by Alcohol from solution in dilute sulphuric 
acid. Dose, gr. ss-ij. 

Liquor Ferri Subsulphatis, Solution of Ferric Subsulphate, MonseFs Solution, — 
is an aqueous solution of Basic Ferric Sulphate, containing 43.7 per cent, of the salt. A 
dark reddish-brown, almost syrupy liquid, of very astringent but not caustic taste, and 
acid reaction, mixing with water or alcohol in all proportions without decomposition. Is 
but slightly irritating and powerfully astringent, chiefly used locally as an astringent and 
hemostatic, but may be given internally in doses of mjij-x, well diluted. 

Liquor Ferri Tersulphatis, Solution of Ferric Sulphate, — is an aqueous solution of 
Normal Ferric Sulphate, Fe 2 (S0 4 ) 3 , containing 28.7 per cent, of the salt. Has the same 
properties as described for the preceding, but a less sp. gr. Is used to make other prepara- 
tions of Iron. 

Ferri Valerianas, Ferric Valerianate, — a dark, tile-red, amorphous powder, of faint, 
valerianic odor, and mildly styptic taste, insoluble in cold water, decomposed by hot 
water, readily soluble in alcohol. Of doubtful value as a valerianate. Varies somewhat 
in chemical composition. Dose, gr. j-iij, in pill. 

Compound Iron Salts and their Preparations. 

Liquor Ferri et Ammonii Acetatis, Solution of Iron and Ammonium Acetate 
(Basham's Mixture), — prepared from Tincture of Ferric Chloride 2, Diluted Acetic 
Acid 3, Solution of Ammonium Acetate 20, Aromatic Elixir 10, Glycerin 12, Water to 
100. An excellent and very pleasant preparation, having some diuretic and diaphoretic 
powers. Dose, ^ ij-v, well diluted. 



FERRUM. 



237 



Ferri et Ammonii Citras, Iron and Ammonium Citrate, — prepared from Solution 
of Ferric Citrate 10, Ammonia Water 4, mixed and evaporated. Transparent, garnet- 
red scales, deliquescent, readily soluble in water, insoluble in alcohol. Dose, gr. ij-v. 

Ferri et Ammonii Sulphas, Ferric Ammonium Sulphate, Ammonio-ferric Alum, — 
pale, violet crystals, efflorescent, of styptic taste and slightly acid reaction, soluble in 3 of 
water, insoluble in alcohol. Is the least astringent of the sulphates of iron, but more so 
than any of the salts formed by vegetable acids. Dose, gr. iij-xv. 

Ferri et Ammonii Tartras, Iron and Ammonium Tartrate, Ammonio-ferric Tar- 
trate, — transparent, reddish-brown scales, slightly deliquescent, of sweetish and slightly 
ferruginous taste, very soluble in water, insoluble in alcohol. Contains an equivalent of 
about 25 per cent, of Ferric Oxide, and has but slight irritant qualities. Dose, gr. v-xx. 

Ferri et Potassii Tartras, Potassio-ferric Tartrate, — transparent, garnet-red scales, 
slightly deliquescent* of sweetish and slightly ferruginous taste, very soluble in water, 
insoluble in alcohol. Is the least disagreeable in taste of all the iron preparations, and 
contains a little more ferric oxide than the preceding salt. Is but slightly astringent and 
is not constipating. Dose, gr. v-x. 

Ferri et Quininse Citras, Iron and Quinine Citrate, — prepared from Ferric Citrate 
85, Quinine, dried, 12, Citric Acid 3, Aq. Destil. q. s. ad 100, mixed and evaporated. 
Thin, transparent, yellowish-brown scales, slowly deliquescent, of bitter taste, slowly sol- 
uble in water, slightly soluble in alcohol. Contains \\% per cent, of dry quinine. 
Action, — astringent and stimulant to the digestive tract. Dose, gr. iij-v. 

Ferri et Quininse Citras Solubilis, Soluble Iron and Quinine Citrate, — Ferric 
Citrate 85, Quinine, dried, 12, Citric Acid 3, Ammonia Water, Distilled Water, to ico. 
Thin, transparent scales, of greenish, golden-yellow color, rapidly soluble in cold water, 
partially soluble in alcohol. Dose, gr. iij-v. 

Vinum Ferri Amarum, Bitter Wine of Iron, — has of the preceding 5 parts, Tinct. 
Aurantii Dulcis 15, Syrup 30, White Wine to 100. May replace the various " elixirs of 
iron and calisaya." Dose, gj-iv. 

Ferri et Strychninse Citras, Iron and Strychnine Citrate, — Ferri et Ammonii Citras 
98, Strychninse I, Ac. Citric I, Aq. Destil. 120, mixed and evaporated. Transparent, 
garnet-red scales, deliquescent, readily soluble in water, slightly so in alcohol. Contains 
I percent, of Strychnine. Action, — astringent and stimulating. Dose, gr. j-iij. 

Syrupus Ferri, Quininae et Strychninae Phosphatum, Syrup of the Phosphates 
of Iron, Quinine and Strychnine. [Described under Phosphorus.] 

Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphiles with Iron. 
[Described under Phosphorus.] 

Unofficial Preparations of Iron. 

Ferri Albuminas, Iron Albuminate, — a cinnamon-brown powder, soluble in water 
acidulated slightly with HC1. Dose, gr. x-xxx, in simple aqueous solution, or in pill. 

Ferri Arsenas, Ferrous Arsenate, Fe 3 As 2 8 , — a green, tasteless powder, insoluble in 
water, soluble in HC1 acid. Its activity is due to the arsenic alone. Dose, gr. y^—g-. 

Ferrum Dialysatum, Dialysed Iron, — composition varies from Fe 2 Q 6 -|- l2Fe 2 3 to 
Fe 2 Cl 6 + 95Fe 2 3 , and is a 10 per cent, solution of Ferric Oxychloride in water. Pre- 
pared by treating a solution of Chloride of Iron with Ammonia, ferric hydrate being 
precipitated, this being dissolved by agitation is placed in a dialyzer and suspended in 
water, which is renewed as long as it shows a trace of HC1 acid. It is a reddish-brown 
liquid, free from astringent, styptic taste, but is a very feeble chalybeate, incapable of 
absorption except by change into a hydrated sesquioxide in the alimentary canal. Is used 
as a chalybeate, and as an antidote to Arsenic, but is not considered an eligible prepara- 
tion. Dose, TTlx-xxx. 

Syrupus Ferri et Manganesii Iodidi, Syrtip of Iron and Manganese Iodide, — is a 
pale, straw-colored liquid, containing a little sulphate of potassium, and in each fluid ^ 
has 50 grains of the mixed iodides in the proportion of Iron Iodide 3 parts to I of Man- 
ganese Iodide. Dose, mjc-xxx-gj. 

Syrupus Ferri et Manganesii Phosphatis, Syrup of Iron and Manganese Phos- 
phate, — as used by Dr. Simpson, of Edinburgh, contains in each g of syrup 2 grains of 
Iron Phosphate and 1 grain of Manganese Phosphate. Dose, 3J. 

Mistura Ferri Aromatica, Aromatic Iron Mixture, — Pale Bark 4, Calumba 2, 
Cloves I, Iron wire 2, Tr. Cardamomi Co. 12, Tr. Aurantii Cort. 2, Aq. Menth. Pip. 50. 
— Macerate the first 4 in the last one for 3 days, filter, add the tinctures and make up to 
5o. 



238 FERRUM. 

Mistura Ferri Laxans, Laxative Iron Mixture, — Ferri Sulph. gr. ij. Magnesii Sulph. 
5jj, Ac. Sulphurici Dil. TT^iij, Spt. Chloroformi TTVxx, Aq. Menth. Pip. ad |j j. Dose, t ^j. 

Mistura Ferro-salina, Ferro-salhie Mixture, — Magnesii Sulph. |jj, Potassii Bitart. 
gj, Ferri Sulph. Exsic. gr. x, Aquas quart j. Dose, a wineglassful. 

Notes on the Preparations of Iron. 

Oxides and Carbonates, including Ferrum Reductum, Ferri Car- 
bonas Saccharatus, Mistura Ferri Composita, Pil. Ferri Comp., Massa 
Ferri Carb., Ferri Oxidum Hydratum, Ferri Oxidum Hyd. cum Mag- 
nesia, and Mist. Ferri Aromatica, — possess the hsematinic action of iron 
with but little astringency, and are therefore selected to restore the blood 
in anaemia, chlorosis and amenorrhcea, with tendency to dyspepsia and 
constipation. The Hydrated Oxides are only used as antidotes in arseni- 
cal poisoning. Ferrum Reductum is one of the best forms for internal 
use, but gives rise to sulphuretted or phosphoretted eructations which are 
very disagreeable. The Subcarbonate is little more than the Red Oxide, 
but in the Massa Ferri Carb. the oxidation is prevented by the sugar. 

Mineral Acid Salts and their preparations comprise the Sulphate in 
its 3 forms, the solutions of the Subsulphate and Tersulphate, the Phos- 
phate, Pyrophosphate and Hypophosphite, the Chloride and its prepara- 
tions and the Liquor Ferri Nitratis. They are characterized by their 
astringent and corrugating action, and are used locally especially as 
hemostatics, the Solution of the Subsulphate being preferred for topical 
use, as it is powerfully styptic but not corrosive. The Tincture of the 
Chloride is one of the best preparations for internal use, and is most 
agreeable in the form of Creuse's tasteless preparation, which is made as 
follows, — Liq. Ferri Chloridi gj, Acidi Citrici 544 grains, Sodii Carb. 
1000 grains or q. s., Aquae Destii. ^j, Alcoholis q. s. Dissolve the citric 
acid in the distilled water and heat to the boiling point, gradually adding 
sodium carbonate until the acid is saturated ; mix this with the iron solu- 
tion and make up to ^iv with alcohol. Of the Phosphates the best is the 
Pyrophosphate, which is easily assimilated, readily soluble and entirely 
unirritating. 

Vegetable Acid Salts and their preparations comprise the Lactate, 
the Citrate and its preparations, also the preparations of the Acetate and 
the Tartrate. They are the least irritating to the stomach but are also 
the least efficient as chalybeates. They may be administered in white 
wines, or with alkalies and vegetable acids in effervescing mixtures. 

Other Compounds are those in which Iron is combined with bodies 
equally active, as the preparations of the Iodide, those with Quinine, 
Strychnine, etc. Generally these preparations are used for a twofold 
purpose, namely, to relieve anaemia and at the same time act upon the 
specific ailment on which the anaemia depends. 

The Albuminate is considered by several authorities to be the most 
readily assimilated of all the iron preparations. 



FERRUM. 239 

Physiological Action. 

Metallic iron is not inert, for in the stomach it acquires molecular 
activity through its oxidation, setting hydrogen free. It is a normal con- 
stituent of the blood (1 part to 230 of red corpuscles), existing probably 
as an oxide in combination with haematin, which is not formed without 
it. It is also found in the bile, lymph, chyle, gastric juice, in the pigment 
of the eye, in the milk and the urine. Given medicinally in small doses 
it promotes appetite and digestion, and improves the quality of the blood, 
increasing the number of the red corpuscles. In the stomach all the salts 
of iron are converted into the Chloride and in the duodenum into an 
alkaline Albuminate, entering the blood along the whole length of the 
alimentary canal. Only a small portion of iron is absorbed, the rest being 
eliminated by the intestinal canal, blackening the faeces by conversion 
into a sulphide. Of the portion absorbed from the alimentary canal, 
only a small part reaches the systemic circulation and is eliminated by 
the kidneys, the greater part being excreted by the liver with the bile. 

Iron in large doses, or small ones long-continued is directly unfavorable 
to digestion, nausea and vomiting being produced by the soluble prep- 
arations; the per-salts are actively irritant; the Iodide, Chloride, Nitrate 
and Sulphate being active poisons, are highly astringent, and act injuri- 
ously on the teeth. 

Locally most of the iron salts are more or less constringing to the tis- 
sues and the mucous membranes, acting as hemostatics and astringents 
by virtue of their power to coagulate albumen, and acting injuriously on 
the teeth. The Tincture of the Chloride is considered diuretic. 

In compatibles. 

Alkalies and their carbonates, Acids, acidulous salts, and vegetable Astringents are 
incompatible with most preparations of Iron, the latter group being so by vinue of their 
Tannic and Gallic Acids which form a deep blue-black precipitate (Tannate of Iron) 
with the per-salts. The Tincture of the Chloride is decomposed by alkalies, alkaline 
earths and their carbonates, astringent vegetable infusions, and by mucilage of acacia, 
which latter produces therewith a brown, semi-transparent jelly. 

Therapeutics. 
The chief indication for the internal administration of Iron is anaemia, 
when plethora exists it is contraindicated. It should always be given 
after meals, and occasionally suspended for a time, to avoid deranging 
the stomach. When appetite and digestion are promoted by Iron it will 
do the greatest amount of good, many authorities holding that the prin- 
cipal benefit derived from its use, even in anaemia, is due to its stimulating 
action upon digestion and the primary assimilation. The Sulphate is here 
probably the most efficient salt and is well used in combination with aloes 
when there exists any intestinal torpor, especially as it increases the cathar- 
tic power of the latter drug, economizing it, and conferring upon it a 



24O FICUS FCENICULUM. 

permanence of action, which alone it does not possess. In pseudo-leuco- 
cythaemia, chorea of anaemic girls at the age of puberty, epilepsy and 
neuralgia of the anaemic, amenorrhcea and other menstrual disorders of 
the same class of subjects, and in acute rheumatism of pale, cachectic 
persons, the chalybeates are generally very efficient remedies, especially 
the Tincture of the Chloride. The same preparation is extensively 
employed in erysipelas and diphtheria with good results. In albuminuria 
with chronic disease of the kidneys the Tincture of the Chloride is a 
useful chalybeate diuretic. In many cardiac diseases of the anaemic, fatty 
heart, weak heart, dilatation, mitral disease, etc., ferruginous preparations 
are often of signal advantage. In the syphilitic cachexia, chancroid, and 
sloughing phagedena, the Iodide gives good results, particularly when the 
subject is one of debilitated constitution. In the nocturnal incontinence 
of children the Syrup of the Iodide is one of the most efficient remedies. 
In all chronic affections of the respiratory organs, when hemorrhage is 
not existing or threatened, the Iron, Quinine and Strychnine Phosphate 
is used with much benefit. In passive hemorrhages, especially when due 
to anaemia, the Tincture of the Chloride is very effective, and in all active 
bleeding the Solution of the Subsulphate locally used is a prompt and 
efficient hemostatic. A weak solution of this preparation Q5J ad Bviij), 
used in the form of spray, is the most serviceable astringent in obstinate 
epistaxis, and in hematemesis the same solution may be swallowed in 
small quantities at short intervals. In chronic diarrhoea and dysentery 
the Solution of the Nitrate is an efficient astringent, and a weak solution 
of the Chloride is used as a rectal injection against thread-worms. 

In arsenical poisoning the most effective antidote is the Hydrated 
Oxide, which forms with Arsenous Acid an almost insoluble compound. 
The solutions used in its preparation should be kept on hand and only 
mixed when wanted for use. 



FICUS, Fig, — is the fleshy receptacle of Ficus Carica, bearing fruit upon its inner 
surface. The fig-tree is a member of the nat. ord. Urticacese and a native of the shores 
of the Levant, but is cultivated in Southern Europe and in other warm countries. Figs 
contain about 62 per cent, of grape sugar, also gum, fat, etc., and are a constituent of the 
official Confectio Sennas. 

Figs are demulcent, laxative and nutritious. They are used in their fresh state as an 
aliment, but if eaten in quantity may produce flatulence, enteralgia and diarrhoea. They 
are chiefly used as an article of diet in habitual constipation, but may be employed as an 
ingredient of demulcent decoctions, and locally as a poultice to gum-boils. 



FCENICULUM, Fennel, — is the fruit of Fceniculum capillaceum, a European 
cultivated plant of the nat. ord. Umbelliferse. It is l /e to y 3 of an inch long, oblong, 
slightly curved, separable into 2 mericarps, and having 5 ribs, and several oil-tubes, odor 
and taste aromatic. It contains a volatile oil, united with a terpene, and is a constituent 
of Pulvis Glycyrrhizse Compositus. 



FRANGULA FUCHSIN FUCUS GALBANUM. 24 1 

Oleum Fceniculi,(9z7 of Fennel, — the volatile oil, a light-yellow colored liquid, hav- 
ing the odor of fennel, a warm taste and neutral reaction, soluble in alcohol. It is an 
ingredient of Spiritus Juniperi Compositus. Dose, Tnjj-v. 

Aqua Fceniculi, Fennel Water,— contains 2 parts of the oil in 1 000 of distilled 
water. Dose, ^ss-^j. 

Fennel is an aromatic stomachic and a mild stimulant. It is chiefly used as an agree- 
able carminative in flatulence and colic, and as a corrigent to Senna, Rhubarb, and other 
disagreeable medicines. An infusion is often used as an enema to expel flatus in infants. 



FRANGULA, Buckthorn, — the bark, collected at least one year before being used, 
of Rhamnus Frangula, or Alder Buckthorn, a European shrub of the nat. ord. Rham- 
nese. Occurs in quilled pieces gV inch thick, outer surface of gray-brown color, with 
numerous small warts. It contains several principles, of which the only important one 
is Frangulin, or Ramnoxanthin, a lemon-yellow, odorless and tasteless glucoside, in- 
soluble in water and but sparingly so in alcohol or ether, and thought to be identical 
with Cathartin, the active principle of Senna. Another species of the genus Rhamnus is 
described under the title Rhamnus Purshiana. 

Extractum Frangulae Fluidum, Fluid Extract of Frangula. — Dose, ^ss-ij. 

Frangula-bark when fresh is a violent irritant to the gastro-intestinal tract, producing 
vomiting, purging, and much pain. The old dried bark is a safe purgative without irri- 
tant qualities, and is much used in the constipation of pregnancy, and other conditions 
requiring purgation. The fluid extract is the best form for administration. 



FUCHSIN, Roseine, Magenta, Anilin Red (Unofficial), — is the Hydtochlorate of 
Rosanilin, C 20 H 10 N 3 -)-HCl, occurring in brilliant, elongated crystals having a green lustre, 
readily soluble in water and therewith making a bright red solution. Given internally it 
has produced salivation, vomiting, and diarrhoea; and when injected intravenously it has 
caused trembling, staggering, albuminuria and fatty degeneration of the kidneys, symptoms 
which are thought to be possibly due to the presence of Arsenic or Anilin as impurities. 
It imparts a magenta color to the urine, and is excreted by the kidneys, liver and sali- 
vary glands. It has been found to be very efficient in reducing albuminuria, in many 
instances having entirely arrested it. It is best administered in pill with a vegetable 
extract as Liquorice or Gentian, and in doses of gr. ^-iv, according to age. 



FUCUS VESICULOSUS, Bladder-wrack, Sea-wrack (Unofficial),— is a peren- 
nial plant of the nat. ord. Algse, growing on the shores of the Atlantic and Pacific Oceans 
as a sea- weed. It has a flat leaf, with a midrib throughout its length, and small spherical 
vesicles, filled with air, in the leaf. It contains mucilage and much Soda in saline com- 
bination, also Iodine, but less of the latter than other algae growing in deeper water. A 
decoction of the fresh plant is the best form for administration. 

Fucus Vesiculosus is one of a number of marine plants which are used in various parts 
of the world as food for man and cattle and as manure. The species under consideration 
is considered alterative and tonic, and has been employed in goitre, glandular and joint 
enlargements and psoriasis, but especially to produce absorption of adipose tissue in the 
obese. An extract is sold under the title "Anti-fat." 



GALBANUM (Unofficial), — is a gum-resin obtained from Ferula galbaniflua, an 
Asiatic plant of the nat. ord. Umbelliferse, and probably from other allied plants. It 
occurs in minute tears, agglutinated into a hard mass, of balsamic odor and acrid, bitter 
taste. It contains a Volatile Oil isomeric with Turpentine, a Gum, and a mixture of 
Resins which yield by dry distillation a blue oil and Umbelliferon, a tasteless substance 
in satiny crystals. Dose, gr. x-xx, in pill or emulsion. 

Galbanum is stimulant, expectorant and antispasmodic, acting much like Ammonia and 
Asafetida, and usually given with either of these substances. It is used in chronic bron- 
chitis and catarrh of mucous membranes generally, in amenorrhcea and chronic rheumatism. 
16 



242 GALLA GAULTHERIA — GELSEMIUM. 

GALLA, Nutgall, — is an excrescence on Quercus lusitanica, the Dyer's Oak, a shrub 
of the nat. ord. Cupuliferse, growing in Western Asia, and is caused by the puncture and 
deposited ova of the insect Cynips Gallcc tinctoricz. Galls are hard, globular bodies, 
from y z to ^ inch in diameter, of blackish-gray color, tuberculated on the surface, having 
a central cavity, and an intensely astringent taste. They contain from 15 to 75 per cent, 
of Tannic Acid, about 5 per cent, of Gallic Acid, and other unimportant constituents. 
Dose, gr. v-xv. 

Tinctura Gallse, Tincture of A T utgall, — strength 20 per cent. Dose, ^ss-iij. 

Unguentum Gallae, Nutgall Ointment, — strength 10 per cent. 

The action of Nutgalls is powerfully astringent, due to the Tannic and Gallic Acids 
contained in them. Having no special action or use of their own, their qualities may be 
learned by consulting the articles AciDUM Tannicum and Acidum Gallicum, ante, 
pages 71 and 81. 



GAULTHERIA, Wintergreen (Unofficial), — is the leaf of Gaultheria procumbens, 
an American evergreen plant of the nat. ord. Ericacese, having a peculiar flavor, a frag- 
rant odor, and an aromatic and astringent taste. Its active principle is the Volatile Oil, 
which is official. It also contains Tannic Acid, Arbutin, Urson, Ericolin, etc. 

Oleum Gaultheriae, Oil of Wintergreen, — is the volatile oil, a liquid of peculiar and 
aromatic odor, sweetish, warm taste, and a slightly acid reaction. It is readily soluble in 
alcohol, and consists of Methyl Salicylate 90 per cent., and Gaultherilene, a hydrocarbon, 
10 per cent. Dose, n\iij-x. It is nearly identical with the Volatile Oil of Betula. 

Spiritus Gaultheriae, Spirit of Gaultheria, — has of the oil 5 per cent., dissolved in 
95 of alcohol. Used for flavoring. Dose, gss-ij. 

Gaulfherise is stimulant and slightly astringent. Its chief value is as one of the sources 
of the oil named after it, which is also found in the sweet birch and many other plants, 
and, containing so large a proportion of Methyl Salicylate or Methylsalicylic Acid, is 
powerfully antiseptic and antipyretic. In large doses it is irritant to the stomach, in one 
case ^j having caused death by violent gastritis. 

Oil of Gaultheria is used successfully as a substitute for Salicylic Acid in many condi- 
tions, especially in rheumatic and gouty disorders. The plant has been used as an 
emmenagogue and a galactagogue, but its principal employment is in the form of the 
spirit as an agreeable flavoring agent. 



GELSEMIUM, Gelsemium, Yellow Jasmine, — is the rhizome and 
roots of Gelsemium sempervirens, a climbing plant of the nat. ord. 
Loganiaceae, with showy yellow flowers, which grows in the forests of the 
southern U. S. , forming festoons from one tree to another. The rhizome 
is cylindrical, long, about an inch thick, of a light yellowish-brown color, 
an aromatic, heavy odor and a bitter taste. It contains a volatile oil, a 
resin and an alkaloid, Gelsemine, in combination with Gelsemic Acid. 

Dose, gr. ij-xx. 

Preparations. 

Extractum Gelsemii Fluidum, Fluid Extract of Gelsemium, — alcoholic. Dose, 
rtyj-xx. 

Tinctura Gelsemii, Tincture of Gelsemium, — strength 15 per cent. Dose, n\x~3;j. 

Gelsemina, Gelsemine, C n H ]9 N0 2 (Unofficial), — an amorphous, colorless, inodorous, 
nearly insoluble solid, of intensely bitter taste, and strong basic properties, neutralizing 
the strongest acids, and with them forming soluble salts. Dose, gr. ^V~sV 

Physiological Action. 
Gelsemium is a powerful motor-depressant, causing paralysis of motility 
and depression of sensibility by central action on the spinal cord. It is 



GELSEMIUM. 243 

also antispasmodic and diaphoretic. In moderate doses it produces 
languor, slowing of the cardiac rate, enfeebled muscular action, impaired 
sensibility, drooped eyelids and dilated pupils, with some diaphoresis. 
In toxic dose, as a teaspoonful of the fluid extract, it produces vertigo, 
diplopia, drooped eyelids and dilated pupils (paralysis of 3d nerve), 
labored respiration, slow and feeble heart, dropped jaw, staggering gait, 
extreme muscular weakness and almost complete anaesthesia, profuse 
diaphoresis, loss of articulation, and death by asphyxia from paralysis of 
the muscles of respiration, consciousness being preserved until C0 2 nar- 
cosis sets in. Convulsions, with backward movements, occur in animals 
but not in man. Motion is affected before sensibility in warm-blooded 
animals, sensibility before motion in frogs. 

Gelsemium is not an arterial depressant, although it lowers the heart- 
rate, and is not irritant to the gastro-intestinal tract, but it produces a 
decided lowering of the body temperature. The effects of a moderate 
dose pass off in about three hours. 

. Antagonists and Incompatibles. 

Morphine is the most complete antagonist, so are also Digitalis, Ammonia, Alcohol, 
and to some extent the tincture of Xanthoxylum fraxineum. Emetics, heat, faradization 
of the respiratory muscles and artificial respiration are measures of prime importance. 
The caustic Alkalies and Tannic Acid are chemically incompatible. 

Therapeutics. 

Gelsemium is indicated in all conditions of exalted nerve function, and 
contraindicated whenever there is a weak heart. It is best used in 
cerebro-spinal meningitis, mania with great motor excitement and persist- 
ent insomnia, delirium tremens, many forms of sleeplessness, pneumonia 
and pleurisy if the heart be strong, coughs of convulsive and spasmodic 
character, neuralgia of the fifth nerve, remittent fever, after-pains, ovarian 
neuralgia, dysmenorrhcea, irritable bladder of women, and incontinence 
of urine from spasm of the vesical muscular fibres. In most of these 
affections the remedy must be pushed to the inducing of some physio- 
logical symptoms, but its action should not be carried beyond the pro- 
duction of drooped eyelids, diplopia and muscular debility. It has also 
been used with varying success in intercostal neuralgia, myalgia, sciatica, 
spasmodic asthma, sick headache, eczema, pruritus and tetanus. Its 
especial field, however, is in remittent and typho-malarial fevers and 
cerebro-spinal meningitis. It is not suitable to low fevers and has not 
sufficient power as a cardiac depressant to be of much use in sthenic 
forms. 

There is much evidence for the claim made for the drug Gelsemine, ot 
singular efficiency in antagonizing the mental condition occasionally 
manifested by an unusual degree of dread, in regard to some approach- 
ing ordeal, or ordinary trial of life ; as, for example, that of a woman 



244 GENTIANA. 

concerning her impending confinement, or of a student in reference to 
his examinations. In very many such cases, the use of Gelsemine, in 
small doses frequently repeated (gr. T -J- 7 ter die), has seemed to remove 
the state of abnormal fear entirely. 



GENTIANA, Gentian,— is the root of Gentiana lulea, the Yellow 
Gentian, one of a numerous family of plants (nat. ord. Gentianeae), 
inhabiting the mountainous districts of Europe. An American species, 
G. Caiesbczi, Blue Gentian, is considered nearly equal in value to the 
official species. Gentian occurs in cylindrical pieces or longitudinal 
slices of the root, which is ^ to i inch thick and several inches long, 
brown externally, yellowish-brown within, of faint, peculiar odor, and 
taste at first sweetish, afterwards persistently bitter. It contains an active, 
bitter glucoside, Gentopicrin or Gentianin, C 2 oH 30 12 , which is crystalline 
and soluble in water, also an inert, amorphous body, Gentianic or Gentesic 
Acid, gum, considerable sugar, and a trace of volatile oil, but no tannin. 

Preparations. 

Extractum Gentianae, Extract of Gentian, — aqueous. Dose, gr. j-v. 
Extractum Gentianae Fluidum, Fluid Extract of Gentian, — Dose, gss-j. 
Tinctura Gentianae Composita, Compound Tincture of Gentian, — Gentian 10, 
Bitter Orange Peel 4, Cardamon I, Alcohol and Water to 100. Dose, gss-ij. 

Unofficial Preparations. 

Infusum Gentianae Compositum, Compound Infusion of Gentian, — contains Gen- 
tian 10, Bitter Orange Peel 2.y 2 , Coriander 2^, Alcohol 40, Water to 320. Dose, 

Mistura Gentianae Alkalina, Alkaline Mixture of Gentian, — Ac. Hydrocyan. Dil. 
TT\hj, Sodii Bicarb, gr. xv, Infusum Gentianae Co. to j|j. One dose. 

Mistura Gentianae et Sennae, Mixture of Gentian and Senna, — Infusum Sennse 
^iij, Tr. Cardamomi Co. gj, Infusum Gentianae Co. sjvj. One dose. 

Physiological Action and Therapeutics. 
Gentian is a simple bitter without astringency or aroma, its action 
corresponding to that of Calumba (see ante, page 163), but it is more 
apt to disagree with the stomach. In addition, like Cornus, a member 
of the same class, it has considerable repute as an antiperiodic and 
febrifuge. Gentian has been considered a valuable tonic throughout 
all Europe from the earliest historical times. It is highly esteemed as a 
stomachic tonic in dyspepsia connected with a gouty diathesis, in hysteria, 
jaundice, and convalescence from acute diseases and from malarial fever. 
The compound tincture is an excellent vehicle for cod-liver oil, and the 
now unofficial infusion is a good vehicle for the administration of cha- 
lybeates, mineral acids and neutral salts. The discoloration which iron 
salts make with gentian preparations is probably due to Gentesic Acid and 
not to tannin, as it contains none of the latter. 



GERANIUM GLYCERINUM. 245 

GERANIUM, Cranesbill, — is the rhizome of the indigenous perennial Geranium 
maculatum (nat. ord. Geraniaceae). It is 2 or 3 inches long, horizontal, contorted and 
tuberculated, with thin, fragile rootlets, inodorous, taste astringent. Its active constitu- 
ents are tannic and gallic acids. 

Extractum Geranii Fluidum, Fluid Extract of Geranium. — Dose, TT\v-£j. 

Geranium is an efficient astringent, and its action corresponds with that of Tannic 
Acid (see ante, page 81). Having no unpleasant taste it is a useful agent for infants and 
others having delicate stomachs, and is a very popular domestic remedy in many parts of 
the country. It is especially used in diarrhoeas, dysentery, cholera infantum, hemor- 
rhages, relaxed conditions of mucous membranes, gleet and leucorrhoea. 



GLYCERINUM, Glycerin,— is a liquid obtained by the decom- 
position of vegetable or animal fats or fixed oils, containing not less than 
95 per cent, of absolute Glycerin, C 3 H 5 (HO) 3 , which exists in fats and 
fixed oils in combination with the fatty acids. 

Glycerin is a clear and colorless liquid, of syrupy consistence, hygroscopic, non-drying, 
odorless, of warm and very sweet taste, neutral reaction, sp. gr. 1. 250, soluble in water 
and alcohol, but insoluble in ether, chloroform and fixed oils. It dissolves Tannin, 
Gallic Acid, Carbolic Acid, Salicylic Acid, Bromine, Iodine, etc., and with the aid of heat 
metallic salts and oxides, alkaloids, etc. With strong Nitric Acid it forms Nitro-glycerin, 
and it reduces Potassium Permanganate, Chromic Acid and Chlorinated Lime with great 
violence. An impurity frequently present in it is Acrolein, formed by the use of too high 
a heat in its manufacture, and which is very acrid and poisonous. Glycerin is a con- 
stituent of the 6 Glycerites, Pilulae Phosphori, Mucilago Tragacantha?, Massa Hydrargyri, 
and several extracts and fluid extracts. Dose, gj-ij, diluted. 

Preparations. 

Suppositoria Glycerini, Suppositories of Glycerin, — each has Sodium Carbonate, 
grains \]/ z , Stearic Acid, grains 7^, dissolved by heat in 90 grains of Glycerin, cooled 
in a mould, and wrapped in tin-foil. Used per rectum in chronic constipation. 

Glycerites of Carbolic Acid, Tannic Acid, Starch, Boroglycerin, Hydrastis, Yolk of 
Egg, — are described under the titles of their respective ingredients. 



Physiological Action. 
Glycerin is highly antiseptic, abstracts water from tissues with which it 
comes in contact, and unless pure is often very irritating to the skin. It 
is freely absorbed by all surfaces, cutaneous and mucous, and is decom- 
posed in the system, passing out as formic and other acids. On the 
stomach it has no particular action, but in large quantities it is laxative 
and is said to cause the solution of the red blood corpuscles and hsemo- 
globinuria. The urine of persons using glycerin contains a body which 
acts like sugar in the copper and fermentation tests, but is not sugar. 
Glycerin is a good emollient and is considered nutritive by many 
authorities. 

Therapeutics. 
Glycerin has been used as a substitute for Cod-liver Oil in wasting dis- 
eases, but with little benefit. It has also been tried as a remedy in 
diabetes, but with unsatisfactory results so far as reported, except as a 



246 GLYCYRRHIZA. 

sweetening substitute for sugar in the dietary of those afflicted with that 
disease. It is said to be fatal to intestinal trichinae, and to be an efficient 
internal remedy in acne and flatulence. In chronic constipation, most 
excellent results are obtained from rectal enemata of Glycerin, or from 
the official suppositories thereof. As a vehicle it is used for many drugs, 
and is a good ingredient of solutions for hypodermic use, promoting the 
solubility of many alkaloids and acting as an antiseptic. It is also 
employed to preserve and aid the action of the digestive ferments, Pepsin 
and Pancreatin, as well as to prevent the decomposition of vaccine 
lymph. 

Locally it is valuable in many cutaneous affections as an emollient and 
softening agent. In acute coryza it gives great relief if applied by a 
brush or as a spray to the nasal mucous membrane. It is used on cotton 
to the cervix uteri as a depleting agent, and mixed with an infusion of 
flaxseed as an enema to relieve tenesmus in acute dysentery. With tinc- 
ture of Benzoin it is an excellent application to chapped hands or lips 
and fissured nipples. In the external auditory canal it is usefully 
employed to soften cerumen, diminish the secretion of pus, deplete the 
tissues, and keep the surface moist. 

Glycozone (Unofficial), — is claimed to be a stable compound resulting from the 
reaction between chemically pure glycerin and 15 times its volume of ozone; and not a 
mixture of hydrogen dioxide with glycerin. It is very hydroscopic, and must be kept 
tightly corked, to prevent deterioration. It is said to act upon diseased tissue in the 
same manner as Hydrogen Dioxide (which see), but more slowly; and may be used in 
full strength as an application to wounds and suppurating surfaces, to stimulate healthy 
granulations, and generally as an antiseptic surgical dressing. It is mixed with water 
(I to 10) as a rectal injection ; and may be administered internally, in doses of ^j-ij in 
a wineglassful of water, in gastric affections, — as dyspepsia, pyrosis, ulcer and catarrh of 
the stomach. 



GLYCYRRHIZA, Glycyrrhiza, Liquorice Root,— is the root of 
Glycyrrhiza glabra, var. glandulifera , a plant of the nat. order Legumi- 
nosae, native in southern Europe and Asia, but largely cultivated in many 
other parts. It occurs in long pieces, \ to 1 inch thick, longitudinally 
wrinkled, of a grayish-brown color externally, tawny-yellow internally, 
pliable and tough, and of a somewhat acrid, sweet taste. It contains a 
yellow, amorphous glucoside, Glycyrrhizin, C 24 H 36 9 , also Glycyrrhizic 
Acid, Asparagin, sugar, resin, gum, etc. Glycyrrhizin when boiled with 
dilute acids yield glucose and a very bitter substance named Glycyrreiin. 

Preparations. 

Extractum Glycyrrhizae, Extract of Glycyrrhiza, — is the commercial extract of the 
root, occurring in glossy-black rolls, of sweet, peculiar taste. Not less than 60 per cent, 
of it should be soluble in cold water. 

Extractum Glycyrrhizae Purum, Pure Extract of Glycyrrhiza, — made with Aqua 
Ammonia and Water, by percolation and evaporation to a pilular consistence. Dose, in- 
definite. 



GOSSYPIUM. 247 

Extractum Glycyrrhizae Fluidum, Fhiid Extract of Glycyrrhiza, — made with Aqua 
Ammonia and diluted Alcohol. Dose, indefinite. 

Mistura Glycyrrhizae Composita, Compound Mixture of Glycyrrhiza, — Brown 
Mixture, — has of the Pure Extract 3 parts, Syrup 5, Acacia 3, Tr. Opii Camph. 12, 
Vinum Antimonii 6, Spt. .-Etheris Nitrosi 3, and Water to 100. Dose, £> j- Jjj. 

Pulvis Glycyrrhizae Compositus, Compound Powder of Glycyrrhiza, — Senna 18, 
Glycyrrhiza 23^, Oil of Fennel 4, Washed Sulphur 8, Sugar 50 parts. Dose, a tea- 
spoonful. 

Trochisci Glycyrrhizae et Opii, Troches of Glycyrrhiza and Opium, — each has of 
Extract of Glycyrrhiza gr, ij, Powdered Opium gr. Jg, Acacia, Sugar and Oil of Anise. 
Dose, j-ij every hour. 

Glycyrrhizinum Ammoniatum, Ammoniated Glycyrrhizin, — the sweet principle of 
Liquorice rendered soluble and therefore tasteable by Ammonia, believed to be the form 
in which Glycyrrhizin exists in the root. Occurs in brownish-red scales, very sweet, and 
soluble in water or in alcohol. Dose, gr. v-xv. Is a constituent of Velatine, for which 
see page 199. 

Physiological Action and Therapeutics. 
Liquorice is demulcent and mildly laxative. It has an agreeable taste, 
and increases the flow of saliva and mucus when slowly chewed or 
sucked, the increased secretions acting as emollients to the throat. It is 
used in many pharmaceutical preparations, covering the taste of Senna, 
Senega, Hyoscyamus, Turpentine, Ammonium Chloride, the bitter Sul- 
phates, and to some degree the bitterness of Quinine. The powdered ex- 
tract or root is used as an excipient in pills and troches. The Compound 
Mixture is an efficient expectorant, much employed in acute bronchitis and 
catarrhal laryngitis, but owing its power over cough mainly to the Opium 
contained in it. The Compound Powder is a gentle laxative, of which 
Senna is the most active ingredient. The Troches are used for cough, 
but must be carefully prescribed to children, as each troche contains gr. 
i^g- of Powdered Opium. 



GOSSYPIUM, Cotton,— is the hairs of the seed of Gossypium 
herbaceum, and of other species of Gossypium (nat. ord. Malvaceae), 
freed from adhering impurities and deprived of fatty matter. In this 
form it is official as Gossypium Purificatum, Purified Cotton, Absorb- 
ent Cotton, insoluble in ordinary solvents, but soluble in copper ammo- 
nium sulphate solution. Cotton-fibre is familiar in appearance to every 
one, but when examined microscopically, it shows as flattened, hollow 
and twisted bands, spirally striate, and slightly thickened at the edges. 
It is a modification of Cellulose, C 12 H 10 O 10 , and corresponds therewith in 
all its ordinary chemical properties. 

Preparations of the Cotton Plant. 

Gossy'pii Radicis Cortex, Cotton Root Bark, — thin bands or quilled pieces, brown- 
ish-yellow exteriorly, white interiorly, of slightly acrid and astringent taste. Dose, gr. 
xxx- gj. 

Extractum Gossypii Radicis Fluidum, Fluid Extract of Cotton Root Bark, — 
made with Glycerin and Alcohol, by maceration and percolation. Dose, TT^xxx-gj. 



248 GOSSYPIUM. 

Oleum Gossypii Seminis, Cotton-seed Oil, — the fixed oil expressed from the seeds 
and purified. Is yellow, odorless, of bland taste and neutral reaction, soluble in ether, 
but slightly soluble in alcohol. Is introduced into the pharmacopoeia for the reason that 
it constitutes most of the " Olive Oil" sold in foreign-shaped bottles and under foreign- 
appearing labels. It is directed to be used in the official Liniments of Ammonia and 
Camphor. 

Pyroxylinum, Pyroxylin, Soluble Gun-cotton, Colloxylin, — is official for the purpose 
of making Collodium. It is prepared by macerating Cotton in a mixture of Sulphuric and 
Nitric Acids, washing, draining and drying. 

Collodium, Collodion, — made by dissolving Pyroxylin 3, in Ether 75 and Alcohol 25. 

Collodium Flexile, Flexible Collodion, Collodion 92, Canada Turpentine 5, Castor Oil 
3, mixed thoroughly. 

Collodium Stypticum, Styptic Collodion, — Ether 25, Alcohol 5, Tannic Acid 20, 
Collodion to 100. 

Collodium Cantharidatum, Cantharidal Collodion, Blistering Collodion, — Canthar- 
ides 60, Flexible Collodion 85, Chloroform q. s. to 100. 

Physiological Action. 
Cotton-root is believed to be an efficient emmenagogue and oxytocic 
by Southern practitioners, also somewhat of a galactagogue, but experi- 
ments on pregnant animals have not confirmed this view of its action. 
The Oil of the seed is very bland and may be applied to all the purposes 
for which Olive Oil is used. Cotton itself, when freed from oily matter, 
is remarkably absorbent of water, and is a good agent for excluding air 
from injured surfaces. Pyroxylin is highly inflammable, and explosive 
at 300 F. Collodion is also inflammable, and rapidly dries on exposure 
to the atmosphere by evaporation of its ether, leaving a transparent film 
of Pyroxylin on the surface to which it has been applied ; which film, if 
the flexible collodion be used, does not contract on drying or readily 
crack, making it an excellent protective application. Styptic Collodion 
is a solution of Tannin, and is an excellent hemostatic. Cantharidal 
Collodion is a convenient blistering agent, suitable for cases where the 
patient is inclined to remove a blister if applied in the ordinary way. 

Therapeutics. 

Absorbent Cotton is a valuable agent in surgical practice, being em- 
ployed as an application in burns and scalds, erysipelas, articular rheuma- 
tism, etc., to exclude the atmosphere, allay pain, and when covered with 
oiled silk or rubber cloth to keep up local perspiration. It may be car- 
bolated, borated or salicylated, by soaking in the respective solutions, and 
then used as an antiseptic dressing for wounds, ulcers, etc. It is employed 
by the pharmacist in funnels to filter oils, and for the preparation of the 
official waters. 

Cotton-root Bark is much employed by the negroes of the Southern 
States in decoction as a supposed abortifacient, oxytocic and emmena- 
gogue. It is used in the south for intensifying uterine action in normal 
labor, in dysmenorrhcea and amenorrhcea. A decoction, of ^iv in a 
quart of water boiled to a pint, is the favorite preparation, administered 
in wineglassful doses. 



GRANATUM. 249 

Collodion is used as a protective covering for superficial burns, ulcers 
and wounds, slight cuts, cracked nipples, anal fissures, and erysipelas. 
For these affections the flexible collodion should be used, but where it is 
desirable to produce pressure on the part the ordinary form is best, as it 
contracts in drying with considerable force. This property makes it 
highly useful in drawing the edges of wounds together, bringing pressure 
on buboes, incipient boils, carbuncles, etc. 

Styptic Collodion has many uses as a hemostatic and protective which 
will suggest themselves, and the Cantharidal form is a convenient epispas- 
tic for uneven surfaces, the therapeutics of which are detailed under Can- 
tharis. 



GRANATUM, Pomegranate, — is the bark of the stem and root 
of Punica Granatum, a small tree of the nat. ord. Lithrariese, cultivated 
in subtropical countries. It occurs in thin quills of yellowish-gray color, 
warty or ridged on the external surface, inodorous, of astringent and 
slightly bitter taste. It contains Tannic and Punico-tannic Acids, Man- 
nite and an active liquid alkaloid Pelletierine, C 8 H 13 NO, which is soluble 
in water, alcohol, ether, chloroform, etc., and has strong basic proper- 
ties. There are no official preparations. 

Unofficial Preparations. 

Extractum Granati Fluidum, Fluid Extract of Pomegranate. — Dose, gss-jss. 

Decoctum Granati, Decoction of Pomegranate, — gxvij of bark from the fresh root 
in ^ xvij of boiling water, boiled down to ^ xij and strained. Dose, ^ iv-vj every hour, 
preceded and followed in a few hours by a brisk cathartic. The decoction of the Br. 
Phar. is of 1 to 8 strength and is given in doses of ^ ij-iv. 

Pelletierinae Tannas, Pelletierine Tannate. — Dose, gr. v-xx, taken fasting and fol- 
lowed in 15 minutes by a sharp purgative. 

Physiological Action and Therapeutics. 
Granatum and its alkaloid are tasniafuge, and very efficiently so, rarely 
failing to bring away the whole worm. The decoction is usually em- 
ployed, but lately Pelletierine has been coming into fashion, a proprietary 
form being sold as " Tanret's Pelletierine" in bottles containing one 
adult dose at three dollars each. The decoction, in full doses, causes 
nausea and vomiting, flatulence, purging, and sometimes cramps in the 
legs, giddiness, dimness of vision, general numbness of the limbs and 
increase of the quantity of urine. 

For the expulsion of tape-worm a mixed treatment by Pomegranate- root bark, Pump- 
kin seeds and Oleoresin of Male-fern is preferred by many practitioners. The following 
formula has proved very efficient. R. Granati ^ij, Aquae Ojss, boiled to 3; vij ; Pep- 
inis !|j, deprived of outer coats and beaten to a paste with fine powdered sugar; Oleo- 
resinse Aspidii, gr. xxx, made into emulsion with Acacia and the above decoction of 
Granatum, then added to the paste of Pepo, and flavored with Syrups up to 3jix. One- 
third of this to be taken in the morning after a light diet and a laxative on the previous 



25O GRINDELIA GUAIACUM. 

day. If not successful the second and third portions may be taken at intervals of 3 hours. 
The worm should be passed sitting in a tepid sitz-bath, to prevent the expelled portion 
tearing off the head by its weight. ' 



GRINDELIA, — the leaves and flowering tops of Grindelia robusta, 
and of Grindelia squarrosa, herbaceous Californian plants of the nat. ord. 
Compositae, having a branched stem, lower leaves spatulate and tapering 
at the base, upper leaves oblong, pointed and have broad bases, flowers 
yellow, odor balsamic, taste pungently aromatic and bitter. It contains 
a resin, a volatile oil, and an alkaloid with basic properties. 

Extractum Grindeliae Fluidum, Fluid Extract of Grindelia. — Dose, TT^x— 3 j. 

Grindelia is antispasmodic and a motor-depressant, inducing paralysis 
in small animals beginning in the hind extremities. It slightly slows the 
heart and respiration, and produces mydriasis and hypnotic effects if 
given in sufficient quantity, with reduced cutaneous sensibility and slug- 
gish reflexes. It has a pungent taste, creates a sense of warmth in the 
stomach, and in small doses promotes appetite and digestion. It is 
eliminated by the pulmonary mucous membrane and the kidneys, and is 
markedly diuretic. 

Grindelia has been used chiefly in spasmodic asthma, bronchitis and 
whooping-cough, which it greatly relieves. It is a useful remedy in spas- 
modic coughs, dyspnoea of various pulmonary and cardiac affections, 
hay-fever, and chronic cystitis. Locally it is highly efficient as a sedative 
lotion (1 part of the fluid extract to 9 of water) in poisoning by Rhus 
toxicodendron, and in skin diseases attended with itching and burning 
sensations. 



GUAIACUM, Lignum Vitse, — is official in two forms, Guaiaci 
Lignum, the heart-wood of Guaiacum officinale and of Guaiacum sanctum, 
and Guaiaci Resina, Guaiac, the resin of the wood of Guaiacum offi- 
cinale, a large West Indian tree of the nat. ord. Zygophyllese. The Resin 
is the important constituent, and itself consists of three resins, namely, 
Guaiaconic Acid, C 19 H 20 O 5 , 70 per cent., Guaiac Acid, C 6 H 8 3 , resem- 
bling Benzoic Acid, and Guaiarec Acid, C 20 H 26 O 4 ; also an indifferent 
resin. The wood also contains a yellow coloring matter, gum, etc. 

Guaiaci Lignum, Guaiacum Wood, — generally used in the form of 
raspings of greenish-brown color containing whitish particles, of resinous 
odor, taste slightly acrid. Is a constituent of Decoctum Sarsaparillae 
Compositum. 

Guaiaci Resina, Guaiac, — occurs in large masses of a greenish-brown 
or reddish-brown color, feebly aromatic, taste somewhat acrid, fracture 



GUARANA. 251 

having a glassy lustre, insoluble in water, soluble in alcohol, ether, chlo- 
roform and alkaline fluids. Dose, gr. v-xxx, in wafer. Is a constituent 
of Pil. Antimonii Composite. 

Preparations. 

Tinctura Guaiaci, Tincture of Gtcaiac, — 20 per cent. Dose, IT^ v-gj, in mucilage 
or syrups, as the resin is precipitated by water. 

Tinctura Guaiaci Ammoniata, Ammoniated Tincture of Guaiac, — has of Guaiac 
20, Aromatic Spirit of Ammonia to 100. Dose, TTL v-^ss. 

Physiological Action. 
Guaiac is diaphoretic, expectorant and alterative. Its taste is acrid and 
very disagreeable. Internally it is a local stimulant, producing salivation, 
an acrid sensation in the throat, warmth in the epigastrium, increase of 
the gastric and intestinal secretions and the flow of bile, and reflex stimu- 
lation of the heart. Its continued use causes gastric catarrh, and in large 
doses it is a gastro-intestinal irritant, causing vomiting, purging and 
severe congestive headache. Though a colloidal body it enters the blood,- 
stimulates the liver and other excretory glands and the production of 
bronchial mucus, and causes increased circulation and diaphoresis. 
Sometimes it fails to act on the skin and then is markedly diuretic. 

In compatibles. 

Mineral Acids and Spirit of Nitrous Ether are chemically incompatible with Guaiac 
preparations. 

* Therapeutics. 

Guaiacum was first used as an antisyphilitic, being employed in decoc- 
tion and in large quantity, with a spare diet and external warmth. It 
acquired a great reputation in that disease during the 16th century, but 
it is now abandoned therefor except as an ingredient of the Compound 
Decoction of Sarsaparilla. It is a very efficient remedy in tonsillitis, 
given in gss doses of the tincture in emulsion with mucilage or yolk of 
egg, to abate the inflammation and abort the disease. It has considerable 
reputation in neuralgic dysmenorrhcea, amenorrhcea, chronic rheumatism, 
gout, lumbago and sciatica. The ammoniated tincture in water makes a 
cleanly and not very disagreeable gargle. 



GUARANA, — is a dried paste chiefly consisting of the crushed or pounded seeds of 
Paullinia Ctipana, a climbing plant of the nat. ord. Sapindaceae, growing in Brazil. It 
occurs in brown cakes or sticks, having an odor of chocolate, and a bitter, astringent taste, 
partly soluble in water and in alcohol. It contains 25 per cent, of tannic acid, gum, albu- 
men, starch, and a greenish fixed oil, also an alkaloid Guaranine (5 per cent.), which is 
thought to be identical with Caffeine. The specimens of Guarana in the market are very 
untrustworthy, unequal in quality and expensive, it being a secret mixture prepared in 
Brazil. Hence it has been omitted from the list of Squibb's preparations, a fluid extract 
of green coffee being substituted in its place. 

Extractum Guaranae Fluidum, Fluid Extract of Guarana. — Dose, ix\x-£i]. 



252 GURJUN H^EMATOXYLON HAMAMELIS. 

Guarana has similar actions to those of Coffee, the active principles of both plants being 
perhaps identical, both chemically and physiologically. It is chiefly employed in the 
treatment of nervous sick-headache (migraine) administered in half-drachm doses of the 
fluid extract when the attack is developing. It has been used in the diarrhoea of phthisis, 
convalescence from acute diseases, and generally in conditions requiring tonic treatment. 



GURJUN BALSAM, Balsamum Dipterocarpi, Wood Oil. (Unofficial),— is an 
oleoresin obtained from incisions in various trees of the genus Dipterocarpus, growing in 
India. It is thick, opaque and grayish-brown by reflected light, soluble in chloroform 
and partly so in alcohol, ether and volatile oils, odor balsamic, taste bitter. It contains from 
40 to 70 per cent, of a Volatile Oil, a Resin and Gurjunic Acid. Dose, VC\x-£i], in 
emulsion, or in capsules. 

The properties of this balsam are similar to those of Copaiba, but it is less disagreeable 
and less apt to upset the stomach, also less actively diuretic. It has been used with good 
success in leprosy, given internally in full doses and used locally at the same time. Mixed 
with 4 parts of Lime-water it is well applied in chronic eczema, lupus and psoriasis. 



H^EMATOXYLON, Log-wood, — is the heart-wood of Hcematoxylon campe- 
chianum, a tree of the nat. ord. Leguminosae, native of tropical America, but naturalized 
in the West Indies. It occurs in chips or powder of a dark brown-red color, often with 
a greenish lustre, of feeble and agreeable odor, taste sweet and astringent, and colors the 
saliva a dark pink when chewed. It contains Tannic Acid, and a sweet, crystalline color- 
ing principle named Hematoxylin, C 10 H u O 6 , which is colorless when pure, but turns red 
on exposure to light. 

Preparations. 

Extractum Haematoxyli, Extract of Hcematoxylon, — Dose, gr. v-xx. 

Decoctum Haematoxyli, Decoction of Hce?natoxylon (Unofficial), — strength I in 17. 
Dose, ,^j-ij. * 

Logwood is mildly astringent, its properties depending on the Tannin contained in it. 
As it is devoid of irritating qualities it is well adapted to the diarrhoeas and hemorrhages 
of young children. It does not produce constipation nor disorder the bowels, but colors 
the urine and stools blood-red, and has caused phlebitis. It has been used as an hemostatic 
in bleeding of the lungs, and hemorrhages from the uterus and intestines, and as an as- 
tringent in leucorrhcea. 



HAMAMELIS, Witch-hazel, — the leaves, collected in autumn, 
of Hamainelis virgimana, a shrub of the nat. ord. Hamamelaceae, growing 
in the United States, having yellow flowers and oval-shaped leaves about 
4 inches long, which are inodorous, but of a bitter and astringent taste. 
They contain about 8 per cent, of Tannic Acid, a bitter principle and 
probably some volatile matters, but the chemistry of the plant has not 
been fully studied. 

Preparations. 

Extractum Hamamelidis Fluidum, Fluid Extract of Hamamelis. — Dose, TT\J-3J, 
is the only official preparation, and is prepared from the leaves. 

Hamamelin (Unofficial), — is an uncertain extract of very indefinite composition. 
Dose, gr. j-ij. 

Distilled Extracts, so-called, but really Waters distilled from the bark, are sold by 
various manufacturers, and are said by the vendors to contain the volatile principles of 
the plant. Pond's Extract is such a preparation, said to be made by distilling the bark 
with a very dilute alcohol, and a proprietary medicine of uncertain composition. 



hedeoma helleborus. 253 

Physiological Action and Therapeutics. 
No trustworthy experimentation has yet been made with this drug. It 
is tonic, astringent, styptic and sedative, owing most of its properties to 
its Tannin, but appears to possess some special influence over the venous 
circulation similar to that of Aconite on the arterial system. In full 
doses it may produce severe throbbing pain in the head. It is used both 
internally and locally with great benefit in hemorrhoids, particularly those 
of the bleeding variety, varicose veins and ulcers, varicocele, venous con- 
gestions and threatening local inflammations. It is highly recommended, 
in hemorrhages from the nose, stomach, lungs, rectum and kidneys, in 
threatened abortion, and externally for sprains and bruises, foul ulcers, 
the pruritus of eczema, leucorrhcea and gonorrhoea. An Ointment of 
Witch-hazel is found in the shops, and suppositories may be prepared 
extemporaneously by evaporating the fluid extract and incorporating the 
residue with cocoa-butter. 



HEDEOMA, Pennyroyal, — the leaves and tops of Hedeoma pulegioides, a plant of 
the nat. ord. Labiatse, common to all parts of the U. S., having a four-sided, hairy stem, 
pale blue flowers, leaves l / z inch long, glandular on the under surface, odor strong and 
mint-like, taste pungent. Its only important constituent is the Volatile Oil, which is 
official. 

Preparations. 

Oleum Hedeomae, Oil of Pennyroyal, — is the volatile oil, readily soluble in alcohol. 
Dose, nyj-x. 

Spiritus Hedeomae, Spirit of Pennyroyal (Unofficial), — contains I part of the oil in 
9 of alcohol. Used externally or as spray. 

Hedeoma is a stimulant aromatic, also somewhat carminative and emmenagogue. Its 
odor is extremely repulsive to insects, especially fleas and mosquitoes. In warm infusion 
it is a popular remedy for amenorrhcea and flatulent colic. It maybe used as a corrective 
with other medicines, and the spirit is well employed on the hands and face to keep away 
mosquitoes. The writer has known death by narcosis to result from an overdose of the 
oil self-taken to produce an abortion. 



HELLEBORUS, Hellebore (Unofficial),— the rhizome and root- 
lets of Helleboius niger (Black Hellebore) and Helleborus viridis (Green 
Hellebore), plants of the nat. ord. Ranunculaceae, natives of Europe. A 
third variety, Helleborus occidentals, growing in Greece, is probably the 
true Hellebore of the ancients. The rhizome is 1 to 3 inches long, 
knotty, with transverse rings, of rancid odor when freshly bruised, and 
bitter, acrid taste. Its most important constituents are two glucosides, 
Helleborin and Helleborem, both crystalline and very poisonous. 

Preparations. 

Extractum Hellebori Nigri, Extract of Black Hellebore (Unofficial). — Dose, gr. j-x 
cautiously. 

Extractum Hellebori Nigri Fluidum, Fluid Extract of Black Hellebore (Unoffi- 
cial). — Dose, nyj-xv. 



254 HOANG-NAN. 

Helleborin, C 36 H 42 6 (Unofficial), — crystalline, insoluble in water, soluble in alcohol 
and chloroform. 

Helleborei'n, C 26 H 44 15 (Unofficial), — crystalline, very soluble in water, slightly so in 



Physiological Action and Therapeutics. 

Black Hellebore is a drastic, hydragogue cathartic, and an emmen- 
agogue. In overdoses it is a violent gastro-intestinal irritant, producing 
vomiting, hypercatharsis, vertigo, cramps and convulsions, which may 
result fatally. Locally applied, the fresh root is violently irritant to the 
skin, producing inflammation and vesication. 

Helleborin is an active poison, acting on the tongue like Aconite, 
and on the nervous system as a narcotic, producing in animals paresis of 
motion and sensation, cerebral and spinal congestion, dilated pupils and 
death. It is less irritant than Helleborein to the mucous membranes. 

Helleborein is less actively toxic to animals, but is very irritant, 
producing conjunctivitis, sneezing, salivation, nausea, vomiting and 
purging. It affects the heart like Digitalis, small doses frequently re- 
peated slowing its action, but large ones quicken it and then suddenly 
paralyze it through the pneumogastric nerve. Respiration is at first 
accelerated, then slowed and rendered laborious. Diuresis is a constant 
result, the kidneys and uterus are congested, gradual paralysis and severe 
convulsions follow, and death occurs by paralysis of the heart. 

Black Hellebore is an old remedy, having been highly esteemed by 
the early physicians in insanity, dropsies, worms, cutaneous affections and 
amenorrhcea. It has at present gone out of fashion, but might be use- 
fully employed in dropsies and as a revulsant in acute cerebral affections. 
Recently Helleborein has come into notice as a substitute for Digitalis 
in cardiac affections, as being of less bulk and more definite composition. 
Its action on the heart is obtained by doses much smaller than those 
necessary for its irritant effects on the gastro-intestinal canal. Its solu- 
bility in water and the freedom with which it can be used hypodermically 
are important qualities to recommend it. 



HOANG-NAN, or Hwang-Nao (Unofficial),— is the bark of Strychnos Gaul- 
theriana, Tropical Bind- weed, a creeping vine of the nat. order Loganiaceae, found in 
the mountains of Tonquin. It contains the alkaloids Strychnine and Brucine, thus 
resembling in composition its congeners Nux-Vomica and Ignatia, but differing from 
them, as they do from each other, in the proportional quantities in which the alkaloids 
are contained, — Brucine predominating in this plant, as Strychnine does in the other two. 

Like the other members of the Strychnos family, Hoang-Nan is an active tetanizer, its 
action generally corresponding with that of Nux-Vomica. It was first brought into notice 
by the missionary fathers stationed in the French colonies in Asia, they having found its 
employment general among the natives for leprosy and hydrophobia. Along the coast of 
Tonquin and Cochin- China, and in Pondicherry, Trinidad, Venezuela, etc., it has an 
established reputation in the two terrible diseases mentioned, also as a remedy for the 
bites of venomous serpents and other reptiles, scrofulous and syphilitic ulcers, indolent 



HUMULUS. 255 

sores, etc. It has been used successfully for malarial fevers, in lieu of quinine, and is 
highly spoken of by Father Brosse, as a stimulant to the intellect, without producing any 
subsequent depression. 

The dose of the powdered drug is about gr. iij-v ; of the aceto-alcoholic Extract, gr. 
l A- l A ; and of the concentrated Tincture, tt\J-v. 



HUMULUS, Hops, — the strobiles (fruit-cones) of Humidus Lupu- 
/us, a cultivated creeping plant of the nat. ord. Urticaceae. They are 
ovate, 1 to 1^ inch long, and consist of a hairy, undulating axis and 
several membranous, greenish scales, odor aromatic, taste bitter, aromatic 
and slightly astringent. Its constituents are wax, resins (50 per cent.), 
tannin (5 per cent.), a liquid volatile alkaloid named Lupuline, a Vola- 
tile Oil (2 per cent.) which consists in part of Valerol and Trimethyl- 
amine, and the crystalline, bitter principle, Lupulinic Acid (\\ per cent.). 
These, except tannin, are more abundant in the glandular powder of the 
strobiles, which is named Lupulin. 

Preparations. 

Tinctura Humuli, Tincture of Hops, — strength 20 per cent. Dose, gj-ij. 

Infusum Humuli, Infusion of Hops (Unofficial), — ^ ss to the pint. Dose, ^j-iv. 

Lupulinum, Lupulin, — is the glandular powder separated from the strobiles, of bright 
brownish-yellow color, aromatic and bitter taste. The Volatile Oil resides in the 
Lupulin grains, and contains Valerol, which is changed into Valerianic Acid by long 
exposure, giving a disagreeable odor to old hops. Dose, gr. v-xv. 

Extractum Lupulini Fluidum, Fluid Extract of Lupulin, — alcoholic. Dose, 

"l x -3h 

Oleoresina Lupulini, Oleoresin of Lupulin, — an ethereal extract. Dose, gr. ij-v. 
Tinctura Lupulini, Tincture of Lttpulin (Unofficial), — strength *^. Dose, gss-ij. 
Mineral acids and metallic salts are chemically incompatible with preparations of Hops. 

Humulus is a bitter tonic, and a feeble hypnotic, also somewhat dia- 
phoretic, astringent and anaphrodisiac. It increases the cardiac action 
and the cutaneous circulation. After slight cerebral excitement it pro- 
duces calm and a soporific disposition, especially if the solution admin- 
istered be strongly alcoholic. The stomachic and tonic effects are due 
to the bitter principle, lupulinic acid, and are found in bitter ale. The 
primary stimulant and secondary sedative effects are due to the volatile 
oil and are also possessed by ales and beer. 

Hops are used as a tonic and calmative in delirium tremens, in which 
a combination of the tincture with Tr. Capsici is very efficient and is an 
excellent substitute for alcohol. In dyspepsia of atonic form Humulus 
is an excellent stomachic tonic, and in nervous irritability the fluid ex- 
tract of Lupulin may be used as a calmative and hypnotic, or the hop- 
pillow, which certainly exercises considerable influence, imaginary or 
otherwise. A poultice of hops is a favorite domestic application in in- 
flammations and pain. Lupulin has been used with benefit in irritable 
bladder, and alcoholism, and as an anaphrodisiac in the treatment of 



256 HYDRANGEA HYDRARGYRUM. 

chordee, gonorrhoea, spermatorrhoea and other affections of the genito- 
urinary organs. 



HYDRANGEA (Unofficial), — is the root of Hydrangea arborescens, a plant of the 
nat. ord. Saxifragaceae, growing in the southeastern U. S. It is a white, tough root, 
having a thin brown bark which peels off in spots, inodorous, taste insipid, afterwards 
pungent. It contains gum, albumen, starch, resin, and a ferrous salt, with other salts. 
Dose, gss-^ij, best in fluid extract. A decoction of the root may be used in doses of 

Hydrangea has been long used by the Cherokee Indians in calculous affections, and 
reports of cases by competent observers show that it is of unquestionable utility in this 
class of disorders, promoting the removal of gravel from the bladder, and relieving pain 
during the passage of renal concretions through the ureters. Large doses produce ver- 
tigo, oppression of the chest, and considerable cerebral disturbance. 



HYDRARGYRUM, Mercury, Quicksilver, Hg,— is a shining, 
silver-white metal, fluid and slowly volatile at ordinary temperatures, 
solidifies at — 39 F., boils at 675 F., volatilizes without residue, 
insoluble in ordinary solvents, wholly soluble in nitric acid, odorless and 
tasteless, sp. gr. 13.558 at 59 F. 

Preparations of Mercury. 

Hydrargyrum cum Creta, Mercury with Chalk, Gray Powder, — has of Mercury 
38, Honey 10, Prepared Chalk 57, Water to 100, triturated together to a uniform gray 
powder. Dose, gr. ss-x. 

Massa Hydrargyri, Mass of Mercury, Blue Mass, Blue Pill, — has of Mercury 33, 
Liquorice 5, Althaea 25, Glycerin 3, Honey of Rose 34. Each grain contains gr. l / z of 
Mercury. Dose, gr. ss-xx. 

Unguentum Hydrargyri, Mercurial Ointment, Blue Ointment, — Mercury 50, Lard 
25, Suet 23, Oleate of Mercury 2, triturated together, until globules of Mercury cease to 
be visible under a lens having a magnifying power often diameters. 

Emplastrum Hydrargyri, Mercurial Plaster, — Mercury 30, Oleate of Mercury 1.2, 
Lead Plaster to 100. 

Emplastrum Ammoniaci cum Hydrargyro, Ammoniac Plaster zvith Mercury, — 
see ante, page 107. 

Chlorides and their Preparations. 

Hydrargyri Chloridum Corrosivum, Corrosive Mercuric Chloride, Bichloride of 
Mercury, Corrosive Sublimate, Hg Cl 2 , — heavy, colorless crystals, of acrid, metallic taste, 
and acid reaction; soluble in 16 of water and 3 of alcohol, in 2 of boiling water, 1. 2 of 
boiling alcohol, 4 of ether and in about 14 of glycerin. Dose, gr. ^-"tV 

Hydrargyri Chloridum Mite, Mild Mercurous Chloride, Subchloride of Mercury, 
Calot7iel, Hg 2 Cl 2 , — a heavy, white, impalpable powder, odorless and tasteless ; insoluble 
in water, alcohol or ether. Is an ingredient of Pil. Antimonii Co. and Pil. Catharticae 
Co. Dose, gr. ^V"*- 

Hydrargyrum Ammoniatum, Ammoniated Mercury, White Precipitate, Mercuric 
Ammonium Chloride, NH 2 HgCl, — is a white, insoluble powder, odorless and tasteless. 
Only used externally. 

Unguentum Hydrargyri Ammoniati, Ointment of Ammoniated Mercury, White 
Precipitate Ointment, — Ammoniated Mercury 10, Benzoinated Lard 90. 

Oxides and their Preparations. 

Hydrargyri Oxidum Flavum, Yelloiv Mercuric Oxide, HgO, — an orange-yellow, 
heavy, impalpable powder, odorless and tasteless, insoluble in water or alcohol, but wholly 
soluble in nitric or hydrochloric acid. Used to prepare : — 

Unguentum Hydrargyri Oxidi Flavi, Ointment of Yellow Mercuric Oxide, — 
strength I to 9 of Ointment (Unguentum). 



HYDRARGYRUM. 257 

Oleatum Hydrargyri, Oleate of Mercury, — has of the Yellow Oxide 20, Oleic 
Acid 80. 

Hydrargyri Oxidum Rubrum, Red Mercuric Oxide, Red Precipitate, HgO, — a 
heavy, orange-red, crystalline powder, having the same properties as the yellow oxide, 
from which it differs only in being crystalline, and in not such a minute state of sub- 
division. Dose, gr. -^"To- 

Unguentum Hydrargyri Oxidi Rubri, Ointment of Red Mercuric Oxide, — strength 
I to 8)4 of Unguentum and l / z of Castor Oil. 

Iodides and their Preparations. 

Hydrargyri Iodidum Rubrum, Red Mercuric Iodide, Red Iodide (Biniodide) of 
Mercury, HgL 2 , — a scarlet-red, crystalline powder, almost insoluble in water, soluble in 
130 of alcohol, in solution of Potassium Iodide or of Mercuric Chloride. Prepared by 
double decomposition between Potassium Iodide 5, and Mercuric Chloride 4 parts. Dose, 

g r - 70-to- 

Liquor Arsenii et Hydrargyri Iodidi, Solution of Arsenic and Mercuric Iodide, 

Donovan's Solution, — see ante, page 131. 

Hydrargyri Iodidum Flavum, Yellow Mercurous Iodide, Protiodide of Mercury, 

Hg 2 I 2 , — a dull green or greenish-yellow powder, insoluble in alcohol or ether and almost 

so in water. 

Acid Combinations and their Preparations. 

Liquor Hydrargyri Nitratis, Solution of Mercuric Nitrate, — a liquid containing in 
solution about 60 per cent, of Mercuric Nitrate, Hg(N0 3 ) 2 , with about 11 per cent, of 
free Nitric Acid. Prepared from the Red Mercuric Oxide 40, by Nitric Acid 45, and 
Distilled Water 15. Used as a caustic. 

Unguentum Hydrargyri Nitratis, Ointment of Mercuric Nitrate, Citrine Ointme?it, 
— prepared by dissolving Mercury 7, in Nitric Acid 17%, and adding Lard Oil 76. 

Hydrargyri Subsulphas Flavus, Yellow Mercuric Subsulphate, Basic Mercuric 
Sulphate, Turpeth Mineral, Hg(HgO) 2 S0 4 , — a heavy, lemon- yellow powder, practically 
insoluble in water or alcohol, soluble in nitric acid, and in 10 of HC1 without residue. 
Dose, as an emetic, gr. ij-v. 

Cyanide. 

Hydrargyri Cyanidum, Mercuric Cyanide, Hg(CN) 2 , — colorless, prismatic crystals, 
of bitter, metallic taste, soluble in 12.8 of water and in 15 of alcohol at 59 F. Dose, 

or i—i 

S r> TOO TO* 

Triturations. 

These may be prepared according to the general formula under " Triturationes" in the 
Pharmacopoeia, 10 parts of the substance to 90 of Sugar of Milk. Mercury itself or any 
of its salts may be so treated with excellent results, the particles being much finer and 
therefore more easily absorbed than if rubbed up with another agent. 

Unofficial Preparations. 

Lotio Hydrargyri Flava, Yellow Wash, — prepared by adding Corrosive Sublimate 
gr. xviij to Lime water ^x, producing the yellow oxide, a favorite application for syph- 
ilitic sores. 

Lotio Hydrargyri 'Nigra, Black Wash, prepared by adding Calomel gr. xxx, to 
Lime-water £ x, producing the black oxide, and used as an application to syphilitic sores. 

Unguentum Hydrargyri Nitratis Rubrum, — Red Ointment of Mercuric Nitrate, 
Brown Citrine Ointment, — differs from the official ointment only in being made with Cod- 
liver Oil, which gives it a brown color, and a more agreeable odor. 

Physiological Action. 

Mercury is tonic, purgative, alterative, antiphlogistic and sorbefacient, 

but not directly cholagogue. Some of its salts are corrosive poisons, 

others are local caustics, all produce by long-continued administration the 

peculiar cachexia termed Hydrargyrism. The metal itself is inert, but 

17 






2$& HYDRARGYRUM. ♦ 

by combination with the acids and fluids of the body becomes active, and 
is easily absorbed in any form, passing into the blood from the skin,' 
mucous membranes, lungs and stomach, in each case probably as an Oxy- 
albuminate of Mercury. Entering the stomach in any form it is first 
converted into a double Chloride of Sodium and Mercury, then uniting 
with the albuminous juices to form a complex molecule of Mercury, Sodi- 
um, Chlorine and Albumen, which being soluble in an excess of sodium 
chloride or albumen, exists in solution, and is easily absorbed, being 
decomposed in the blood and changed to the oxyalbuminate. Entering 
the intestines a purgative action is soon set up, of more or less severity 
according to the preparation used, a small portion only is absorbed, the 
rest being converted into a Sulphide and excreted with the faeces, unless 
combined with opium, which delays its progress through the intestines 
and permits of its greater absorption. In the blood its effects, in small 
doses, are tonic, but in quantity it indirectly produces impoverishment 
thereof, impairs the ozonizing function, diminishes the red corpuscles, 
and consequently disorders nutrition and deranges digestion. From the 
blood it enters the tissues, where it remains for an indefinite period, exert- 
ing a peculiar influence, termed "alterative," on all processes character- 
ized by growth of young cells, but not producing any definite anatomical 
changes either in the viscera or the nervous tissue, though in the latter a 
low form of inflammation arises, resulting in loss of coordination-power. 
It stimulates most of the glands of the body, to the production of patho- 
logical secretions, especially the salivary glands and the pancreas, and 
is excreted with comparative slowness by all the excretory organs, 
being found in the saliva, sweat, milk, urine and bile. It tends to accu- 
mulate in the liver, while stimulating its cells, and is not a cholagogue, 
though stimulating the flow of bile already secreted by reflex action on 
the bile-ducts due to its direct purgation of the duodenum. Its excretion 
is hastened and completed by the use of Potassium Iodide. 

In small doses administered for a short time the mercurial preparations 
are blood-tonics, improving its general condition, increasing the number 
of red corpuscles and the body weight. They soon begin to promote 
waste by stimulating the lymphatic system, and if the small doses are long 
continued or the quantity is increased, symptoms of mercurial poisoning 
begin to manifest themselves. 

The first symptoms of Hydrargyrism are fetid breath, swollen and 
spongy gums having a bluish line along their margins, stomatitis, sore and 
loosened teeth, inflamed and tender salivary glands pouring out a peculiar, 
thin saliva of foul odor in large quantity, and a metallic taste in the mouth. 
Anorexia, diarrhoea and fever follow, also ulceration and in some cases 
even gangrene of the lips and tongue. If the use of the drug be contin- 
ued nutrition will be greatly impaired through the extreme promotion of 



HYDRARGYRUM. 259 

retrograde metamorphosis, and various nervous disturbances will follow, 
the effects being emaciation, pallor, oedema, ulcerated skin, erythematous, 
vesicular or pustular eruptions, headache, insomnia, neuralgia, tremor 
through paresis of the muscles of the head and extremities, epilepsy, coma 
and convulsions. In pregnant women abortion will occur by reason of 
the impoverishment of the blood. Indeed, as Dr. Ringer said in the 
earlier editions of his Handbook of Therapeutics ', the phenomena produced 
by mercury are singularly similar to those which will result from syphilis, 
and the serious symptoms known as secondary and tertiary syphilis can 
be produced both by syphilis and by mercury. The drug is a specific 
antagonist to the syphilitic virus, probably by reason of its affecting the 
same organs and tissues of the body on a similar line of action, both poi- 
sons mutually destroying each other in the organism. It is certainly 
capable of bringing about a radical cure of syphilis, if introduced into 
the system in considerable quantity and its use protracted over a very long 
time, the action of the drug in all cases being kept short of ptyalism or 
any pronounced physiological effects. 

Salivation is most readily produced by Blue Mass, next by Calomel, 
and less easily by Gray Powder. Individuals differ greatly in their sus- 
ceptibility to the action of mercury, some persons having been affected 
after a single moderate dose. Children are not easily salivated. Inhala- 
tion of mercurial vapors is apt to affect the nervous system most ; its 
internal administration and that by inunction are more likely to produce 
salivation. 

The observations on the antiphlogistic and sorbefacient actions of 
Mercury are clinical rather than physiological, but it is generally agreed 
that exhibited in inflammation mercurials antagonize the increase of the 
haemic fibrin which is so constant an effect of the inflammatory process, 
and that in chronic diseases attended by the formation of semi-organized 
deposits, a mild mercurial course will almost insensibly remove the new- 
formed material. 

A not uncommon result of full doses of Blue Pill is an acute coryza of 
very severe character, which the writer has frequently observed to follow 
on neglect of the old-fashioned precaution to "work off" the mercurial 
by a saline cathartic. The symptoms produced are those of a severe 
attack of influenza, — epistaxis, conjunctivitis and obstinate muco-purulent 
discharge from the nasal passages being especially marked. Similar effects 
have been observed during physiological experiments with mercury on 
animals by Overbeck and Bennett. 

Notes on The Action of the Preparations. 
Metallic Mercury is not used internally except in the finely-divided 
form obtained in Blue Pill and Gray Powder, which are capable of pro- 



260 HYDRARGYRUM. 

ducing all the effects above described. Mercurial Ointment is the pre- 
paration generally used for inunction, a piece the size of a small nut 
being daily rubbed into the soft skin at the flexures of joints. The Oleate 
painted over the surface is a more cleanly method of making the same 
application. Both these preparations are efficient parasiticides. 

The Bichloride is the most actively toxic of the mercurial salts. It is 
probably the most active zymoticide and parasiticide, a solution of i part 
in 2000 being efficiently antiseptic for use as injections or dressings, and 
one of i to 250 being the usual strength for use against epizoa and para- 
sitic skin affections. It is a very active gastro-intestinal irritant, in toxic 
dose producing nausea, retching and vomiting, a metallic taste, constric- 
tion of the fauces, burning pain in the stomach, suppression of urine, 
bloody diarrhoea, collapse and death often preceded by convulsions. It 
affects specifically the lower bowel [Calomel preferring the upper intes- 
tine], and produces inflammation and ulceration of the rectum. It is, 
however, one of the most manageable and efficient of the mercurials 
when used in proper doses. 

The Subchloride (Calomel) is very insoluble and unirritating, taste- 
less, laxative in grain doses, decomposed by the alkaline contents of the 
intestines, the Oxide of Mercury being formed, and acts especially on the 
excrementitious glandular appendages of the upper intestine, stimulating 
the liver by indirect reflex action as a duodenal purgative. In the pres- 
ence of alkaline chlorides it is converted into the Bichloride, but not in 
sufficient quantity to render it dangerous in the gastro-intestinal canal. 
Externally applied it is very sedative to the mucous membranes and the 
skin. Calomel is a very efficient diuretic, in small doses frequently re- 
peated. 

Ammoniated Mercury is an Ammonio-Chloride, and a useful stimu- 
lant and parasiticide when used locally in the form of ointment. 

The Iodides are actively poisonous, the Red being much the most 
irritant, in overdoses producing symptoms and results very similar to 
those caused by the Bichloride. The Cyanide is also actively poisonous. 
The Yellow Subsulphate is a prompt and usually harmless emetic, but 
has occasionally produced fatal results by local irritant action. The 
Oxides are irritant, the Red being the most so, and are rarely used inter- 
nally. The Acid Nitrate is a good escharotic, the pain caused by it 
being transient though severe, and its caustic action being comparatively 
superficial. The Ointment of the Nitrate (Citrine Ointment) is more 
irritant than that of the Ammoniated Mercury, and generally needs dilu- 
tion. All these preparations may produce the constitutional effects of 
mercury, and their administration should be carefully watched for the 
first symptoms of mercurialization. 



HYDRARGYRUM. 26 1 

Antidotes and Inco?upatibles. 

Albumen in some form, the white of one egg to gr. iv of the Bichloride, forms the 
albuminate, which must be at once evacuated by emesis or the stomach pump, as it is 
soluble in excess of albumen or in the alkaline contents of the intestines. 

The Chlorides are incompatible with very many agents, and the Bichloride should be 
administered in distilled water or pill by itself, being easily decomposed. Calomel is 
decomposed by alkaline Iodides or Bromides. The combination of Calomel with Hydro- 
chloric Acid or Chlorides is apt to produce Corrosive Sublimate. In the "mixed treat- 
ment " of syphilis, a mercurial is combined in solution with Potassium Iodide, and the Red 
Iodide is the preparation usually selected, as the Bichloride is decomposed by the Potas- 
sium Iodide, Red Iodide of Mercury being precipitated. All trouble regarding incom- 
patibility can be avoided by using sugar of milk triturations according to the general 
official formula therefor. In this form, says Piffard, " a larger proportion of the drug is 
utilized for specific purposes, while but a small amount remains to give rise to local 
irritation." 

Therapeutics. 

Mercury is undoubtedly a specific in syphilis, but is not applicable to 
the tertiary form of that disease. It is best administered in very small 
doses carefully watched and stopped just short of ptyalism, but renewed 
and so continued for a long time. Fumigation by Calomel volatilized by 
heat, or inunction by the Oleate or by Mercurial ointment may be used 
when the stomach will not bear any mercurial. The hypodermic method 
is also used, employing a solution of the Bichloride gr. j to ^j each of 
glycerin and distilled water, of which the dose is n^x once daily; or the 
Albuminate in solution with Sodium Chloride. The Yellow Iodide in 
doses of gr. y 1 ^ to y§ thrice daily with Opium is the best preparation for 
internal use. Accuracy of diagnosis is an absolutely necessary prelimi- 
nary to the administration of Mercury, for where there is no syphilitic 
virus to be antagonized the constitutional effects of mercurials will become 
manifest sooner and may do great harm in feeble subjects, besides the risk 
of mistaking them for the results of the disease supposed to be present. 

Tonsillitis, parotitis and other acute glandular inflammations of the 
throat and neck may often be rapidly cured by Calomel gr. -^ or Gray 
Powder gr. -I- every two hours. In irritable stomach with obstinate vom- 
iting the same small doses of Calomel every half hour are very efficient. 
The dysentery of adults with slimy and bloody stools is best treated by 
small doses (gr. yJtf) °f tne Bichloride, and in the diarrhoea and dysen- 
tery (ileo-colitis) of infants Gray Powder gr. 1 or Calomel gr. -^ will be 
found very effective. In gastric ulcer and in the first stage of hepatic 
cirrhosis, the Bichloride in doses of gr. -^ to -fa thrice daily is a good 
remedy. Typhoid fever is treated in Germany by daily doses of Calomel, 
gr. x, for three days as an antipyretic. Diphtheria is by many practition- 
ers, considered to be best antagonized by Calomel in large doses, and in 
this affection the Cyanide has .many advocates given in doses of gr. j^q"- 
■jfty every hour, a weak solution being at the same time used as a gargle. 
Asiatic cholera is frequently treated by small, repeated doses of Calomel 
with Opium from the start. Inflammations of sthenic character in the 



262 HYDRASTIS. 

stage of exudation, especially when affecting serous membranes, are con- 
sidered by many authorities to be best met by the free use of mercurials, 
but this treatment is fast going out of favor, excepting in cases of iritis, 
which, however, is very often of syphilitic causation, and pneumonia, 
which is frequently treated, according to the best American authorities, 
with sedative doses (gr. xv-xx) of Calomel. 

In the general condition known as "biliousness," manifested by 
whitish or clay-colored stools, constipation, nausea, anorexia, coated 
tongue, slight jaundice, etc., mercurial purgatives have long been a rou- 
tine remedy, but mild saline purgatives are by many authorities considered 
equally efficient. As an antiseptic to the gastro-enteric tract in many 
forms of stomach and intestinal disorders (dyspepsia septica), the admin- 
istration of minute doses of the Yellow Oxide of Mercury will be found 
remarkably efficient. It is best used in trituration with sugar of milk, 1 
to 1000, and in daily doses of gr. & V~5V By the use of these small 
doses failing digestion and nutrition may almost certainly be improved. 

In membranous laryngitis or true croup the Subsulphate as an emetic 
is by many considered to have some specially beneficial influence. 

Locally, an ointment of Calomel 3J to §j of Lard is an excellent 
antipruritic, and ointments of the Chlorides and Iodides are much used 
in skin diseases, particularly psoriasis, herpes, acne, and pityriasis. In 
-parasitic affections a lotion of the Bichloride, gr. ij to §j of distilled 
water, or a 5 per cent. Oleate with ^jth part of Ether, are very efficient. 
The Oleate is a serviceable application to syphilitic indurations, but is not 
deemed advisable when ulceration exists. In conjunctivitis Calomel may 
be used as a sedative application, or still better an Ointment of the Yellow 
Oxide, gr. x to g of Vaseline, triturated to the utmost fineness before 
mixing. Goitre and enlarged spleen are often speedily reduced by rubbing 
into the skin covering them the Ointment of the Red Iodide somewhat 
diluted and applied before a hot fire or in the direct sunlight. The Acid 
Nitrate Solution is one of the best caustics for destroying chancroid and 
syphilitic warts and vegetations. Black and Yellow Wash are used as 
applications to syphilitic erosions and ulcerated indurations. 

As an antiseptic injection or application to dressings a solution of the 
Bichloride, gr. vijss in a quart of hot water ( 20 1 00 ), is probably the most 
efficient that can be used, and still weaker solutions (g x 00 ) are sufficiently 
antiseptic for most purposes. 



HYDRASTIS, Golden Seal,— the rhizome and roots of Hydrastis 
canadensis, a small plant of the nat. ord. Ranunculaceae, growing in most 
parts of the U. S. The rhizome is 1 y 2 inch long, rough, bent and branched, 
externally of a yellowish-gray color, internally a bright reddish-yellow, 



HYDRASTIS. 263 

having numerous thin, brittle rootlets, a slight odor and a bitter taste. 
It contains an, unnamed Resin and 3 alkaloids, Hydrastine, C 21 H 21 N0 6 , 
white and crystalline, soluble in alcohol, ether, etc., Berberine, C 20 H 17 NO 4 , 
yellow crystals soluble in hot water and alcohol, but not in ether (see page 
147), and Xanthopuccine, also yellow and crystalline. All these alkaloids 
unite with acids to form salts. From Hydrastine is prepared an oxidation 
product or artificial alkaloid, Hydrastinine, C n H u N0 2 , the Hydrochlorate 
of which is official. 

Preparations. 

Extractum Hydrastis Fluidum, Fluid Extract oj Hydrastis. — Dose, TTLv-xxx. 

Tinctura Hydrastis, Tincture of Hydrastis, — strength, 20 per cent. Dose, £ss-ij. 

Glyceritum Hydrastis, Glycerite of Hydrastis, — Hydrastis 2, in Glycerin I, by per- 
colation, with Alcohol and Water. Used as a local application. 

Hydras tininae Hydrochloras, Hydrastinine Hydrochlorate, C U H 11 N0 2 HC1, — the 
hydrochlorate of an artificial alkaloid derived from Hydrastine. Light yellow, amorphous 
granules, deliquescent, very soluble in water, also in 3 of alcohol. Dose, gr. j in 10 per 
cent, solution, as a hypodermic injection. 

Hydrastin (Unofficial), — an impure extract precipitated by Hydrochloric Acid from 
the alcoholic solution, chiefly consisting of Berberine Muriate. Dose, gr. ij-v. 

Physiological Action. 
Hydrastis is a simple bitter and a stomachic tonic. It promotes 
appetite and digestion and increases the secretions of the gastro-intestinal 
tract and the flow of bile, but if long used it will derange digestion and 
produce constipation. It is possessed of antiperiodic powers, and is a 
protoplasmic poison, arresting the movements of the white blood-corpus- 
cles. By many observers it is also considered alterative to the mucous 
membranes, deobstruent to the glandular system, cholagogue, diuretic 
and antiseptic. The alkaloid Hydrastine produces effects on the 
nervous system somewhat similar to those caused by Quinine, but seems 
to be devoid of toxic power, large doses only producing a sense of warmth 
in the epigastric region, and noises of a rushing character in the ears. 

Incoinpatib les . 

Tannic Acid, Hydrochloric Acid and the Alkalies are chemically incompatible with 
preparations of Hydrastis. 

Therapeutics. 
Hydrastis is chiefly used as a stomachic tonic, an antiperiodic, a mild 
laxative, and an antiseptic. Its alkaloid (Hydrastine) and extract 
(Hydrastin) are ranked high in the treatment of intermittents and chronic 
malaria, though much less efficient than Quinine. It is an excellent 
remedy locally and internally in all forms of catarrh, especially that of 
the stomach, duodenum, gall-ducts, bladder, uterus and vagina. Internally 
it is efficient in many glandular swellings, in chronic constipation due to 
a sluggish state of the liver or deficiency of the other intestinal secre- 
tions, in chronic dyspepsia, and as a substitute for alcohol in dipsomaniacs 
when a catarrhal state of the stomach has been induced. In gonorrhoea, 



264 HYDROCOTYLE HYDROGENII DIOXIDUM. 

gleet, and chronic nasal catarrh, it is locally employed with much benefit, 
also in syphilitic affections of the mouth, throat and nares. As a local 
alterative and antiseptic application it is highly recommended for unheal- 
thy ulcers and sores, cancerous ulcerations, mercurial and aphthous stoma- 
titis, rectal fissure, fistula and prolapse, internal and external hemorrhoids, 
cracks, fissures and abrasions of the nipples, erosion and ulceration of the 
cervix uteri, and in conjunctivitis with muco-purulent discharge. In 
gonorrhoea a very efficient injection is an infusion of Hydrastis, gj of the 
powdered root to gviij of boiling water, or the fluid extract diluted in the 
proportion of gss or 3J to the pint of water, but it should not be used 
until the acute stage has subsided. 

Hydrastinine has long been known as a uterine vaso-constrictor, and as 
such has been successfully employed in metrorrhagia. It has lately been 
credited with powerful qualities as an antispasmodic, and also as efficiently 
diminishing the excitability of the cerebral cortex. It is considered prefer- 
able to Hydrastine on account of its stimulant action on the cardiac mus- 
cle, and the persistent constriction which it produces in the walls of the 
vessels. The Hydrochlorate is employed in grain doses hypodermieally, 
using a 10 per cent, solution ; the injections being best made, for men- 
strual irregularities, during a few days previous to the expected term. It 
has been used with great benefit in uterine hemorrhage and dysmenorrhcea ; 
also in metritis, endometritis, myomata and pyo-salpingitis. More 
recently it has been employed in the treatment of hydrophobia, strych- 
nine-poisoning and epilepsy, in the latter case having been given per orem 
in doses of gr. %-% up to gr. ij daily \ and with benefit in four cases out 
of six. 



HYDROCOTYLE, Pennywort (Unofficial),— is the leaf of Hydrocotyle asiatica, a 
small plant of the nat. ord. Umbelliferse, a native of southern Africa and India. It con- 
tains a peculiar, oleaginous substance, Vellarine, which has a bitter, persistent taste, and 
is thought to be the active principle. It has long been used in its native countries as an 
alterative to purify the blood, and has been found of great service in eczema, lupus, pso- 
riasis, syphilitic and scrofulous sores, and in leprosy. An ounce of the dried plant or 
leaves is given daily in infusion. It causes great itching over the whole body, ovarian 
pain in females, and urinary irritation. In one case in which the drug was being given 
for lupus of the hand a severe orchitis was set up without any other apparent cause. It 
certainly exerts a markedly special influence on the genito-urinary tract. 



HYDROGENII DIOXIDUM, Hydrogen Dioxide, H 2 2 — is 

official in the aqueous Solution, viz. : — 

Aqua Hydrogenii Dioxidi, Solution of Hydrogen Dioxide, Solution 
of Hydrogen Peroxide, — a slightly acid, aqueous solution, containing, when 
freshly prepared, about 3 per cent, of the pure Dioxide, corresponding 
to about 10 volumes of available oxygen. Prepared by agitating Barium 



HYDROGENII DIOXIDUM. 265 

Dioxide in cold distilled water, adding Phosphoric and Dilute Sulphuric 
Acids, filtering and diluting to the required strength. Dose, 3J-iij, 
diluted with 3 to 4 of water. 

A colorless liquid., without odor, slightly acidulous, producing a peculiar sensation and 
soapy froth in the mouth, of sp. gr. 1. 006 to 1.012 at 59 F., liable to deteriorate by age, 
heat, or protracted agitation. 

Physiological Action and Therapeutics. 

Hydrogen Dioxide, or Oxygenated Water, commercially known as 
Peroxide of Hydrogen, consists of water, to which nascent oxygen has 
been presented, whereby an additional atom of this element has entered 
into combination with the hydrogen, producing H 2 2 . In its purest 
condition it is a colorless liquid of sp. grav. 1.452, evolving when heated 
475 times its volume of oxygen gas. The commercial article is an aque- 
ous solution thereof, containing about 15 volumes of available oxygen, at 
which strength it is said to be permanent at ordinary temperatures : but it 
is found to undergo decomposition, in time, especially if agitated. When 
fresh, it is one of the most powerful oxidizing agents known, by reason 
of the facility with which it parts with oxygen to oxidizable substances 
brought in contact with it. It is, consequently, a powerful, yet non-toxic 
antiseptic, destroying morbid products and organized fermentations to 
which it is applied. In contact with a suppurating surface, it generates a 
white foam, as the result of its action on the pus. This soon subsides, 
leaving the subjacent tissue cleansed of all morbid secretions. One part 
added to 1000 of water containing sewage or infectious microbes, is suffi- 
cient to destroy the various organisms therein, if allowed to act for 24 
hours. 

As a bleaching agent, Hydrogen Dioxide has long been employed on 
delicate fabrics, and on the human hair for the production of the "bleached- 
blonde" hue so fashionable lately in certain circles of society. Asa 
cleansing agent for foul wounds, ulcers, sores, and the like, it is highly 
efficient ; and has been used with great benefit as a gargle or spray to the 
throat and nasal passages, in quinzy, croup, diphtheria, scarlet fever, 
ozaena, and other morbid conditions of these parts. As a diagnostic agent 
in determining the presence of pus, it is injected into the part in which 
suppuration is suspected, and indicates its contact with pus by causing 
an almost immediate swelling up of the part. If such a spot is cut into at 
once, pain is not felt. In this manner a number of suppurating buboes 
have been treated with great success. 

As a disinfectant of drinking water suspected of pollution it is highly 
recommended, as it does not impair the taste or other potable qualities 
of the water, in the small quantity (1 to 1000 parts) needed for its effi- 
cient action. Used internally, it imparts oxygen to the blood, improves 
digestion, and relieves spasm of the respiratory apparatus, — aborting the 



266 HYOSCYAMUS. 

paroxysms of whooping-cough. It gives great relief in chronic bron- 
chitis with dyspnoea, and operates well in phthisis by promoting diges- 
tion, palliating cough, and giving increased activity to chalybeate reme- 
dies. 

Pyrozone is the name given by a well-known manufacturer to a concentrated solution 
of Hydrogen Dioxide in Ether. It professes to contain about 50 per cent, of the dioxide, 
and is a very potent and efficient oxidizer, intended for external use only. It has abund- 
ant applications in the practice of surgeons. (Squibb.) 

Sanitas is a proprietary solution for disinfecting purposes, containing Hydrogen Diox- 
ide, and described under Terebinthina. 



HYOSCYAMUS, Henbane,— the leaves and flowering tops, col- 
lected from plants of the second year's growth, of Hyoscyamus niger, a 
biennial plant of the order Solanaceae, growing in Europe and the north- 
ern U. S. The leaves are ovate, often ten inches long and 4 broad, of 
grayish-green color, glandular-hairy, midrib prominent, odor heavy and 
narcotic, taste bitter and acrid. It contains an alkaloid Hyoscyamifie, 
C 17 H M NO s , which is isomeric with Atropine and identical with Daturine 
and Duboisine, occurring as an oily liquid or in tufted crystals of silky 
lustre and yellow color, soluble in hot water, alcohol or ether. Another 
substance, JTyoscine, is by some authorities considered a derivative of 
Hyoscyamine, by others a second alkaloid. It is semi-liquid, isomeric 
with Atropine, and yields Tropic Acid and Pseudotropine. Hyoscyamus 
leaves also contain a fatty Oil and much Potassium Nitrate, while from 
their destructive distillation an empyreumatic Oil is obtained which is a 
powerful narcotic. 

Preparations. 

Extractum Hyoscyami, Extract of Hyoscyamus, — Dose, gr. j, when active. 

Extractum Hyoscyami Fluidum, Fluid Extract of Hyoscyamus, — Dose, TT^v-xx. 

Tinctura Hyoscyami, Tincture of Hyoscyamus, — Strength 15 per cent. Dose, 3J- 
iv ; as a hypnotic ^ ss-j is necessary. 

All the preparations of Hyoscyamus are uncertain in strength and in activity, so much 
so that the effective dose of the extract official in U. S. P. 1870 ranged from 2 to 250 
grains. 

Hyoscyaminae Sulphas, Hyoscyamine Sulphate, (C 17 H 23 N0 3 ) 2 H ? S0 4 , — small, yellow 
scales or crystals, which are deliquescent, of bitter taste, and very soluble in water and in 
alcohol. It varies much in purity of the base and consequently in activity. A grain of 
the commercial article, which was formerly very impure, has been given with impunity, 
but gr. ^L of the pure alkaloid has produced violent poisoning. Dose, hypodermically, 
should not exceed gr. g 1 -; by the mouth gr. i^-j may be given in urgent cases. 

Hyoscyaminae Hydrobromas, Hyoscyamine Hydrobromate, C 17 H 23 N0 3 HBr, — a 
yellowish-white, amorphous mass, or prismatic crystals, of tobacco-like odor, and acrid, 
bitter, nauseous taste; deliquescent, soluble in y^ of water and in 2 of alcohol. Dose, as 
the Sulphate. 

Hyoscyamine of good quality is difficult to procure and is very expensive, while 
Duboisine is easily obtained in any quantity, so that if these alkaloids prove to be physio- 
logically as well as chemically identical, as is now claimed, the latter will be used to the 
exclusion of the former. 

Hyoscinae Hydrobromas, Hyoscine Hydrobromate, C 17 N 21 N0 4 HBr-|-3H 2 0, — color- 
less, transparent, rhombic crystals, odorless, of acrid, slightly bitter taste; soluble in 2 of 
water and in 13 of alcohol. Dose, gr. xhifit ^v mouth, gr. a&TfsV hypodermically. 



HYOSCYAMUS. 267 

Physiological Action. 

Hyoscyamus has similar action to that of Belladonna, Duboisia and 
Stramonium, except that it is the least powerful and irritant of the group, 
but the most calmative and hypnotic. The delirium produced by it is 
never furious and is without hyperemia, but is accompanied by insomnia. 
It is more stimulant to the vaso-motor system and to the cardiac 
accelerator apparatus than is Stramonium, but is less active on the 
pneumogastric. It has decidedly laxative and carminative effects on the 
intestines and a very marked sedative influence on the urinary passages. 

Hyoscyamine corresponds in action to the plant and its congeners, 
being considered by many authorities as almost identical with Atropine, 
but less powerful. No death has directly resulted from it. Except in 
very large doses it is more an anodyne or anaesthetic than a narcotic or 
soporific. It is a mydriatic, excites the cerebral functions and depresses 
the spinal. Many observers deny that it has any soporific influence. 

Hyoscine is a cerebral and spinal sedative, and a powerful hypnotic, 
directly depressing the higher functions of the brain, and affecting the 
heart but feebly. It is probably the action of this agent which prevents 
Hyoscyamus having the excitation and delirium of Belladonna. After 
the hypodermic administration of a full dose (gr. J-^), there is, in most 
subjects, a period of semi-maniacal delirium, with flushed face and dry 
mouth, lasting from one to two hours, and followed by the sedative 
action of the drug, during which the pulse-rate and frequency of respi- 
ration, at first quickened, are distinctly lowered. It especially affects 
the motor tract of the spinal cord and the cerebral cortex, slightly de- 
presses the heart, but paralyzes respiration. It is free from irritant qual- 
ities and may be used hypodermically. Its habitual use brings on mus- 
cular paralysis and delirium of violent character. It is coming into use 
as a hypnotic by alcoholics and nervous subjects, and will probably ere 
long be responsible for many deaths. As a mydriatic its reputation is 
doubtful, some observers claiming greater power for it in this respect 
than that of Atropine, while others say that mydriasis may follow its use 
but is not always produced by even large doses. 

Antagonists and Incompatibles. 

These are the same as for Belladonna (see ante, page 143). Liquor Potassae though 
incompatible is frequently prescribed in combination with Hyoscyamus. All the fixed 
caustic alkalies decompose its alkaloid, as also those of the allied plants. 

Therapeutics. 
Hyoscyamus is a valuable narcotic and is chiefly used as a hypnotic and 
anodyne when Opium is contraindicated, and for children. It is by far 
the best agent to use in acute mania with high motor excitement, obsti- 
nate insomnia and varied hallucinations. Chronic mania has been more 



268 ICHTHYOCOLLA. 

benefited by it than by any other drug, and it is very efficient in insanity 
characterized by frequent delusions. In delirium tremens and the delir- 
ium of fevers it is an excellent hypnotic, and the monomania of hypo- 
chondriacs is alleviated and often cured by it. Whooping-cough, 
nervous coughs, and especially a dry, tickling night-cough, are greatly 
alleviated by full doses of Hyoscyamus. It is also efficient in colic of 
various forms, to palliate the trembling of paralysis agitans and mercurial 
tremor, and to relieve the pains and disordered coordination of locomotor 
ataxia. In constipation it is a good remedy, the extract being much 
employed in combination with other purgatives to render them more effi- 
cient and less drastic, but the quantity used is generally too small to be 
of any particular benefit. The tincture is an efficient remedy in irrita- 
bility of the bladder from any cause. 

Hyoscyamine may be used for the same purposes as Atropine, but 
being liable to considerable variation in purity and activity, it is not a 
popular agent with the profession. 

Hyoscine has been used in neuralgia, whooping-cough, insomnia from 
cerebral excitement, delirium tremens, asthma and enteralgia, also in oph- 
thalmic practice as a mydriatic. The Hydrobromate is the salt in general 
use, in doses of gr. yig-hypodermically, gr. -^to^perorem. It efficiently, 
but temporarily, controls the shaking of paralysis agitans ; and is highly 
useful at times in the treatment of the morphine-habit, especially for the 
extreme restlessness and insomnia resulting from the final withdrawal of 
that drug. In such cases, however, it must be used only for extreme 
cases, and should not be given habitually, as it excites a high degree of 
delirium in most subjects, at first, followed after about 2 hours by its 
secondary sedative influence. Excessively or carelessly employed, in 
such cases, it is liable to seriously derange the mental faculties, in the 
same manner as Atropine ; and is probably responsible for many of the 
impaired intellects which emerge from the so-called "Bichloride of Gold 
Cures " for alcoholism. 



ICHTHYOCOLLA, Isinglass, — is the swimming bladder of Acipenser Huso, and 
of other species of Acipenser (Sturgeon). It occurs in horny sheets, semi-transparent, 
iridescent, soluble in 24 parts of boiling water, forming on cooling a transparent jelly. It 
is the purest form of Gelatin known. 

Preparation. 

Emplastrum Ichthyocollae, Isinglass Plaster, Court Plaster, — consists of Isinglass 
10, Glycerin I, Alcohol 40, Water and Tincture of Benzoin, spread on taffeta and allowed 
to dry. 

Isinglass is slightly nutritious, but has no advantage over any other form of gelatin. It is 
used for clarifying liquids, and in solution as a test for tannin. The plaster is a common 
protective application. 



IGNATIA ILLICIUM. 269 

IGNATIA, St. Ignatius' Bean (Unofficial),— is the seed oi 
Strychnos Ignatii, a small tree of the nat. ord. Loganiaceae, native in the 
Philippine Islands, and also called Ignatia Amara. The seed is about an 
inch long, ovate, irregularly angular, hard and horny, enclosing an 
irregular cavity containing an oblong embryo, inodorous, taste very 
bitter. It contains the alkaloids Strychnine and Btucine, about 1 per 
cent, of each, for a description of which see the title Nux Vomica. 

Tinctura Ignatiae, Tincture of Ignatia (Unofficial), — strength 10 per cent. Dose, 
|j,ij-x. 

Physiological Action and Therapeutics. 

Ignatia closely resembles Nux Vomica in action, a poisonous dose pro- 
ducing the same exaltation of the spinal functions, with muscular twitch- 
ing, tetanic spasms, and death by asphyxia through tetanic fixation of the 
respiratory muscles, but containing a greater quantity of Strychnine than 
the latter it is more powerful in the same dose. It especially exalts the 
susceptibility of the sensory nerves, and of the nerves of special sense, 
for a time, but an opposite condition soon succeeds, manifested by numb- 
ness and torpor with great mental depression. It causes a feeling of con- 
striction about the throat and a sensation of intense anguish at the pit of 
the stomach. Its antagonists and incompatibles are the same as for Nux 
Vomica. 

Ignatia is recommended for hysteria, to control the general hyperaes- 
thesia, also for insomnia, clavus hystericus, mental excitement or depres- 
sion, aphonia, diseased appetite, and convulsive crying or laughing. It 
will often remove the intercostal neuralgia of hysterical subjects, and the 
sensation as of a ball rising to the throat (globus hystericus). Cerebro- 
spinal irritability is diminished by small doses though excited by large 
ones, Ignatia being probably the most efficient controller of functional 
phenomena of the cerebro-spinal axis. In the convulsions of children 
from intestinal irritation without cerebral congestion, and in insomnia 
from nervous erethism, small doses of Ignatia are used with the happiest 
results. It is by many practitioners preferred to Nux Vomica as a stom- 
achic tonic, and is useful in the treatment of dyspepsia, hypochondriasis 
and various nervous affections. 



ILLICIUM, Star Anise, — is the fruit of Illicium verttm, an Asiatic shrub of the nat. 
ord. Magnoliacese, and is formed by 8 boat-shaped carpels arranged in a star shaped whorl 
around a central axis which is the top of the stalk. Each carpel contains a single seed, 
flat, oval, glossy, and of a brownish-yellow color. It contains a Volatile Oil which is 
chemically and practically identical with the Oil of Anise. Another species, Illicium 
anisatum {Illicium 1'eligiosum), is very poisonous, causing vomiting, epileptiform convul- 
sions, dilated pupils and cyanosed countenance. Its carpels are more woody, shrivelled 
and wrinkled, and end in a curved beak. Illicium is recognized officially as a source of 
the Oil of Anise, and has similar actions and uses to those of Anisum. (See ante, page 
115.) 



27O INULA IODUM. 

INULA, Elecampane,— is the root of Inula Helenium, a plant of the nat. ord. 
Composite, growing in Europe and N. America. It occurs in slices or sections, exter- 
nally grayish- brown, internally white, fleshy and full of resin cells, of peculiar, aromatic 
odor, pungent and bitter taste. It contains a volatile oil, a resin, a crystalline substance 
named Helenin, C 6 H 8 0, and a peculiar principle resembling starch, Inulin, C 6 H 10 O 5 , 
which is found in Arnica, Taraxacum and other plants. Having the same chemical com- 
position as starch, Inulin differs from the latter in being colored yellow by iodine, and 
depositing from its solution in hot water as the solution cools. It is contained in Elecam- 
pane in large quantity, from 19 to 44 per cent., the latter in autumn. There are no offi- 
cial preparations, but a decoction (^ss to Oj) may be given in doses of ^j-ij. Dose of 
the powdered root, gr. xx-^j. 

Inula is a gentle stimulant to the secretory organs, and is said to be expectorant, dia- 
phoretic and diuretic. In large doses it causes nausea and vomiting. It was formerly 
supposed to be emmenagogue and was much used in amenorrhcea. It is now chiefly em- 
ployed as a domestic remedy in chronic bronchitis and dyspepsia, and to promote the 
eruption in exanthematous fevers. 



IODUM, Iodine, I, — is a non-metallic element, existing in sea-weed, 
sea- water, some fresh waters and fresh-water plants, also in sponge, oysters, 
eggs, cod-liver oil, rock salt and several ores. It occurs in bluish-black 
rhombic plates, of metallic lustre, peculiar odor, acrid taste, and neutral 
reaction, sparingly soluble in water (1 in 5000), readily so in ether, and 
in 10 of alcohol, also in a solution of potassium iodide or sodium chlo- 
ride. It volatilizes slowly at ordinary temperatures, and produces a dark- 
blue color with gelatinized starch in a cold solution. Internally it is 
generally administered in the form of an Iodide or as the Compound 
Solution of Iodine. Dose, gr.ss-j. 

Preparations of Iodine. 

Tinctura Iodi, Tincture of Iodine, — strength 7 per cent. Dose, TnJ-v; but it is gen- 
erally used as a local application, or for injection into cavities. 

Liquor Iodi Compositus, Compound Solution of Iodine, LugoVs Solution, — has of 
Iodine 5, Potassium Iodide 10, in Distilled Water to 100. Dose, Try-x, well diluted. 

Unguentum Iodi, Ointment of Iodine, — has of Iodine 4, Potassium Iodide 1, Water 
2, Benzoinated Lard 93. 

Iodized Phenol, Carbolated Iodine (Unofficial), — is a mixture of Iodine and crystal- 
lized Carbolic Acid in varying proportions, generally I of the former to 4 of the latter: 
for local use, especially in gynecology. 

Iodides and their Preparations. 

Ammonii Iodidum, Ammonium Iodide, NHJ, — a deliquescent, granular, white 
salt ; soluble in 1 of water and in 9 of alcohol at 59 F. Dose, gr. ij-x or more. 

Potassii Iodidum, Potassium Iodide, KI, — a colorless, deliquescent, crystalline salt, 
of saline and bitter taste; soluble in 0.8 of water and in 18 of alcohol at 59 F. Dose, 

g r - v -3h 

Unguentum Potassii Iodidi, Ointment of Potassium Iodide, — has of the Iodide 
12, Sodium Hyposulphite 1, Hot Water 10, Benzoinated Lard 77. 

Sodii Iodidum, Sodium Iodide, Nal, — minute, deliquescent crystals; soluble in 0.6 
of water and in 1.8 of alcohol. Dose, gr. v-3 j. 

Strontii Iodidum, Strontium Iodide, SrI 2 (H 2 0) 6 , — colorless, hexagonal plates, of 
bitter, saline taste ; very soluble in water and in alcohol. Dose, gr. v-xxx. 

Iodoformum, Iodofor??i (Pormjyl Iodide), CHI 3 , — small, lemon-yellow, lustrous crys- 
tals, of saffron-like and very penetrating odor; very slightly soluble in water, soluble in 
about 52 of alcohol, 12 of boiling alcohol, and in 5.2 of ether; very soluble in chloroform, 
benzin and fixed and volatile oils. Its solutions have neutral reaction. Dose, gr. j-v. 



IODUM. 271 

To remove its odor without forming a compound the best agents are Thymol (gtt. ij ad 
5j), Oil of Mirbane (gtt. vj ad gr. xv), Oil of Bitter Almonds, or Oil of Rose (gtt. j ad 
gj). Oil of Turpentine is particularly serviceable in removing the odor from the hands, 
or from spatulas, mortars, etc. 

Unguentum Iodoformi, Iodoform Ointment, — Iodoform, finely pulverized, 10, Ben- 
zoinated Lard 90, thoroughly mixed by trituration. 

Other Iodides and preparations thereof are — Argenti Iodidum, Arseni Iodidum, 
Liquor Arseni et Hydrargyri Iodidum, Hydrargyri Iodidum Rubrum, Hydrargyri Iodidum 
Flavum, Syrupus Ftrri lodidi, Pilulse Ferri lodidi, Plumbi Iodidum, Sulphuris Iodidum 
and Zinci Iodidum. As these preparations are allied in action and uses less to Iodine 
than to the other elements in their composition, they are described under other titles. 
(See Argentum, Hydrargyrum, etc.) Ethyl Iodide or Hydriodic Ether is described 
under vEtber (see ante, page 86). 

Preparation of Hydriodic Acid. 

Syrupus Acidi Hydriodici, Syrup of Hydriodic Acid, — contains I per cent, of ab- 
solute Hydriodic Acid, HI. Dose, 3J-iv, well diluted. 

Physiological Action. 

Iodine is irritant to the mucous membranes and to the skin. Applied 
to the latter it stains a deep yellowish-brown color and combines with 
the albumen of the tissue, causing considerable pain and subsequent ex- 
foliation of the epidermis. Vesication may be quickly produced if the 
quantity used be large. Inhaled its vapor irritates the respiratory 
mucous membrane, producing sneezing, cough, dyspnoea, also pain in 
the chest and the frontal sinuses. In the gastro-intestinal canal it is 
equally irritant, but is gradually converted into the iodide or iodate of 
sodium, in which form or as an albuminate it is absorbed into the blood. 
Iodine decomposes organic molecules, and in the presence of phospho- 
retted or sulphuretted gases it acts like chlorine but more feebly, uniting 
with their hydrogen and thus breaking up those noxious compounds it is 
disinfectant and deodorant. 

The Iodides of Sodium, Potassium, etc., are very diffusible and are as 
rapidly excreted ; setting free nascent oxygen (Ozone) and Iodine at the 
points of elimination, they are remotely irritant to the mucous mem- 
branes, setting up violent coryza, with soreness of the throat, acute con- 
junctivitis, profuse mucous discharges, headache and irritation of the 
kidneys and the skin. Intravenous injections of these salts produce at 
first a rapid elevation of arterial pressure with acceleration of the cardiac 
rate ; followed by slowing of the heart, and later on, lowered blood-pres- 
sure with increased heart rate. If used for any length of time they 
induce great waste and rapid elimination of waste products, causing 
anaemia, emaciation and mental depression ; but these effects are 
credited chiefly to the metallic constituent, being most severe from the 
potassium salt. They combine with certain poisons in the system, partic- 
ularly Lead, Mercury, and the products of the syphilitic disease, hasten- 
ing their elimination. Iodism is the term applied to the general condi- 
tion produced by these agents, and comprises the symptoms above noted 



272 IODUM. 

together with frontal headache, ptyalism, a saline taste in the mouth, 
dysphagia, temporary impotence, and an acneform eruption on the face 
and limbs. Sometimes the eruption is furuncular or even purpuric. It 
is less apt to result from the use of the Strontium Iodide than from that 
of the others. The copious dilution of these preparations with water 
promotes their excretion, and to a great extent prevents the development 
of unpleasant results. 

Iodoform contains from 94 to 97 per cent, of Iodine and naturally 
resembles the latter in action. Locally its action is anaesthetic and pow- 
erfully antiseptic. It is one of the best agents to prevent decomposition 
and to destroy the germs of putrefaction and of disease, but must be 
carefully employed, as when used in quantity on an extensive^raw surface 
it has often produced fatal results with symptoms of narcotic poisoning. 
The first sign of its dangerous absorption is increase of temperature, which 
may reach 104 or more, then headache, quick and feeble pulse, marked 
anxiety and restlessness, and suddenly collapse and death may supervene. 
The quantities which have produced fatal results from local absorption 
have varied from 525 to 4500 grains. In small doses internally it is con- 
sidered to be a tonic and alterative, wasting does not occur, but the body 
weight increases and the general condition improves. In these respects 
its action markedly differs from that of Iodine or the Iodides. In medic- 
inal doses internally administered for any length of time it may cause 
profuse salivation. 

Ethyl Iodide (see ante, pages 86 and 89} is used by inhalation to bring 
the system rapidly under the influence of Iodine. It is a good antispas- 
modic and general stimulant and a very slow anaesthetic. 

Antagonists and Incompatibles. 

Restorative agents and vaso-motor tonics, Quinine, Digitalis, etc., are therapeutically 
antagonistic. Starch is the antidote to free Iodine, but the stomach must be evacuated, as 
the Iodide of Starch is not inactive. The mineral acids 7 metallic salts, ammonia and 
vegetable alkaloids are incompatible with Iodine, and if the potassium salt be prescribed 
with Potassium Chlorate a poisonous compound will result. In chronic poisoning by the 
iodides a free salivary flow induced by chewing Pyrethrum root will hasten the elimina- 
tion of the drug. 

Therapeutics of Iodine. 
The tincture or the compound solution are much employed locally as 
counterirritants and by injection into cavities as alterative applications, 
instances of which are their use in glandular tumors, hypertrophied ton- 
sils, cervical and ovarian cysts, empyema, hydrocele, etc. In various skin 
diseases, as chloasma, lentigo, lupus, the tincture or a glycerite is well 
applied, and in many splenic and hepatic disorders of chronic type the 
ointment or tincture is a favorite counterirritant application. In sores, 
ulcers, and fissures, the Iodide of Starch or a mixture of Iodoform and 
Tannin, are strongly recommended, and the tincture is much used locally 



IODUM. 273 

to promote absorption of the products of acute inflammations. In acute 
catarrh and hay-fever inhalations of Iodine-vapor, or that from Iodized 
Phenol are very serviceable, and in the vomiting of pregnancy 1- to 5- 
drop doses of the tincture every hour are often efficient. The compound 
solution well diluted is given thrice daily in typhoid fever with good 
results in many cases, and in malarial fevers the same preparation com- 
bined with Carbolic Acid has remarkably curative power. In strumous 
conditions Iodine internally is much more efficient than any of the 
Iodides. 

Therapeutics of the Iodides. 

Potassium Iodide is the most frequently used of the Iodides, and is the 
form in which Iodine is generally administered internally. It is usually 
administered in simple solution or in the compound infusion or syrup of 
Sarsaparilla. Though its mode of action has never been explained satis- 
factorily, it is known by clinical experience to counteract many patholog- 
ical conditions, to promote the absorption of morbid products, and the 
elimination of several metallic poisons. It is almost of specific rank in 
tertiary syphilis and its results, as neuralgiae, paralyses from gummata, 
ulcerations, syphiloma of the internal viscera, lupus, chronic rheumatism 
and sciatica, in all of which when of syphilitic origin this iodide in large 
doses (50 to 150 grains daily) to saturation of the system will speedily 
cause improvement. So in mercurial poisoning and other chronic metal- 
lic toxsemise, the best treatment is by rapid saturation with Potassium 
Iodide. The products left behind by pneumonia, pleurisy and pericar- 
ditis often yield to moderate doses (5 grains), which if used for a pro- 
longed period seem to retard the changes of chronic nephritis. It is the 
best remedy for the early stage of hepatic cirrhosis, and acts as a most 
efficient expectorant in chronic bronchitis. Aneurisms are often cured 
by large doses (20 to 30 grains) of Potassium Iodide, the sac becoming 
solid by fibrinous deposit. In acute catarrh and hay-fever, it is useful 
with Arsenic, the Iodized Phenol being at the same time used locally in 
weak solution. In tonsillitis and simple sore throat a weak solution (gr. 
ij-v to the J) is a good gargle, and in large doses it is often efficient in 
spasmodic asthma induced by bronchial catarrh. 

Ammonium Iodide in grain dose repeated frequently is an excellent 
remedy in acute catarrh, hay-fever, duodenal catarrh and its accompany- 
ing jaundice, in chronic and capillary bronchitis, and in catarrhal pneu- 
monia to prevent caseation of the products. In the first stage of hepatic 
cirrhosis and in chronic malarial poisoning it is equally efficient adminis- 
tered in conjunction with Arsenic. Being somewhat more irritating than 
the other iodides it is usually given in smaller quantity, but being less 
stable it is more energetic in action. 

Sodium Iodide may be used instead of the potassium salt, in all affec- 
18 



274 IODUM. 

tions in which the latter is indicated : but requires to be administered in 
somewhat larger doses, being less active and less toxic. Strontium 
Iodide is still less liable to produce eruptions, and has been used with 
benefit in scrofulous, rheumatoid and cardiac disorders. 

Hydriodic Acid is used as a substitute for Iodine and the Iodides. As 
an alterative it is believed by some to possess all the powers of Iodine 
while it is much less offensive to the taste and the stomach. It has been 
used with benefit in asthma and bronchitis. The acid itself is not now 
official, as it is liable to change by the development of free Iodine. 

Iodoform is chiefly employed in local diseases as an antiseptic, anaes- 
thetic and alterative agent. It may be dusted in fine powder over a wound 
or sore, or used in ethereal solution to saturate gauze or absorbent cotton. 
It is particularly useful as an application to sloughing and phagedenic 
ulcers, gunshot wounds, chancroids, fistulae, sinuses and painful affections 
of the rectum or uterus. Internally it may be used as a general tonic and 
alterative in syphilis and other cachexias, also for neuralgia, and is fre- 
quently prescribed with Iron. Triturated with Tannin it forms a useful 
application to the cervix uteri in erosions and ulcerations thereof, or an 
Iodo-tannin may be prepared by saturating the Tincture of Iodine with 
Tannic Acid, and applied on a cotton tent to the uterine mucous mem- 
brane in many chronic affections of that organ. Tuberculosis is success- 
fully treated by Iodoform, which certainly does check the activity of the 
bacillus of that disease. Diabetes has been apparently cured by Iodoform, 
and syphilis may be combated successfully thereby in lieu of Potassium 
Iodide. 

Unofficial Substitutes for Iodoform. 

Aristol, Dithymol Iodide, — is a combination of Iodine and Thymol, containing nearly 
46 per cent, of the former, and is prepared by adding an alkaline solution of Thymol to 
a solution of Potassium Iodide and Iodine. It occurs as an amorphous, odorless, unstable, 
non-toxic powder, of a brown-red or fawn color, insoluble in water or glycerin, sparingly 
soluble in alcohol, freely so in ether, chloroform and fatty oils. As its -Iodine leaves it 
readily, no heat should be used in dispensing it, and it should not be mixed with alkalies, 
metallic oxides, or starch. It is used locally as a substitute for Iodoform. 

Aristol is highly praised by those who have used it in the local treatment of ulcers, 
wounds, and other breaches of the tissues; in which it is considered nearly, if not quite, 
as efficient as Iodoform, with the great advantage of being odorless. Excellent results 
have been obtained with it in the treatment of indolent soft ulcers, lupus, psoriasis, 
syphilitic ulcerative processes, eczema, severe burns, affections of the ear, nose and 
pharynx, as well as in the various cases in gynecological and dermatological practice in 
which Iodoform has hitherto stood supreme. Its prolonged use may give rise to chronic 
iodine poisoning. 

Aristol is best applied in powder, in solutions in Oil or Ether (5 to 10 per cent.), or as 
ointments with a base of Lanolin or Vaseline (5 to 10 per cent.). A useful application is 
a liniment, prepared by dissolving 5 grains of Aristol in gij of a mixture of equal parts 
of Ether and Alcohol, then incorporating £] of soft Soap therewith. 

Europhen, Isobutyl-orthocresol Iodide, — is produced by the action of Iodine upon 
Isobutyl-orthocresol in a solution of Potassium Iodide, and contains about 27 per cent, of 
Iodine, which it gives up to metallic oxides and mercury salts, and when brought into 
contact with aqueous liquids. It occurs as a very fine, amorphous, yellow powder, of 
aint, aromatic odor like that of saffron; insoluble in water and in glycerin, soluble in 



IPECACUANHA. 275 

alcohol, ether, chloroform and fatty oils; readily decomposed by heat and by starch, 
slowly by light. It is five times lighter and more bulky than Iodoform, and is used as a 
substitute therefor in all local applications where a dry antiseptic is required. Like 
Aristol, it should be kept in a dry place, and protected from the action of light. 

Europhen is a recent addition to the list of substitutes for Iodoform, and is perhaps 
the most highly vaunted of them all. Compared with the latter substance, its freedom 
from unpleasant odor, its greater bulk and lightness, and its powerful antiseptic and 
bactericidal qualities, make it an ideal application to sores and wounds, as also for the 
many protective requirements of minor surgery. Its virtues are probably due to the 
readiness with which it liberates free, nascent Iodine, when in contact with aqueous 
liquids ; being fully equal in this respect to Iodoform. Used externally, it is dusted on in 
powder, or applied as a 5 to 10 per cent, ointment with Lanolin as a base. It must not 
be combined with metallic oxides or mercurials, nor with zinc starch paste. For hypo- 
dermic use a 3 to 10 per cent, solution in Olive Oil is employed. A mixture of Europhen 
and Aristol, equal parts of each, is highly recommended for adhesiveness. 

Bismuthi Subiodidum, Bismuth Subiodide, BiOI, — is a heavy, amorphous, brick-red 
powder, insoluble in any reagent without decomposition. (See ante, page 148.) 

Bismuthi Subgallas, Bismuth Subgallate, Dermatol, — is a very fine saffron-yellow, 
odorless powder. (See ante, page 148.) 

These are two of the very best among the agents proposed as substitutes for Iodoform 
in local applications. They are non-irritant, powerfully bactericidal, and entirely odor- 
less. In the author's experience the Subiodide is exceedingly efficient in stimulating the 
growth of granulations in a large wound, such as that often necessary in the surgical 
treatment of fistula in ano. They are described under Bismuth [ante, page 149). ■ 

Iodol, Telra-iodo-pyrrol, — is obtained by treating Pyrrol, (a coal-tar product), with a 
solution of Iodine in Potassium Iodide, usually known as Potassium lodo-iodide solution. 
It occurs in very long, minute, delicate, prismatic crystals, of a yellowish tint, sparingly 
soluble in water, but readily in alcohol. When even slight decomposition is going on the 
crystals take on a brown tinge, due to the free iodine. Its odor is very slight, it being 
practically odorless when pure ; and, unlike Iodoform, it has no toxic properties when 
undecomposed. It contains about 89 per cent, of Iodine. Dose, gr. ss-v, in tablet. 

Though insoluble practically in water, Iodol dissolves readily in the gastric juice, and 
is rapidly absorbed and as quickly diffused throughout the system. It has the same 
general action as Iodoform, except that it is devoid of toxic power. 

Iodol is a very close rival to Iodoform, and is used in almost every instance where the 
latter agent is applicable (Squibb). It should replace Iodoform largely as a topical 
application, on account of its freedom from unpleasant odor. Internally it is highly 
esteemed as a remedy in chronic gastric catarrh, intestinal catarrh, and in ulceration of 
the gastro-intestinal mucous membrane. It has been found to be highly useful in 
bronchitis, bronchial catarrh, and in various respiratory neuroses ; and has seemed to 
render good service in the treatment of tuberculosis and syphilis. In eczema of the ear 
Iodol has recently proved very efficient. In moist confluent eczema of the pinna, extend- 
ing within the auditory canal, the powder should be blown into the canal and upon the 
surrounding parts, after the surfaces have been thoroughly cleansed. In the dry, external 
form, it is best applied as an ointment with Lanolin. The inflammation disappears 
generally within two weeks, but irrigation should be kept up for a short time afterwards 
in order to complete the treatment. (Chatellier.) 



IPECACUANHA, Ipecac, — is the root of Cephaelis Ipecacuanha, 
a small shrubby plant of the nat. ord. Rubiacese, growing in Brazil. The 
root is of the thickness of a small quill and about 4 inches long, of dull 
gray-brown color, contorted and finely wrinkled, internally white, tough 
and ligneous; odor slight but nauseous, taste acrid, bitter and nauseating. 
It contains starch, gum, a trace of volatile oil, a crystalline alkaloid, 
Emetine, C 2 oH 30 N05, and a glucoside named Ipecacuanhic Acid. Dose 
of the powdered root, as an expectorant gr. ss-ij, as an emetic gr. 
xv-xxx. 



2j6 IPECACUANHA. 

Preparations. 

Extractum Ipecacuanhae Fluidum, Fluid Extract of Ipecac,— Dose, flbj-v. 

Syrupus Ipecacuanhae, Syrup of Ipecac, — strength 7 per cent. Dose, gj-iv. 

Vinum Ipecacuanhae, Wine of Ipecac, — strength 10 per cent. Dose, TTjJ-^j. 

Pulvis Ipecacuanhae et Opii, Powder of Ipecac arid Opium, Dover's Powder 
{Pulvis Doveri), — has of Ipecac 10, Powdered Opium 10, Sugar of Milk 80, triturated 
together to a fine powder. Dose, gr. ij-xv or xx. 

Tinctura Ipecacuanhae et Opii, Tincture of Ipecac and Opium, — has of Tincture 
of Deodorized Opium 100 evaporated to 80, Fluid Extract of Ipecac 10, Diluted Alcohol 
to 100. Is a fluid representative of Dover's powder. Dose, n\ij-xx or xxx. 

Trochisci Ipecacuanhae, Troches of Ipecac, — each troche contains of Ipecac about 
gr. ]/ 3 . Dose,j-iij. 

Trochisci Morphinae et Ipecacuanhae, Troches of Morphine and Ipecac, — each 
troche contains about gr. J 7 of Morphine Sulphate, about gr. ^ of Ipecac, with Oil of 
Gaultheria, Sugar, etc. Dose, j-iij. 

Emetina, Emetine (Unofficial), — a crystalline alkaloid, white, becoming yellow, odor- 
less, bitter, nearly insoluble in water, but forming with acids salts which are readily 
soluble. Is powerfully poisonous in large doses. Dose as an expectorant, gr. T |o~?o '■> 
as an emetic, gr. %-%. 

Physiological Action. 

Ipecac is nauseant, emetic, expectorant, cholagogue, diaphoretic, hemo- 
static, sternutatory, and counterirritant. Applied to the skin it produces 
pustulation, and used as snuff it excites violent sneezing and reflex 
mucous secretion, in some persons the smallest inhalation of the dust ex- 
citing an asthmatic paroxysm. Internally, small doses (gr. }£-}() act as 
a stomachic tonic and increase the gastric secretions; larger doses 
(gr. v-xx) are nauseant and emetic in from 20 minutes to half an hour, 
but the emesis produced is not violent nor is it followed by much depres- 
sion. If these doses are repeated a tolerance of the stomach to the drug 
becomes established and a cathartic action is produced, the stools having 
a peculiar bilious character. The circulation is only slightly affected by 
Ipecac, but it relaxes the skin and increases the broncho-pulmonary 
mucus, being diaphoretic and expectorant. In large doses it is decidedly 
irritant to the intestinal canal, but here also it is capable of the same tol- 
erance as in the stomach. In poisonous doses it has frequently produced 
hemoptysis and other hemorrhages. 

Emetine, the active principle, causes death in animals by cardiac 
paralysis, and the autopsies show evidences of gastro-intestinal irritation 
and hyperaemic lungs with patches of hepatization. 

Antagonists and Incompatibles. 

Narcotics generally antagonize the emetic action, so also do Bismuth, Carbolic and 
Hydrocyanic Acids. The salts of Lead and Mercury, Vegetable Acids and astringent 
infusions are incompatible with Ipecac. 

Therapeutics. 
Ipecac is much used as an emetic, being safe, efficient and non-depres- 
sant, though slow of action. It is the best agent of the kind to relieve 
the stomach in acute indigestion and bilious sick-headache, and an ipecac- 



IRIS. 277 

vomit is frequently very serviceable at the commencement of eruptive, 
continued and periodical fevers. The syrup is a favorite domestic emetic 
to cut short an attack of spasmodic laryngitis, and it may be used bene- 
ficially in membranous croup and capillary bronchitis. 

Dysentery is a disease in which large doses of Ipecac (gr. xx every 4 
hours) are used with great success, especially in the epidemic form, and 
in the summer dysentery of teething children. Tolerance must be estab- 
lished to produce its curative action. In small doses (rnj of the wine) 
frequently repeated, it will relieve many kinds of vomiting, especially 
those of nervous origin, perhaps through a sedative action on the pneu- 
mogastric. As an antihemorrhagic, it has been efficiently employed in 
post-partum hemorrhage, menorrhagia, epistaxis, hemoptysis, etc., and it 
is considered very useful in night coughs, acute catarrh and bronchitis, 
spasmodic asthma and hay fever. In most of these affections slightly 
nauseating doses must be used. 



IRIS, Blue Flag, — is the rhizome and roots of Iris versicolor, an 
indigenous plant of the nat. ord. Iridese, growing in moist meadows and 
on the borders of swamps, having large blue flowers and a horizontal 
rhizome, 2 to 4 inches long, with long rootlets, slight odor, but an acrid, 
nauseous taste. It contains tannin, sugar, starch, gum, an acrid resin, 
fixed oils and traces of an alkaloid. Dose of the powdered root, gr. v-xx. 

Preparations. 

Extractum Iridis, Extract of Iris. — Dose, gr. j-v. 

Extractum Iridis Fluidum, Fluid Extract of Iris. — Dose, ^v-^j. 

Iridin or Irisin (Unofficial), — is a so-called resinoid found in the shops, of undeter- 
mined composition, but probably an oleoresin precipitated by water from an alcoholic 
preparation. Dose, gr. j-v. 

Physiological Action and Therapeutics. 

Iris when fresh is actively purgative, emetic and diuretic, producing 
severe nausea and prostration. Iridin has been the subject of experimen- 
tation upon dogs, and is shown to be a powerful hepatic stimulant with 
considerable influence on the intestinal glands, being more purgative than 
Euonymin and less irritant than Podophyllin. In very small doses it 
causes obstinate constipation by producing rectal inactivity. 

Iris is very serviceable in duodenal catarrh with obstruction of the bile- 
ducts and consequent jaundice, also in malarial poisoning, bilious remit- 
tents, and jaundice of malarial origin. It is used" in many hepatic and 
intestinal disorders as a cholagogue and purgative of mild but efficient 
action, also as a diuretic in dropsies. In small doses (try of a tincture) it is 
strongly recommended in a peculiar blinding headache in the right supra- 
orbital region with nausea or vomiting, supposed to be of hepatic origin. 



2/8 JALAPA. 

JALAPA, Jalap, — is the tuberous root of Ipomxa Jalapa, a Mexi- 
can plant of the nat. ord. Convolvulaceae. It is large, turnip-shaped, 
externally dark-brown and wrinkled, internally grayish-brown with numer- 
ous concentric circles composed of small resin-cells, odor slight, taste 
sweetish and acrid. It contains 15 to 20 per cent, of the official Resin, 
which is composed of two resin's, Jalapin, soft, soluble in ether, and 
Convolvulin, C 31 H 50 O ltJ , which is hard, insoluble in ether, and the most 
active of the two. 

Preparations. 

Extractum Jalapae, Extract of Jalap. — Dose, gr. ij-x. Is an ingredient of Pil. 
Catharticse Co., and Pil. Catharticse Vegetabiles. 

Resina Jalapae, Resin 0/ Jalap, — prepared from a tincture by precipitation by water. 
Is insoluble in water, soluble in alcohol. Dose, gr. ij-x. 

Pulvis Jalapae Compositus, Compound Powder of Jalap, [Pulvis- Purgans), — 
has of Jalap 35, Potassium Bitartrate 65, rubbed together until thoroughly mixed. 
Dose, gr. x-gj. 

Physiological Action and Therapeutics. 

Jalap is an active cathartic, producing copious and watery stools, with 
considerable tormina and tenesmus, also sometimes nausea. It does not 
produce hemorrhoids, but does increase the secretions of the intestinal 
canal and the flow of bile. Its action is not due to any one of the contained 
principles, but all the active constituents are found in the resin. Com- 
pared with other agents of the same class its action most resembles that of 
Scammony. It is more drastic than Senna and less irritant than Gam- 
boge, but in overdoses may produce dangerous hypercatharsis. 

Convolvulin in sufficient dose is an active irritant poison, producing 
gastro-enteritis and narcotism. Its action as a purgative seems to be 
wholly local, as from its intravenous injection no catharsis results, yet it 
exerts little if any irritant action on the conjunctiva, nasal mucous mem- 
brane or skin. It is not eliminated in the urine or the faeces, and is there- 
fore probably destroyed in the system by oxidation. 

In olden bowel-moving times Jalap and Calomel were used together in 
doses of gr. x each (" ten and ten "), as a routine purgative prescription. 
Less ponderous doses are now considered equally efficient, and one grain of 
each agent with the same quantity of Extract of Hyoscyamus as a correct- 
ive may be used with advantage at the onset of fevers and inflammations. 
As the compound powder it is much employed to produce free watery evacu- 
ations in ascites and anasarca. Being nearly tasteless it is a useful cathartic 
for children, and may be administered in Syrup of Rhubarb (gr. ij-v in 
3ss). As a vermifuge it is efficient as an adjunct to more powerful agents, 
and is employed with Calomel and Santonin for the expulsion of lumbrici. 
Jalap is contraindicated in all inflammatory conditions of the intestinal 
mucous membrane, but in proper doses it is one of the most manageable 
and efficient cathartics. 



JAMBUL JUGLANS JUNIPERUS. 279 

JAMBUL, Jamun (Unofficial), — the seeds and bark of the Etigenia Jambolana, a 
native tree of India, has a very varied history of successes and failures in the treatment 
of diabetes. The British Medical Association has directed its Committee on Therapeutics 
to investigate thoroughly the claims made for and against this agent, so that some reliable 
information may be expected concerning this very important question. One writer con- 
tends that any efficient preparation should be made from the fresh seeds, discarding the 
pericarps, and avoiding the application of heat; also that a weak alcoholic menstruum 
exhausts the drug and gives a stable preparation. 

Late reports, from observers abroad and in this country, show that favorable results are 
obtained with Jambul in many cases of diabetes, even after the unsuccessful use of all the 
usual remedies. In two severe cases, in which 7 and 3 per cent, respectively of glucose 
was excreted, the urine was brought back to normal and kept there for two years, by the 
use of this remedy. It should be given with or after meals, in water or wine sweetened 
with a small quantity of saccharin, and accompanied by general treatment. 



JUGLANS, Butternut, — is the bark of the root, collected in autumn, of Juglans 
cinerea, the Butternut or White Walnut, an indigenous forest tree of the nat. ord. 
Juglandacese. It occurs in flat or curved pieces, the outer surface smooth, dark-brown, 
mottled and nearly free from corky remnants of the outer bark, odor feeble, taste bitter 
and acrid. It contains an orange-yellow, crystalline and acrid substance named Juglandic 
Acid or Nucin, resembling Chrysophanic Acid, also some resin, volatile acid, etc., but 
neither tannin nor any alkaloid. 

Extractum Juglandis, Extract of Juglans. — Dose, gr. v-xx or more. 

Juglans is a mild cathartic operating without the production of pain or irritant symp- 
toms. It is never used in substance, but the extract is a good laxative in doses of gr. v-x, 
and a purgative in larger doses. It has considerable reputation in dysentery and chronic 
constipation. 



JUNIPERUS, Juniper, — the source of the official Oleum Juniperi, 
is the fruit of Juniperus communis, an evergreen shrub of the nat. ord. 
Coniferse, growing in Europe and N. America. The fruit or berry is dark- 
purple with a bluish-gray bloom, having a three-rayed furrow at the apex, 
internally pulpy, containing 3 triangular, bony seeds. It contains a Vol- 
atile Oil, which consists of terpenes and camphors in complex combi- 
nation, also a non-crystallizable principle named Juniperin, and grape 
sugar, resin, formic, acetic and malic acids, etc. The Oil, a Spirit, and 
a Compound Spirit are official. 

Preparations. 

Oleum Juniperi, Oil of Juniper, — is the volatile oil, a colorless or faintly greenish- 
yellow liquid, sp. gr. 0.850 to 0.890; of terebinthinate and sweetish taste, and the odor of 
juniper; soluble in 4 times its vol. of alcohol, and in an equal vol. of carbon disulphide. 
Dose, rr\,v-xv. 

Spiritus Juniperi, Spirit oj Juniper, — has of the Oil 5 in Alcohol 95. Dose, £j-iv 
or more, according to the quantity of alcohol desired. 

Spiritus Juniperi Compositus, Compound Spirit of Juniper, — has of the Oil 8, Oil 
of Caraway 1, Oil of Fennel I, Alcohol 1400, Water to 2000. It approximates closely 
to a good grade of Gin. (See ante, page 94). Dose, ^j-iv, or more, according to the 
quantity of alcohol desired. 

Oleum Cadinum, Oil of Cade ( Empyreumatic Oil of Juniper), — is a product of the 
dry distillation of the wood of Juniperus Oxycedrus. It is a tar-like substance, of un- 
certain composition and purity : a dark-brown, clear, thick liquid, of tarry odor and a 
somewhat bitter, burning taste ; insoluble in water, partially soluble in alcohol, com- 



28o KAMALA KAVA-KAVA. 

pletely so in ether, chloroform or carbon disulphide. Used locally as a stimulant in pso 
riasis and chronic eczema. 

Infusum Juniperi, Infusion of Juniper (Unofficial), — has of Juniper Berries 5j in 
Oj of boiling water. Dose, ^j-ij. 

Juniper is a stomachic tonic, diaphoretic, diuretic and aphrodisiac. 
The oil is the active principle, and is readily diffused, exciting increased 
cardiac action, stimulating the renal functions and the action of the skin, 
and causing a subjective sense of heat throughout the system. It is elimi- 
nated chiefly by the kidneys, and may set up renal irritation, in large 
doses producing strangury, priapism, hematuria, suppression of the urine, 
and ursemic convulsions. It imparts a violet odor to the urine, and will 
produce diuresis when inhaled. 

The Oil of Juniper is used to flavor gin and to impart the diuretic power 
popularly ascribed to that liquor. The medicinal use of the juniper 
preparations (spirit and compound spirit) is restricted to their employ- 
ment as vehicles for less irritant diuretics. The oil acts therapeutically 
like the Oil of Turpentine, and may be used in chronic pyelitis and cys- 
titis, prostatorrhcea, gleet, etc., but it is contraindicated in all cases where 
acute inflammation of the kidneys exists. 

Oil of Cade is used locally in chronic skin diseases as a stimulant 
application. It is too active for acute eruptions, but has been used with 
benefit in chronic eczema and psoriasis. The Oil of Tar (see Pix) is 
equally efficient for all the purposes to which the Oil of Cade has been 
applied. 



KAMALA, Rottlera, — the glands and hairs from the capsules of Mallotus philip- 
pinensis, or Rottlera tinctoria, a small tree of the nat. ord. Euphorbiaceae, growing in 
Abyssinia, Arabia, India, China, etc. It occurs as a granular, mobile, brick-red powder, 
inodorous and nearly tasteless, partly soluble in alcohol and ether. It contains several 
resins, one of which is named Rottlerin, C n H 10 O 3 , also tannin, starch, gum, red coloring 
matter, etc. There are no official preparations. Dose, gss-iij. 

Kamala is anthelmintic and purgative, sometimes causing nausea and colic, seldom 
vomiting. It is used as a taeniafuge, and to expel lumbrici and ascarides vermiculares. 
One or two drachms are given suspended in water, mucilage or syrup, and repeated in 4 
hours if necessary. A tincture ( J$ vj in xvj of alcohol) may be used in doses of 5J j- ij ss. 
In India it is used locally in scabies and other skin affections and has been found of 
especial service in herpetic ringworm. As a remedy against tapeworm it is perhaps next 
after Male-fern in efficiency and requires no preparatory treatment. 



KAVA-KAVA, Ava-Kava (Unofficial), — the root of Piper methysticum, a shrub 
of the nat. ord. Piperaceae, growing in South America and the South Sea Islands. The 
root is large, weighing from 2 to 20 pounds, fibrous, light and spongy, and contains a 
crystalline principle, Kavahin or Methysticin, which is analogous to Piperin, an acrid, 
greenish-yellow resin, Kawin, which is probably the active principle, also a Volatile Oil. 
Dose, gss-j, macerated in water, or the same quantity of a fluid extract. 

Kava is intoxicant, diuretic and motor-depressant. A beverage is prepared in the 
Sandwich Islands by chewing the root and then infusing it in water or cocoanut milk, 
which produces a drowsy intoxication with pleasant dreams often of erotic character, and 



KINO KRAMERIA KUMYSS. 28 I 

followed by severe headache. A moderate dose is tonic and stimulant, lessening the 
sense of fatigue and sharpening the mental facilities. It is highly recommended in 
gonorrhoea and gout, also in chronic gleet and obstinate cystitis. 



KINO, — is the inspissated juice of Pterocarpus Marsupium, a tall tree of the nat. ord. 
Leguminosae, growing in India. It occurs in angular, brown-red pieces, shining and 
brittle, inodorous, taste astringent and sweetish, soluble in alcohol. It contains 75 per 
cent, of a variety of tannin named Kino-tannic Acid, C 18 H 18 O g , which gives a greenish 
precipitate with persalts of iron, also a crystalline, neutral substance, Kinoin, C u H l2 6 , 
and Kino-red, formed from Kino-tannic Acid by oxidation, besides gum, pectin, etc. 
There are several other varieties of Kino in the market, brought from S. America, Africa, 
Australia, etc., which are products of other trees than the official one. 

Tinctura Kino, Tincture of Kino, — strength 10 per cent. Dose, TT^x-^ij. 

Pulvis Kino Compositus (Unofficial). — Kino 15, Opium I, Cinnamon 4 (has of 
Opium I in 20). Dose, gr. v-xx. 

The action of Kino is the same as that of Tannic Acid, though less powerful (see 
ante, page 81), and it may be used for the same purposes, both internally and locally. It 
is chiefly employed as an astringent gargle and as a constituent of diarrhoea-mixtures. 
The tincture, in drachm doses, is one of the most efficient means of combating the atonic 
diarrhoea which results from disuse of opium or morphine. 



KRAMERIA, Rhatany, — is the root of Krameria triandra and 
Krameria Ixina, shrubs of the nat. order Polygaleae, growing in S. 
America, the first-named in Peru and the latter in New Granada. It is 
about an inch thick, branched below, more or less knotty, covered with 
a brownish bark which is very astringent ; and contains 20 to 45 per cent, 
of Rhatania-tannic Acid, C 54 H 24 21 , and Rhatanine, C 10 H 13 NO 3 , an alka- 
loid, — also, wax, gum, etc. 

Preparations. 

Extractum Krameriae, Extract of Krameria, — aqueous. Dose, gr. v-x. 
Extractum Krameriae Fluidum, Fluid Extract of Krameria. — Dose, TTLv-^ss. 
Tinctura Krameriae, Tincture of Kra7?ieria, — 20 per cent. Dose, VC^v-^]. 
Syrupus Krameriae, Syrup of Krameria, — Fluid Extract 45, Syrup 55. Dose, 

z ss - 3 ss - 

Trochisci Krameriae, Troches of Krameria, — each troche contains gr. j of the extract, 
with Tragacanth, Sugar and Orange-Flower Water. 

Krameria possesses the same astringent qualities as Tannic Acid (see 
ante, page 81), and may be employed for the same purposes, except as an 
antidote to Antimony. It has long had a high reputation as an injection 
for fissure of the anus, as a local application to spongy gums, and as a 
tonic for debilitated subjects. 



KUMYSS, Koomiss (Unofficial), — is an effervescing fermented 
liquor originally prepared by the Tartars from mare's milk, but now 
imitated with cow's milk by adding sugar of milk, fermenting in open 
tanks, skimming off the casein and butter, then bottling during active 



282 KUMYSS. 

fermentation. Its successful preparation depends on its undergoing slow 
fermentation in a cold room, at 50 F. or less. If the temperature be 
higher, the fermentation will be of the acetous variety, and will result in 
sour milk with heavy curd, feeble effervescence and repulsive taste- 
Wolff's Formula, for its preparation in small quantity, is as follows : — Dissolve s^ss 
(a tablespoonful) of grape sugar in ,fivof water. Dissolve gr. xx (a teaspoonful) of 
Fleischmann's compressed yeast or well washed and pressed out brewer's yeast in J ij of 
cow's milk. Mix the two solutions in a quart champagne bottle, and fill to within two 
inches of the top with good cow's milk. Cork well, secure the cork with wire, keep it in 
a cellar or ice chest, maintaining a temperature of 50 F. or less, and agitate twice daily. 
In three or four days it is ready for use, but should not be kept longer than four or five 
days. Draw it with a champagne tap. 

Kumysgen is a powder containing the elements necessary for the preparation of 
Kumyss, for which a special bottle and tap are also furnished by the manufacturers. It 
is a very convenient manner of making this preparation, and the product tastes just as 
well as that made in the ordinary way. Whether it acts as well therapeutically remains 
to be ascertained. 



Physiological Action and Therapeutics. 

The taste of Kumyss is acidulous and peculiar. In large quantity it 
takes the place of food, each quart equalling four ounces of solids. It is 
said to be a powerful diuretic, especially in cold weather, and in warm 
weather to produce free diaphoresis. It is stimulating and tonic, increases 
the body nutrition and produces considerable somnolence. The stomach 
is very tolerant of it, and retains it when any other food will be rejected. 
It is easily assimilated and very nutritious. 

Kumyss is an invaluable article of diet in many wasting diseases, espe- 
cially phthisis. It is also of great benefit in dyspepsia, the diarrhoea of 
children, convalescence from acute maladies, chronic affections of the 
kidneys, chronic bronchitis, and other cachexias. In cases of feeble 
digestive power g every hour is sufficient, but as its digestion and assimi- 
lation increase it may be given almost ad libitum, and when used with 
other food a half-pint may be taken after each meal. Each quart is esti- 
mated to contain four ounces of solid food, besides from 1 to 3 per cent, 
of alcohol. 

Kefir is the name of a fermented drink prepared from the milk of a cow or mare by 
the addition of a mushroom-like ferment found near the snow-line in the Caucasian Moun- 
tains. It is used by the natives of the Asiatic plains as a remedy for struma, anaemia, 
lung and stomach diseases. Kefir is richer in albumen than Kumyss, is less alcoholic 
and less acid. 

The following table of analysis shows the average composition of Milk, Kumyss and 
Kefir :— 

Cow's milk. 

Albumen, 48 

Butter, 38 

Sugar of milk, 41 

Lactic acid, . — 

Alcohol, — 

Water and salts, 873 



Kumyss. 


Kefir 


II. 2 


38 


2O.5 


20 


22. 


20 


16.5 


9 

8 


918.3 


905 



LACTUCARIUM — LAPPA. 283 

LACTUCARIUM, Lettuce, — is the concrete milk- juice of Lactuca 
virosa, or Acrid Lettuce, a biennial European plant, of the nat. order 
Compositse. It occurs in sections of cakes or irregular pieces showing the 
form of the vessel in which it hardened, externally reddish-brown, inter- 
nally white or yellowish and of waxy lustre, odor heavy and narcotic, taste 
bitter, partly soluble in alcohol and in ether, and yielding a turbid mix- 
ture when triturated with water. Lactucarium is a mixture of several sub- 
stances, the most important being Lactucerin, 42 per cent., a crystalline, 
tasteless body, resembling caoutchouc, insoluble in water and probably 
inert; Lactucin, 0.3 per cent., a neutral principle, crystallizing in pearly 
scales, insoluble in cold water, persistently bitter; Lactucic Ac id, bitter, 
amorphous, but crystallizes after long standing. 

Preparations. 

Tinctura Lactucarii, Tincture of Lactucarium, — 50 per cent. Dose, Tt^x-^ij, 
according to the activity of the drug. 

Syrupus Lactucarii, Syrup of Lactucarium, — has of the Tincture 10 per cent. 

Dose, z')-l'y 

Lactucarium is feebly hypnotic, somewhat sedative and diuretic. It is 
supposed to act similarly to Opium, but very feebly and without depressing 
after-symptoms. Its preparations are very uncertain in activity, and are 
chiefly used as placebos, to allay cough and quiet nervous irritability. The 
syrup is a good vehicle for expectorants and antispasmodics. 



LAPPA, Burdock, — is the root of Arctium Lappa, and of some other 
species of Arctium, the common Burdock, a coarse-looking biennial weed 
of the nat. ord. Compositae, found in waste places and along roadsides in 
Europe, Asia and N. America. Three varieties are recognized, formerly 
known as Lappa major, L. tomentosa, and L. ?ninor, of which the first- 
named is most frequently met with in this country. The root, about a 
foot long, an inch thick, has a feeble odor and a mucilaginous, bitterish 
taste, and contains a bitter principle, traces of a volatile oil, also inulin, 
resin, tannin, mucilage, sugar, etc. 

Extractum Lappse Fluidum, Fluid Extract of Lappa, — made with diluted alcohol. 
Dose, ^j-ij. 

Dr. Squibb recommended a Tincture of the seed ; lb. j of ground seed to gall, j of 
whiskey, allowed to stand for two weeks before decanting, and used in doses of 3 ij-iij 
before meals. 

Lappa promotes all the secretions and is considered aperient, diuretic 
and diaphoretic, without irritating qualities. In decoction it has been a 
popular domestic remedy for many morbid conditions, especially rheuma- 
tism, gout, pulmonary catarrhs, and chronic cutaneous affections. By 



284 LAVANDULA LEPTANDRA — LICOPERDON. 

several practitioners it is praised as an alterative in constitutional diseases, 
as syphilis and scrofula, also as an external application to swellings, 
hemorrhoids and chronic sores. A tincture of the seed has proved re- 
markably efficient as a stomachic tonic and has cured several cases of 
psoriasis inveterata. (See Squibb's Ephemeris, vol. i, page 116.) 



LAVANDULA, Lavender, — the source of the official Oil of Lavender Flowers, is 
the fresh flowers of Lavandula officinalis, a small European shrub of the nat. ord. 
Labiatse, largely cultivated in England. They have a bluish-gray tubular calyx, a violet- 
blue corolla, a fragrant odor, and an aromatic, camphoraceous taste; and contain resin 
and tannin, also a Volatile Oil. 

Official Preparations. 

Oleum Lavandulae Florum, Oil of Lavender Flowers, — is a volatile oil distilled 
from fresh Lavender, and having the fragrant odor of the flowers. It is soluble in alco- 
hol in all proportions, also in 3 times its volume of a mixture of alcohol 3 and water I, 
also in glacial acetic acid. Sp. gr. 0.885 to °-897 at 59 F. Dose, lT\j-v. 

Spiritus Lavandulae, Spirit of Lavender, — has of the Oil 5, in Deodorized Alcohol 
95. A perfume and flavoring. Dose, ^ss-j. 

Tinctura Lavandulae Composita, Compound Tincture of L.avender, — an aromatic 
stimulant, composed of the Oil 8, Oil of Rosemary 2, Cassia Cinnamon 20, Cloves 5, 
Nutmeg 10, Red Saunders 10, Alcohol 700, Water 250, Diluted Alcohol to 1000. Is a 
constituent of Liquor Potassii Arsenitis. Dose, 3 ss-ij. 

Lavender is aromatic, stimulant and carminative, but is rarely used alone as a medicine. 
It is an agreeable flavoring and perfume, in the form of the official spirit, which is sold 
under the name of " Lavender-water" after the addition of Oil of Bergamot and Essence 
of Ambergris. The compound tincture, formerly called the compound Spirit of Laven- 
der, is a very agreeable compound of spices, and is much used as a remedy for gastralgia, 
nausea, flatulence, etc., and as an adjuvant or corrigent of other medicines. 



LEPTANDRA, Culver's Root, — is the rhizome and rootlets of Veronica virginica, 
an indigenous perennial plant of the nat. ord. Scrofularineae. The rhizome is horizontal, 
about 5 inches long and j^inch thick, bent and branched, with thin, wrinkled rootlets, 
inodorous, taste bitter and feel acrid. It contains a glucoside named Leptandrin, which 
is probably the active principle, also Saponin, resin, tannin, etc. The Leptandrin of the 
shops is an impure alcoholic extract. 

Extractum Leptandrae, Extract of Leptandra, — is a constituent of Pil. Catharticse 
Veg. Dose, gr. j-iij. 

Extractum Leptandrae Fluidum, Fluid Extract of Leptandra. — Dose, rnjcx-^j. 

Leptandra is tonic, laxative, and like other resin-bearing purgatives is decidedly chola- 
gogue. The recent root is a violent cathartic, but in the dried state it is less active. It 
is indicated in duodenal indigestion and chronic constipation with insufficiency of the 
biliary and intestinal secretions. 



LICOPERDON GIGANTEUM, Puff-Bail (Unofficial),— is a common fungus of 
the nat. ord. Trichogastres, found in hilly and wooded districts. The dust, which con- 
sists of the capillitium and spores, is a valuable hemostatic, and dusted over bleeding 
surfaces acts promptly in arresting hemorrhage. It has been proposed as a surgical 
dressing, but while useful in emergencies where other agents are unattainable, the fetor 
which results from its application to wounds will prevent its use becoming general for 
this purpose. It may prove of value as an internal hemostatic in hematemesis and the 
hemorrhage of typhoid fever. 



LIMON. 285 

LIMON, Lemon, — is the fruit of Citrus Limonum, a tree of the nat. 
ord. Rutacese, native in Asia, but cultivated in southern Europe and 
many other countries. It is official in the two forms described below. 
The Orange {Citrus Vulgaris and C. Aurantium), the Citron {Citrus 
medico), and the Lime {Citrus acris), all belong to the same genus as 
the Lemon {Citrus Limonum). 

Limonis Cortex, Lemon Peel, — is the rind of the recent fruit, and 
contains a Volatile Oil, C 10 H 16 , which is official, and a bitter crystalline 
glucoside, Hesperidin, C 2 2H 26 12 , chiefly contained in the white portion 
of the rind. 

Limonis Succus, Lemon Juice, — is the freshly expressed juice of the 
ripe fruit, each lemon yielding from ^ to 1 fluid ounce. It contains 
about 7 per cent, of free Citric Acid, besides Phosphoric and Malic 
Acids, Citrates of Potassium and of other bases, etc. Dose, gss-iv. 

Acidum Citricum, Citric Acid, H 3 C 6 H 5 7 -\- H 2 0, — is obtained from 
the juice of the Lemon or the Lime by adding chalk to form Calcium 
Citrate, which is then decomposed by dilute Sulphuric Acid. It occurs 
in colorless, rhombic crystals which are very soluble in water. A solution 
of gr. xvij in ^ss of water corresponds to gss of fresh lemon-juice, and 
this quantity of either will neutralize of Potassium Bicarbonate gr. xxv, 
of Sodium Bicarbonate gr. xx, and of Ammonium Carbonate gr. xivss. 
Dose, gr. x-xxx. 

Citrates of Bismuth, Bismuth and Ammonium, Iron, Iron and Ammo- 
nium, Iron and Quinine, Iron and Strychnine, Lithium, Magnesium, 
Potassium, nine in all, are official. They are described under their 
respective bases, to which rather than to the acid their medicinal qualities 
are due. 

Preparations. 

Oleum Limonis, Oil of Lemon, C 10 H 16 , — is the volatile oil, isomeric with oil of tur- 
pentine, and extracted from fresh lemon peel by mechanical means. It is used for flavor- 
ing and is an ingredient of Spiritus Limonis, Spiritus Aurantii Compositus, and Spiritus 
Ammonise Aromaticus. Dose, tt\J-v. 

Spiritus' Limonis, Spirit of Lemon, Essence of Lemon, — is prepared by macerating 
5 of the Oil and 5 of the Peel, freshly grated, in Deodorized Alcohol to 100. Used for 
flavoring. Dose, according to the amount of alcohol desired to be given. 

Syrupus Acidi Citrici, Syrup of Citric Acid, — has of Citric Acid 10, Water 10, 
Spirit of Lemon 10, Syrup to 100. Dose, indefinite. 

Physiological Action. 

Lemon-Peel is bitter and probably tonic to the stomach, but is only 
used for flavoring purposes. Lemon-Juice, on the other hand, is refrig- 
erant and antiscorbutic, entering the blood as alkaline citrates, potassium 
salts and phosphoric acid, the citrates being therein partly oxidized into 
C0 2 and H 2 0, while the potassium salts and phosphoric acid probably act 
upon the red corpuscles. 

Citric Acid has the same general action as Acetic and the other vege- 



286 LINUM. 

table acids (see Acidum Aceticum, ante, page 61). It is wholly decora- 
posed in the blood, and appears to be non-toxic in man, but used inter- 
nally it may precipitate uric acid and thus promote the formation of 
calculi. 

Therapeutics. 

Lemon-juice is employed largely in the treatment and prevention of 
scurvy, in which disease it possesses powers of specific rank, but whether 
its action therein is due to the citric acid, the phosphoric acid or the salts 
of potassium is not known. Lime-juice is equally efficient but Citric 
Acid itself is not so. 

As refrigerants and Diuretic mixtures in fevers, Lemon-juice and Citric 
Acid are much used, entering into the composition of lemonades, effer- 
vescing draughts, etc., to allay thirst and subdue restlessness, and to pro- 
mote the action of the skin and the kidneys. For acidity of the stomach 
they are efficient if given in small doses before meals, but the mineral 
acids are usually preferred for this purpose. Long-continued they will 
impair digestion and impoverish the blood. Atheromatous degeneration 
of the vessels is said to be retarded by the daily use of lemon-juice, which 
is supposed to dissolve the excess of organic matter and to aid its excre- 
tion. Obesity may be reduced by using the juice of limes or lemons in 
large quantity, but it will be done at the expense of the digestion. Lemon- 
juice has been found of service in acute rheumatism, probably through 
the alkalies which it conveys into the blood. As a local application it 
has been found efficient in pruritus scroti, sunburn, post-partum hem- 
orrhage, and as a gargle in diphtheritic sore throat. 



LINUM, Linseed, Flaxseed, — is the seed of Limun ttsitatissimum 
(flax), a cultivated annual plant of the nat. ord. Linese. The seeds are 
small, flattened, oblong-ovate bodies, brown and glossy, inodorous, taste 
mucilaginous and bitter; and contain 15 per cent, of Mucilage in the 
epithelium, also 30 to 40 per cent, of Fixed Oil in the embryo. Ground 
Linseed should yield not less than 25 per cent, of the fixed oil. 



Preparations. 

Oleum Lini, Linseed Oil, — the fixed oil expressed from Linseed without the use of 
heat. A yellow, oily liquid, of slight odor, bland taste, and neutral reaction, soluble in 
about 10 of absolute alcohol and in \}/ z of ether. Consists chiefly of the Glyceride of 
Linoleic Acid, C 16 H 28 4 , which having a powerful affinity for oxygen becomes resinoid 
on exposure to the air, making it a " drying oil." Dose, ^ ss-ij. 

Infusum Lini, Linseed Tea (Unofficial), — Linseed 3 iij, Liquorice-root gj, Boiling 
Water ^x, infused for four hours and strained. Dose, indefinite. 

Linimentum Calcis, Lime Liniment, Carron Oil, — consists of equal volumes of 
Linseed Oil and Limewater, emulsified by agitation. A favorite application for burns. 



LITHIUM. 287 

Physiological Action and Therapeutics. 
Linseed is demulcent, emollient, expectorant and diuretic. The oil is 
laxative in a dose of gj, and in smaller doses is oxidized in the system 
and excreted as a resinoid body by the kidneys, which it stimulates 
slightly. The Infusion contains the mucilaginous principle and a small 
portion of the oil, and is advantageously used in inflammations of the 
mucous membrane of the throat, the gastro-intestinal tract and the urin- 
ary passages. It is an excellent demulcent in coughs of various kinds, 
and will be found very serviceable in cystitis, irritable bladder, renal 
colic, strangury, etc, The Oil may be administered internally as a laxa- 
tive, and has considerable reputation as a remedy for hemorrhoids in 
doses of ^ij twice daily. For laxative purposes (especially in children) 
it is usually administered as an enema. Externally it is a favorite appli- 
cation to burns, when made into an emulsion with lime-water, as in the 
official Linimentum Calcis. The ground seed (linseed or flaxseed meal), 
is one of the best agents for making poultices, and is universally em- 
ployed for that purpose. (Compare the article Poultices in Part III.) 



LITHIUM, Li, — is represented in the Pharmacopoeia by five of its 

salts, of which the Carbonate is but slightly soluble while the others are 

readily so. The low atomic weight of this metal (7) makes its saturating 

power greater than that of other alkaline metals, hence the value of its 

salts in medicine. 

Salts of Lithium. 

Lithii Benzoas, Lithium Benzoate, LiC 7 H 5 2 , — is classed with the Benzoates and 
described under Benzoinum. (See ante, page 145.) 

Lithii Bromidum, Lithium Bromide, LiBr, — is classed with the Bromides and 
described under Bromum. (See ante, page 149.) 

Lithii Carbonas, Lithium CarboJiate, Li 2 C0 3 , — a light, white powder, permanent 
in the air, odorless, of alkaline taste and reaction, soluble in 80 of water, insoluble in 
alcohol. Dose, gr. ij-xv. 

Lithii Citras, Lithium Citrate, Lig.CgH 5 7 , — a white, deliquescent powder, odorless, 
of faintly alkaline taste and neutral reaction, soluble in 2 of water, almost insoluble in 
alcohol. Dose, gr. v-xxx. 

Lithii Citras Effervescens, Effervescent Lithium Citrate, — prepared from the Car- 
bonate 7, with Sodium Bicarbonate 28, Citric Acid 37, and Sugar to 100. Dose, J5J-ij, 
in water, as an effervescent drink. 

Lithii Salicylas, Lithium Salicylate, 2LiC 7 H 5 3 ,— is classed with the Salicylates 
and described under Salix. 

Physiological Action. 
The Lithium salts have strong alkaline qualities and act on the system 
in the same manner as other alkalies (see under Potassium). The high 
saturating power of this metal makes its salts more alkaline than those of 
Potassium, Sodium or Calcium, hence more efficient in alkalinizing the 
urine. Lithium Urate is the most soluble of the alkaline urates, hence 
the value of lithium salts in the uric acid diathesis. The Carbonate and 



2S8 LOBELIA. 

Citrate are the salts referred to in this connection, the others partaking 
more of the qualities of their acid factors. Both these salts are antacid 
and strongly diuretic, the Carbonate being but slightly soluble is given in 
wafer or in carbonic acid water, and the Citrate in solution. The latter 
may be extemporaneously prepared by adding citric acid to an aqueous 
solution of the carbonate, and in the organism is decomposed, the citric 
acid being oxidized and the carbonate formed. Many mineral waters 
contain small quantities of the carbonate, varying from a mere trace to 
grain o.oi to a pint, an amount so minute as to be practically inert in 
comparison with the much greater quantities of potassium and sodium 
salts in the same waters. 

Therapeutics. 
Lithium Carbonate and Citrate are extensively used in gout and the 
litha^mic diathesis, for the purpose of holding the uric acid in solution as 
lithium urate, and preventing its deposit in the tissues as sodium urate 
which is less soluble. Their prolonged administration is so efficient in 
this affection that they have been credited with the power of dissolving 
uric acid calculi and called lithontriptics. They are also highly useful 
in the indigestion and rheumatism of obese subjects, and in irritable 
bladder from excess of acid in the urine. Lithiated Arsenical Water has 
been lately praised as a remedy in diabetes. 



LOBELIA, Lobelia, Indian Tobacco, — the leaves and tops of 
Lobelia inflata (nat. ord. Lobeliaceae), collected after a portion of the 
capsules have become inflated. The plant is a common annual weed 
growing on roadsides throughout the United States, having pale-green, 
alternate leaves, a single, erect and very hairy stem, with hairy branches 
and small, pale-blue flowers, odor slight but irritating, taste at first mild, 
afterwards burning and acrid. It contains gum, resin, fixed oil, wax, 
lignin, salts of lime, potassium and iron, a liquid alkaloid, Lobeline, which 
is the narcotic principle of the plant, also Lobelic Acid, and an acrid 
substance named Lobelacrin. 

Preparations. 

Extractum Lobelias Fluidum, Fluid Extract of Lobelia. — Dose, ttlj-x. 
Tinctura Lobeliae, Tincture of Lobelia, — 20 per cent. Dose, TT\, v-xxx. 
Infusum Lobelias, Infusion of Lobelia (Unofficial), — ^j to a pint. Dose, 3 j — ^ j * 
Lobelinum, Lobelin (Unofficial), — an impure resinoid. Dose, gr. ss-j. 

Physiological Action. 
Lobelia has an acrid, nauseous taste, and a heavy, unpleasant odor. It 
is expectorant, diaphoretic, emetic, purgative, antispasmodic, motor-de- 
pressant and narcotic. It excites an abundant flow of saliva, much gastric 



LYCOPODIUM. 289 

mucus, profuse urination and sweating, with nausea, vomiting and great 
depression. The heart's action is enfeebled, and the blood-pressure, at 
first increased, soon falls; muscular debility, reduced temperature and 
coma follow, and death occurs by paralysis of the respiratory apparatus. 
The drug produces paralysis of the motor nerve-trunks, the peripheral 
vagi, and probably the respiratory and vaso-motor centres also. It 
strongly resembles tobacco in its action, and is highly dangerous in full 
medicinal doses, having caused many deaths when administered thera- 
peutically, the most important instance of its fatal results being the 
case of Ezra Lovett, Jr., who in 1809 was poisoned by Lobelia admin- 
istered by the founder of the Thomsonian sect of medical practitioners. 
The responsible party escaped conviction on the plea that he gave the 
drug in ignorance of its qualities. 

Antidotes and Incompatibles. 

Tannic Acid to form the insoluble tannate. Strychnine, Picrotoxine and Thebaine 
antagonize its action on the nervous system ; — the vaso-motor excitants, as Alcohol, 
Digitalis, Belladonna, Ergot, etc., antagonize its effects on the circulation. Caustic 
alkalies are incompatible, decomposing the alkaloid. 

Therapeutics. 
Lobelia was a favorite remedy with the Indians at the time of the first 
settlement of the United States, and was introduced into regular practice 
as an anti-asthmatic, after having served as the main stock-in-trade of 
irregular practitioners for many years. Its principal therapeutic action is 
that of an antispasmodic, and in cautious hands it is extremely useful in 
paroxysmal spasmodic asthma, as well as in dry cough with constant tick- 
ling in the throat. As an enema in cases of strangulated hernia the infu- 
sion is much safer than Tobacco and fully as efficient, and may overcome 
the obstruction in intussusception, while the tincture in 2-drop doses every 
hour will often relieve a case of impacted caecum. In constipation from 
atony and deficient secretion a 10-minim dose of the tincture at bed- 
time acts excellently ; and in the poison-oak eczema the infusion is a good 
local application. As an emetic it is entirely too depressant for chil- 
dren's use. 



LYCOPODIUM, — is a very mobile, pale-yellow, fine powder, consisting of the spores 
of the Club-moss, Lycopodiian clavatum, and of other species of Lycopodium (nat. ord . 
Lycopodiaceae). The plant is a native of Europe and the U. S., has a trailing stem sev- 
eral feet long, with smooth, deep-green, pointed leaves, flowers in terminal spikes, and 
yellow capsules which contain the seeds. Lycopodium is odorless, tasteless, floats on water, 
which does not wet it, and burns quickly when thrown on a flame. It should be free 
from pine-pollen, starch, sand and other impurities, which are detected by means of the 
microscope, the spores being about j^ of an inch in diameter, four- sided and reticulated, 
with short projections on the edges. They contain about 47 per cent, of a bland, fixed 
oil. 

The plant was formerly considered to be diuretic and anti-spasmodic, and was used in 
19 



2pO MAGNESIUM. . 

rheumatism, epilepsy and pulmonary and renal disorders. The powder is now employed 
quite extensively in pharmacy to facilitate the rolling of a pill-mass and to prevent adhe- 
sion of pills to each other. It makes an excellent absorbent and protective powder when 
dusted over an excoriated surface, as seen between the thighs of infants. 

By the homoeopathic practitioners Lycopodium is elevated to the rank of an active 
drug when triturated with sugar of milk sufficiently long to break up the seeds and liber- 
ate their oily contents. In their first centesimal trituration ( T ^„) it is said to have pro- 
duced symptoms of high excitement of the circulation and irritation of the urinary organs, 
and they profess to use it with benefit in many affections of the mucous tracts, dyspepsia, 
pyrosis, flatulence, constipation, ileo-colitis of infants, hepatic congestion, aneurism, chronic 
affections of the lungs and bronchi, diphtheria, lithiasis, intertrigo, porrigo capitis, plica 
polonica and pruritus ani, in all of which as an internal remedy- and in high attenuation. 



MAGNESIUM, Mg.— This metal is represented by its Oxide, 
Carbonate, Citrate and Sulphate, of which the latter occurs native in sea- 
water, caves, etc., the others being prepared from it. The first two are 
almost insoluble in water or alcohol. Its salts are either white or color- 
less, and those which are official are as follows : — 

Official Salts of Magnesium. 

Magnesia, Magnesia, Magnesium Oxide, MgO, — made by heating the light carbon- 
ate in a crucible to expel nearly all the carbonic acid. A white, light and very fine 
powder, almost insoluble in water, insoluble in alcohol, and gelatinizes with 15 of water 
after standing j4, hour, having become hydrated. Is a constituent of Pulvis Rhei Com- 
positus, Massa Copaibse and Ferri Oxidum Hydratum cum Magnesia. Dose, gr. x-gj. 

Magnesia 'Pond^rosa, Heavy Magnesia, Magnesium Oxide, MgO, — is a white, dense 
and very fine powder, corresponding in other properties and reactions with Magnesia, ex- 
cept that it does not gelatinize with water. It is made by calcining the heavier variety of 
the carbonate, and is much slower in action than the light magnesia. Dose, gr. x-^j. 

Magnesii Carbonas, Magnesium Carbonate, (MgCO a ) 4 Mg(HO) 2 -(- 5H 2 0, — light, 
friable masses, or powder, odorless and tasteless, insoluble in alcohol, almost insoluble in 
water. Dose, gr. x-^j. 

Magnesii Sulphas, Magnesium Sulphate, Epsom Salt, MgS0 4 -f- 7H 2 0, — colorless 
prisms or acicular needles, slowly efflorescent, odorless, of cooling, saline taste, and neu- 
tral reaction, very soluble in water, insoluble in alcohol. Is a constituent of Infusum 
Sennae Compositum. Dose, 3J-^j. 

Preparations. 

Magnesii Citras Effervescens, Effervescent Magnesium Citrate, — is prepared from 
the Carbonate 10, Citric Acid 46, Sodium Bicarbonate 34, Sugar 8, Alcohol and Distilled 
Water, as required. A coarsely granular, white, deliquescent salt, of acid taste and 
reaction, soluble in 2 of water with copious effervescence, insoluble in alcohol. Dose, 

Liquor Magnesii Citratis, Solution of Magnesium Citrate, — prepared from the Car- 
bonate 15, Citric Acid 30, Syrup of Citric Acid 60, Potassium Bicarbonate 2.]/ 2 , Water to 
360. Dose, £ iv-vj, repeated for catharsis. 

Mistura Magnesise et Asafcetidae, Magnesia and Asafetida Mixture, Dewees 1 Car- 
minative (Unofficial), — contains of the Carbonate 5, Tincture of Asafcetida 7, Tincture 
of Opium 1, Sugar 10, and Distilled Water to 100. Dose, gss-iv. Used for flatulent 
colic and diarrhoea in infants. 

Physiological Action. 
Magnesia and the Carbonate are mildly laxative and antacid, neu- 
tralizing free acids in the stomach and forming therewith laxative salts. 
If used in large quantity for any length of time it may become hydrated 



MAGNOLIA. 29I 

and produce intestinal concretions. The freshly-precipitated hydrate (see 
above, Magnesia) is an antidote to Arsenic in solution, but less effective 
than the Hydrated Sesquioxide of Iron, with which it is combined in the 
official Ferri Ox. Hydratum cum Magnesia. (See ante, page 236.) Mag- 
nesia may also be used in acid or phosphorus-poisoning. 

The Citrate and Sulphate are saline cathartics, the latter being the 
most powerful, producing prompt and free watery discharges, with but 
little griping or irritation, but frequently a sense of coldness and depres- 
sion. The purgative action is chiefly due to their causing a greatly 
increased secretion of intestinal fluids, not by outward osmosis from the 
vessels, as was formerly taught, but by stimulation of the intestinal 
glandular appendages. If the purgative action should not take place a 
diuretic one may result, but to secure the desired catharsis the drug should 
be administered in a considerable quantity of water. Magnesium Sulphate 
is the principal aperient constituent of many of the popular laxative 
mineral waters, as Friedrichshall, Piillna, Hunyadi, etc. 

Therapeutics. 
Magnesia and the Carbonate are used as antacids and laxatives, in acid- 
ity, sick headache, flatulent colic, etc., and as antidotes in poisoning by 
acids, arsenic, phosphorus, mercuric and cupric salts. The Citrate is an 
agreeable laxative, cooling and acceptable to the stomach. The Sulphate 
is the most efficient of the saline cathartics and has a wide field of appli- 
cation. In acute inflammatory conditions, renal and cardiac dropsy, 
ascites from obstruction of the portal circulation, increased blood-pressure 
within the cranium, intestinal obstruction without acute inflammation, the 
constipation of lead poisoning, and habitual constipation from deficiency 
of the intestinal secretions, this agent will be found to be exceedingly 
serviceable. Acute dysentery is well treated by Magnesium Sulphate 
combined with diluted Sulphuric Acid, and followed by Opium and starch 
enemata. Bleeding from hemorrhoids and uterine hemorrhage are often 
relieved by the same combination when other agents fail. In acne 
vulgaris and other obstinate eruptions due to derangement of the stomach 
and intestinal canal, good results are often obtained by a purgative dose 
of the Sulphate daily before breakfast, or by doses of 5 grains in water 
three or four times a day. The same salt, finely triturated, makes an 
excellent dusting powder for cases of acne rosacea. The ferro-saline 
mixture (see ante, page 238) is a very useful laxative in the constipation 
of anaemic women. The bitter taste of Epsom Salt is best covered by 
coffee. 

MAGNOLIA (Unofficial), — is the bark of Magnolia glauca (Sweet Bay, Swamp 
Sassafras), M. acuminata (Cucumber-tree), and M. tripetala (Umbrella-tree), all of 
which belong to the nat. ord. Magnoliacese, and are indigenous to the eastern and 



292 MALTUM — MANACA — MANGANUM. 

southern States. It occurs in quilled or curved pieces, of orange-brown color externally, 
whitish or pale-brown internally, taste astringent, pungent and bitter. It contains a 
crystalline principle named Magnolin, which is insoluble in water, but soluble in alcohol, 
ether, etc. Dose of the powdered bark, g ss-j. 

Magnolia is an aromatic bitter tonic and diaphoretic, usefully employed in chronic 
rheumatism, remittent and intermittent fever. In the latter affection it will arrest the 
paroxysms if used freely. 



MALTUM, Malt (Unofficial), — is the seed of Hordeum distickum, Barley (nat. ord. 
Graminacese), caused to enter the incipient stage of germination by artificial means and 
dried. The germination is allowed to go far enough to develop the maximum amount of 
Diastase, the peculiar ferment by which the starch of the grain is converted into Glucose. 
Malt is the source of beer, ale and whiskey, and is composed of the germinated, dead 
grains with their acrospires and radicles. It should be fresh, not darker in color than a 
pale amber, and of agreeable odor and sweet taste. 

Extractum Malti, Extract of Malt (Unofficial), — is a liquid of the consistence of 
thick honey, containing all the soluble principles of malt in permanent form. It consists 
chiefly of diastase and glucose. Dose, 3J-iv. 

Horlick's Food (Unofficial), — is like Mellin's and many other foods for children, a 
granulated Extract of Malt. Hojfs Malt Extract is another such preparation, contain- 
ing alcohol, and corresponding to a concentrated beer. 

Malt Extract is directly nutritive, containing good food elements, and indirectly so from 
the presence of the ferment Diastase, which converts the starch of bread or other farinas 
into sugar. It is usefully employed in wasting diseases, and mixed with milk or olea- 
ginous foods it aids their digestion and assimilation. It may be used to form a syrupy 
mixture with preparations of Iron or Cinchona. 



MANACA (Unofficial), — is the root of Franciscea uniflora, a shrub of the nat. ord. 
Scrophulariacese, indigenous to Brazil, where it is known as Mercurio-vegetal, or Vege- 
table Mercury, a name applied by charlatans to a number of widely differing plants. 
Very little is known about Manaca, but it has been extensively advertised as an unfailing 
remedy for sub-acute and chronic rheumatism. It is also considered purgative, diuretic, 
emmenagogue and antisyphilitic, being official in the Brazilian Dispensatories, and 
noticed as follows in the Diet, de Botan. Brazileira. 

" This whole plant, but especially the root, excites powerfully the lymphatic system, 
eliminating morbid matter by the skin and kidneys. It is antisyphilitic; the interior bark 
is nauseating and stimulates the throat. In small doses it is resolvent; in larger purga- 
tive, diuretic and emmenagogue. In large doses it is an acrid poison." 

A fluid extract is on the market, the average dose of which is l\ x three or four times 
daily. 



MANGANUM, Manganese, Mn. — This metal is represented in 
the Pharmacopoeia by two of its salts, viz. — the native Black Oxide and 
the Sulphate, as follows: — 

Mangani Dioxidum, Manganese Dioxide, Black Oxide of Manganese, — is the 
native, crude Dioxide of Manganese, containing at least 66 per cent, of the pure Dioxide, 
Mn0 2 . A heavy, grayish-black powder, odorless and tasteless, insoluble in water or alco- 
hol, giving off oxygen gas at a red heat, and if heated with hydrochloric acid it causes 
the evolution of chlorine gas. Is used in preparing Chlorine Water. Dose, gr. ij-x. 

Mangani Sulphas, Manganese Sulphate, MnS0 4 -|- 4H 2 0, — colorless prisms, of 
slightly bitter and astringent taste, faintly acid reaction, very soluble in water, insoluble 
in alcohol. Dose, gr. ij-v. 



MANGANUM. 293 

Preparations. 

Potassii Permanganas, Potassium Permanganate, KMn0 4 , — deep, purple-violet 
prisms, of sweet and astringent taste, neutral reaction, soluble in 16 of water with a 
scanty, brown residue, decomposed by alcohol and by heating to 464 F. It should be 
kept in well-stoppered bottles, and should not be triturated nor combined in solution with 
organic or readily oxidizable substances. Dose, gr. ss-ij, in pill. 

Syrupus Mangani Iodidi, Syrup of Manganese Iodide (Unofficial), — contains about 
2j of the iodide in each ^. Dose, TT^x-xxx. For formula see U. S. Dispensatory. 

Syrupus Ferri et Mangani Iodidi, Syrup of Iron and Manganese Iodide (Un- 
official), — each ^ contains gr. 50 of the mixed iodides in the proportion of 3 of the 
Iodide of Iron to I of that of Manganese. Dose, TT^ x-xxx. For formula see U. S. Dis- 
pensatory. 

Ferri et Mangani Carbonas Saccharatus, Saccharated Iron and Manganese Car- 
bonate (Unofficial), — is a tasteless, reddish-brown powder. Dose, gr. v-xx. For formula 
see U. S. Dispensatory. 

Condy's Red Fluid (Unofficial), — is a solution of Potassium Permanganate in Dis- 
tilled Water, of about 2 per cent, strength, namely gr. viijss to the ^, or gr. 176 in ^20. 
It is used as a deodorant and disinfectant, for closets, bed-pans, and to wash the hands 
and utensils. Is non-irritant, and has the advantage of showing by its change in color 
when it has lost its efficacy. 

Physiological Action. 

The salts of Manganese in small doses improve the appetite and the 
digestion and stimulate the action of the heart. Used in larger doses and 
for considerable length of time they lower the heart's action, paralyze the 
muscular system, especially the muscular coat of the arteries, causing pro- 
gressive wasting, paraplegia, and acute fatty degeneration of the liver. 
They are gastro-intestinal irritants, and the Sulphate is emeto-cathartic 
and decidedly cholagogue. Manganese is closely associated with Iron in 
the blood, bile, etc., in the proportion of about 1 to 20. The Black 
Oxide is an efficient emmenagogue. 

Potassium Permanganate is an active oxidizer, containing as it does 
a large proportion of oxygen which it yields very readily in the form of 
ozone, and then becomes manganese dioxide. This property gives it the 
qualities of an antiseptic, a disinfectant and a deodorant. It is considered 
by some authorities to be an efficient emmenagogue. Used internally it 
must be instantly decomposed in the stomach, and probably is not 
absorbed in its own state. 

Therapeutics. 

The salts of Manganese -are used by those practitioners who affect to see 
a manganese-anaemia in cachectic subjects, but they are always combined 
with ferric preparations. In amenorrhoea, gastrodynia and pyrosis the 
dioxide is a good remedy, and the same salt is used as an ointment in 
many skin diseases. In jaundice of malarial origin or catarrh of the 
biliary passages the sulphate gives good results. 

Potassium Permanganate is employed as an antiseptic and oxidizing 
agent in such affections as diphtheria, scarlatina, septicaemia, erysipelas, 
etc., in which it may be given internally and used locally at the same 



294 MANGO MANNA. 

time. It is given with apparent benefit in dyspepsia, flatulence, lithaemia 
and obesity, and has often seemed to be of service in acute rheumatism. 
In amenorrhcea it is reported to be very efficient, and has lately been used 
with success as a remedy for the bites of venomous serpents and for other 
animal poisons. For internal use it should be given in pill, as the taste 
of a solution is very disagreeable. Locally it is frequently employed (3J 
to the pint) to correct fetor in cancer, ulcer, caries, abscesses, ozaena, and 
it will destroy the odor of a foul breath or that of the fetid perspirations 
of the feet. It is used both as a test and as a corrigent for organic im- 
purities in drinking water. The stain left by it on fabrics may be 
removed by sulphurous acid, but, as sulphuric acid is formed in the 
reaction, the fabric should be immediately washed or rinsed in water. It 
has lately come into use as an antidote against morphine. 

Manganese is becoming more of an acknowledged remedy in derange- 
ments of the menstrual function, as irregular or scanty menstruation, 
amenorrhcea, menorrhagia, and even metrorrhagia. By some authorities, 
the emmenagogue power of potassium permanganate is ascribed to its large 
proportion of oxygen, which it is supposed to give up to the uterus; as, 
until recently, potassium chlorate was supposed to do by the system at 
large. According to the views of others who have studied its action, 
Manganese should be classed with the excito-motors, increasing arterial 
tension, and specifically acting upon the uterus. The best preparation is 
the Dioxide, in freshly-made pills of two grains each, of which 1 to 3 or 
5 pills may be taken twice or thrice daily. Potassium Permanganate has 
generally been the preparation given when the effects of Manganese were 
desired ; but as it causes great gastric irritability, with abdominal pains 
and burning sensations, besides other decidedly unpleasant symptoms, it 
is a difficult matter to get patients to take it for any length of time. 



MANGO (Unofficial), — is the bark of Mangifera indica, an Indian tree of the nat. 
ord. Guttifene. It is supposed to be an astringent with special tonic action upon mucous 
membranes. It is highly recommended by its vendors for nasal catarrh, hemorrhages, 
and muco-purulent discharges from the intestines, uterus, vagina and bronchi. A fluid 
extract is sold, which may be used in doses of n\,x- t ^j. 

Mango-Fruit, or Mangosteen, is the fruit of Garcinia mangostana, nat. ord. Gutti- 
ferae, also from India. It is a powerful astringent, and is used for nasal catarrh, diarrhoeas, 
dysentery, leucorrhrea, etc. 



MANNA, — is the concrete, saccharine exudation of Fraxinus Ornus, or Flowering 
Ash, a tree of the nat. ord. Oleacere, growing in Southern Europe. Manna is produced 
also by several other trees, and substances resembling it are exuded by many plants. 
The official Manna occurs in three-edged, flattish pieces, brownish-while and glutinous 
externally, white and crystalline internally, odor honey-like, taste sweet, slightly bitter 
and faintly acrid. It contains from 40 to 90 per cent, of Mannit, C 6 H u 6 , or Manna- 
sugar, which does not undergo vinous fermentation, and is chemically allied to the 
alcohols and to glycerin. Manna also contains glucose, mucilage, some acrid resin, and 



MARRUBIUM MASTICHE MATICO. 295 

g O in . There are no official 
preparations, but Manna itself may be given in doses of j-fj—ij. 

Manna is a mild laxative, with some tendency to produce flatulence and colic. It is 
usually combined with other purgatives, as Senna, Rhubarb, Magnesia, etc., to disguise 
the taste and increase the effect. It is a constituent of the official Infusum Sennae Com- 
positum. Manna may be eaten by children if of good quality, or may be readily dissolved 
in milk and so administered. 



MARRUBIUM, Horehound, — the leaves and top of Marrubium vulgare, a plant 
of the nat. ord. Labiatse, native in Europe, but naturalized in America. It contains a 
bitter principle named Marrubiin, also a volatile oil, resin, tannin, lignin, etc. There 
are no official preparations. Dose, gss-j. 

Horehound in large doses is laxative, diuretic and diaphoretic, and in ordinary dosage 
it is a gentle tonic and stomachic. It is generally used in catarrhal states of the air- 
passages, over which it seems to have a soothing effect, and is much employed in confec- 
tionery as an ingredient in " cough-drops." 



MASTICHE, Mastic, — is a concrete, resinous exudation from Pistacia Lentiscus, 
a tree of the nat. ord. Anacardiese, growing in the island of Scio. It occurs in globular 
tears, covered with a whitish dust, of weakly resinous odor and slightly terebinthinate 
taste. Alcohol dissolves about 90 per cent, including the resin Mastichic Acid, C 20 H 32 O 3 , 
the remainder consisting of another resin Mastichin, which is soluble in ether and 
resembles copal. There are no official preparations, but Mastic is an ingredient of the 
official Pil. Aloes et Mastiches (see ante, page 105). 

Mastic was formerly used for supposed properties analogous to those of other oleoresins, 
but now its application is confined to dentistry, being employed as a temporary filling for 
carious teeth. A solution in ether is applied on cotton with moderate pressure, and 
remains as a firm plug after evaporation of the solvent. 



MATICO, — the leaves of Piper angiistifolium, a Peruvian shrub of 

the nat. ord. Piperacese. They are 4 to 6 inches long, and prominently 

venated on the under surface, the veins forming deep, angular meshes. 

Matico contains a crystallizable acid named Artanthic Acid, also resin, 

tannin, and a volatile oil. Its odor is aromatic, and its taste astringent, 

spicy and somewhat bitter. 

Preparations. 

Extractum Matico Fluidum, Fluid Extract of Matico. — Dose, g-ss-ij. 
Tinctura Matico, Tincture of Matico, — 10 per cent. Dose, ^ss-ij. 

Matico is an aromatic tonic and stimulant, also aphrodisiac, vulnerary 
and hemostatic. It acts, like cubebs, on the urinary passages, and is an 
excellent alterative stimulant to mucous membranes. It ^ has been used 
with considerable success in mucous catarrhs, as gonorrhoea, leucorrhcea, 
chronic cystitis, etc., also in epistaxis, hemorrhoids, menorrhagia, hemop- 
tysis, hematemesis and other hemorrhages. The under surface of the leaf 
is so formed as to promote coagulation of blood if applied to a bleeding 
surface, and therefore it is a good local hemostatic for trivial cuts or 
wounds. 



296 MATRICARIA MEL MELISSA. 

MATRICARIA, German Chamomile, — the flower-heads of Matricaria Ckamo- 
milla, a European annual plant of the nat. ord. Compositae. They are small, yellow 
flowers, with white ray-florets, the receptacle being hollow, naked and conical, of strongly 
aromatic odor and bitter taste; and contain j^th per cent, of a blue Volatile Oil (the 
color of which is due to Azulen), also a bitter extractive, tannin, etc. There are no offi- 
cial preparations, but the flowers may be eaten or a decoction or infusion used almost ad 
libittim. 

Matricaria is a mild tonic, in large doses emetic, anthelmintic and antispasmodic. It 
is much used in Germany, and in this country is a popular domestic remedy among Ger- 
man people, who use it in infusions as a diaphoretic, etc. This plant is the " Chamo- 
milla" of the homoeopaths, who find in it remarkable power over morbid impressionability 
of the sensory and excito-motor nerves, and administer it in various pains, aggravated at 
night and by warmth, clonic spasms of pregnancy, irritability of teething-children, flatu- 
lent colic, etc. 



MEL, Honey, — is a saccharine secretion deposited in the honey- 
comb by Apis mellijica, the honey-bee; occurring as a pale-yellowish, 
syrupy liquid, gradually becoming crystalline and opaque, of peculiar and 
heavy odor, and a very sweet, faintly acrid taste. It is a strong aqueous 
solution of several sugars (cane and grape sugar, levulose), with wax- 
pollen, coloring and odorous matters, etc. The sugars, which may be 
resolved into Levulose and Dextrose, amount to 70 or 80 per cent. 
Honey is frequently adulterated with starch and artificial glucose, which 
may be detected by the official tests (see U. S. Phar.). Dose, indefinite. 

Preparations. 

Mel Despumatum, Clarified Honey, — is honey heated, skimmed and strained, with 
Glycerin added in the propoition of 5 per cent. It is an ingredient of Confectio Rosoe, 
Mel Rosae, and Massa Ferri Carbonatis. Dose, indefinite. 

Mel Rosse, Honey of Rose — Fluid Extract of Rose 12, Clarified Honey to 100. Dose, 
indefinite ; generally used as a local application to the throat for its astringency and flavor, 
in combination with more active agents. 

Honey is emollient, nutritive and laxative, in some persons giving rise 
to pyrosis, flatulence and colic, and in others to an eruption of urticaria, 
but generally constituting an agreeable article of diet. It is sometimes 
actually poisonous from the presence of toxic agents extracted by the bee 
from certain plants, in this country generally the Mountain Laurel 
(^Kalmia Latifolia). Honey is chiefly used as an emollient in diseases of 
the throat, to relieve dryness, pain, cough and dysphagia. A mixture of 
Honey 8 parts to 1 each of Acetic Acid and Water is official in the Br. 
Phar. under the title Oxymel, and forms a pleasant addition to gargles 
or a vehicle for expectorant medicines. Honey of Rose is somewhat 
astringent, and is used in gargles for the throat and in mouth washes. 



MELISSA, Balm, — the leaves and tops of Melissa officinalis, a European plant of 
the nat. ord. Labiatse, growing also in America. It has a perennial root, which annually 
gives forth several stems from 1 to 2 feet high, with leaves about two inches long, deeply 
serrate, hairy and glandular, and white or yellowish flowers in axillary whorls of four or 



MENISPERMUM MENTHA PIPERITA. 297 

five around half the stem. It contains gum, tannin, bitter extractive, and a fragrant 
essential oil in very small quantity (y$ to *£ per cent). There are no official preparations. 
Balm has little or no action, except to flavor hot water for use as a beverage or a mild 
diaphoretic. 



MENISPERMUM, — is the rhizome and rootlets of Menispermum canadense, the 
Yellow Parilla, or Canadian Moonseed, a woody, climbing plant of the nat. ord. Menis- 
permacese, native of the eastern U. S., having peltate three-to seven-lobed leaves, green- 
ish-yellow flowers in small clusters, and a kidney-shaped fruit. The rhizome is several 
feet long, *£ inch thick, finely wrinkled, rootlets numerous, taste bitter. It contains 
starch, Berberine, and a white alkaloid, which is soluble in alcohol and in ether. 

Extractum Menispermi Fluidum, Fluid Extract of Menisper??ium, — is %rds 
alcohol. Dose, m^v-xx. 

Menispermum is reputed to have tonic properties, and is used in some of the Southern 
States in domestic practice as a substitute for Sarsaparilla in scrofulous conditions. Little 
is known about it of a definite character. 



MENTHA PIPERITA, Peppermint,— the leaves and tops of 
Mentha piperita, a perennial herbaceous plant, of the nat. ord. Labiatse, 
a native of Britain, but largely cultivated elsewhere. The leaves are 
about 2 inches long, ovate-lanceolate, sharply serrate, of aromatic odor, 
and pungent, cooling taste. They contain 1 to 1^ per cent, of a Vola- 
tile Oil, which is official, and a little tannin. 

Menthol, C 10 H 19 OH, — is a stearopten (having the character of a 
secondary alcohol), obtained from the official t>il of peppermint, or from 
Japanese or Chinese oil of peppermint, (from Mentha arvensis and Men- 
tha canadensis) ; by deposit therefrom on exposure to cold. It occurs in 
colorless, acicular crystals, of strong and pure odor of peppermint, and a 
warm, aromatic taste, followed by a sensation of cold when air is drawn 
into the mouth. Soluble only slightly in water, freely in alcohol, ether, 
chloroform, carbon disulphide or glacial acetic acid. Dose, gr. ss-iij, in 
pill or spirituous solution, several times a day. 

Preparations. 

Oleum Menthae Piperitae, Oil of Peppermint, — is the volatile oil distilled from the 
fresh herb ; a colorless or pale yellow fluid of sp. gr. about 0.900, having the odor of 
peppermint, a strongly aromatic taste followed by a cold sensation when air is drawn into 
the mouth. It consists of a liquid terpene, and the stearopten Menthol (see above). Dose, 
ny-v. 

Aqua Menthae Piperitae, Peppermint Water, — has of the oil 2 parts in 1000 of Dis- 
tilled Water. Dose, indefinite. 

Spiritus Menthae Piperitae, Spirit of Peppermint, Essence of Peppermint, — is an 
alcoholic solution containing 10 per cent, of the Oil and I per cent, of the powdered herb. 
Is an ingredient of Mistura Rhei et Sodse. Dose, m^x-ocxx. 

Trochisci Menthae Piperjtae, Peppewnint Troches, — each troche contains 1 per 
cent, of the Oil, with Sugar and Mucilage of Tragacanth. Dose, indefinite. 

Physiological Action and Therapeutics. 
Peppermint is an aromatic stimulant, also carminative and antispas- 
modic. The oil possesses these qualities in greater degree and is also a 



298 MENTHA VIRIDIS. 

local anodyne and anaesthetic when applied locally, especially if its evap- 
oration be prevented. The Chinese oil is particularly anodyne and con- 
tains a large quantity of Menthol. Menthol is antiseptic and locally 
anaesthetic, but not corrosive, and acts also as a vascular stimulant when 
applied to the surface. 

Peppermint is used internally for the relief of nausea and colic, and 
to expel flatus by its local stimulant and after sedative action on the 
bowels. It is an agreeable corrigent for combination with purgatives to 
prevent griping, and efficiently covers the taste of many nauseous sub- 
stances. The spirit is the best form for internal use. The oil is used 
locally to relieve the pain of superficial neuralgia, a cloth being wet with 
it, laid along the course of the affected nerve and covered with oiled silk 
to restrain evaporation. It is also efficient in rheumatism as an anodyne 
counterirritant. 

Menthol is highly praised as an external application in various neural- 
gias, sciatica, pleurodynia, toothache, etc. For neuralgia it is used in 
saturated alcoholic solution painted over the affected nerve. For tooth- 
ache a crystal introduced into the carious cavity is promptly anodyne. 
As an antiseptic it promises well as an application in parasitic skin 
diseases. As the Chinese have used their Oil of Peppermint for ages as 
an application in neuralgias, and as this oil contains a large quantity of 
Menthol, the latter preparation will probably prove a very efficient agent 
in these affections if the cupidity of the manufacturers will allow of its 
being obtained pure. A spray containing 5 to 20 per cent, of Menthol is 
highly recommended in epidemic influenza, also in tubercular laryngitis. 
Menthol is of marked value in almost all cases of pruritus, from whatever 
cause. It possesses high power as an anti-emetic, stopping nausea and 
vomiting after all the usual remedies had failed. For this purpose ten 
drops of a 20 per cent, solution in olive oil are given on sugar. 



MENTHA VIRIDIS, Spearmint, — the leaves and tops of Mentha viridis, the 
" mint" of the kitchen garden, a plant of the nat. ord. Labiatse, indigenous to England, 
but naturalized in many countries. Its constituents and properties are identical with those 
of peppermint, but its odor and taste differ therefrom. 

Preparations. 

Oleum Menthae Viridis, Oil of Spearmint, — is the Volatile Oil distilled from the 
plant. Dose, TT^ij-v. 

Aqua Menthae Viridis, Spearmint Water, — has 2 parts of the Oil in ioooof Distilled 
Water. Dose, indefinite. 

Spiritus Menthae Viridis, Spirit of Spearmint, Essence of Spearmint, — is an alco- 
holic solution containing 10 per cent, of the Oil and I per cent, of the powdered herb. 
Dose, TT\x-xl. 

Spearmint corresponds in action to Peppermint, but is generally less powerful. It is 
usually employed to correct flatulence and to relieve colic, and makes an agreeable flavor- 
ing for many mixtures. 



METHYLENE BLUE MEZEREUM. 299 

METHYLENE BLUE, Tetra - Methyl - Thionine Chloride, NS(C 6 H 3 ) 2 2N- 
(CH 3 ) 2 C1 (Unofficial), — is an anilin derivative, which when pure is seen in small, dark 
blue, scaly crystals, having a copper bronze tinge, soluble in water. Dose, gr. j-iij, four 
or five times a day. 

This substance imparts a blue color to nerve tissue and to the urine. From the facts 
that it manifests a strong affinity for nerve tissue, especially for the axis cylinders of sen- 
sory nerves, and that it is the best staining agent for the microbe found in the blood of 
malarial subjects, this agent has been expected to possess anodyne power over neuralgic 
and rheumatic affections and to act as an antiperiodic in malaria. It has been employed 
by several observers as an antipyretic and internal antiseptic for rheumatism of the joints 
and muscles, for malarial fever, diphtheria, acute nephritis and cancer, with varying 
results. Its best action in malarial affections has been obtained in children, and being 
tasteless may be administered to them with greater ease than quinine, besides being free 
from the vomiting and headache which so often result from the latter drug. In diphtheria 
and in simple, non-diphtheritic ulceration of the throat a ten per cent, soultion is used 
locally with great benefit so far as yet reported. It has lately been employed successfully 
in two cases of chronic cystitis. 



MEZEREUM, Mezereum (Mezereon), — is the bark of Daphne Mezeream and of 
other species of Daphne, plants of the nat. ord. Thymelceaceae, growing in mountainous 
districts of Europe and Asia and cultivated as a garden shrub in Britain. The bark 
occurs in long, thin bands, rolled into disks, brownish-yellow on the surface, whitish and 
silky within, inodorous, taste very acrid. It contains an inert, fixed oil, an inactive 
glucoside, Daphnin, and an acrid Resin, which is the anhydride of a resinous acid named 
Mezereinic Acid. Mezereum is an ingredient of the compound decoction and the com- 
pound fluid extract of Sarsaparilla. Dose, gr. j-x. 

Extractum Mezerei Fluidum, Fluid Extract of Mezereum, — is too acrid for internal 
use. It is an ingredient of the Linimentum Sinapis Compositum. 

Mezereum is a sialogogue, and an intensely acrid, irritant poison, producing violent 
vomiting, purging, nephritis and gastro-enteritis. In small doses it is laxative and diuretic, 
and has had considerable reputation as an alterative. Externally the recent bark is a 
powerful local irritant, speedily producing vesication. 

Mezereum is rarely used internally by itself, but is employed in mixtures with Sarsa- 
parilla, etc., as an alterative in syphilis, rheumatism and some skin diseases of chronic 
type, but with doubtful efficacy. It has been used with good effect in toothache and as a 
masticatory in paralysis of the tongue. Its principal use is as a local irritant to keep up 
the discharge from issues or blisters, and to stimulate indolent ulcers. 



MORRHUiE OLEUM, Cod-liver Oil {Oleum Jecoris Aselli),— 
is a fixed oil obtained from the fresh livers of Gadus Morrhua (Cod-fish) 
or other species of Gadus. It is a colorless or pale yellow, thin, oily- 
liquid, of slightly fishy odor and taste, and faintly acid reaction, soluble 
in ether; sp. gr. 0.920 to 0.925. It consists chiefly of Olein and Mar- 
garin, with a peculiar principle named Gaduin, also Trimethylamine, free 
fatty Acids (oleic, palmitic, stearic), traces of Iodine, Bromine, Sulphuric 
and Phosphoric Acids, the ordinary inorganic salts of animal tissue and 
products, and perhaps bile constituents. When saponified it does not 
yield Glycerin but Oxide of Propyl. Three kinds or varieties are found 
in the market, the pale, the light-brown and the dark. The pale is the 
official oil and the purest. Dose, ^j-ij on a full stomach, increased as 
assimilated. 



300 MORRHUiE OLEUM. 

Unofficial Preparations. 

Glyconin Emulsion of Cod-liver Oil, — 01. Morrhuae %iv, Glyceritum Vitelli ^ix, 
Aromatic Spirit of Ammonia ^j, Sherry Wine ^ij, Diluted Phosphoric Acid ^iv, Es- 
sence of Bitter Almond (sjj of the Volatile Oil in Oss Alcohol) gij. The Cod-liver Oil 
is to be added to the Glyconin very slowly with brisk stirring, and the other ingredients 
added in the order named. 

Hydroleine, Hyd rated Oil, — is said to contain, in each dose of 3jij, Cod-liver Oil n\, 
80, Distilled Water rr^ 35, Pancreatin gr. 5, Soda gr. y£, Salicylic Acid gr. %. 



Physiological Action. 

The action of Cod-liver Oil is that of any other fat, except that it is 
more easily assimilated than any member of the class. Fats in small quan- 
tity are necessary for the digestion of nitrogenous food, and form the 
molecular basis of the chyle, being prepared for absorption by the pancre- 
atic juice and the bile, especially the latter. Fat is an essential con- 
stituent of the products of tissue formation, whether physiological or path- 
ological, and is the principal material concerned in the production of 
force. After oxidation it is excreted as carbonic acid and water. Lo- 
cally applied fats reduce the body temperature. 

Cod-liver Oil is the most easily digestible of fats, penetrating animal 
membranes with comparative ease after being emulsified by the pancreatic 
and biliary secretions, hence entering the lacteal vessels readily and ap- 
pearing to bring with it the oily and nitrogenous elements of the food. 
The result is facilitation of the digestive process, increase of the red 
blood-corpuscles and of the body- weight, and stimulation of healthy cell- 
formation throughout the tissues. The properties of this oil have been 
ascribed to its contained biliary constituent, Iodine, free Oleic Acid, etc., 
but no satisfactory explanation has yet been offered for the difference 
between its action and that of other animal or vegetable oils. 

Therapeutics. 

The use of Cod-liver Oil is that of a nutrient wholly, this action being 
most marked in wasting diseases. In high febrile states or catarrhal con- 
ditions of the gastro-intestinal tract its use is contraindicated, but in 
phthisis a slight degree of fever will not interfere with its beneficial em- 
ployment. It is found to be of most value in chronic forms of phthisis, 
chronic bronchitis and emphysema, chronic rheumatic disorders, atheroma 
of the arteries, strumous skin diseases and diarrhoea, syphilodermata, neu- 
ralgia, chorea and epilepsy. In many disorders referable to exhaustion 
or debility of the nervous centres it is of great value as a nerve tonic, and 
in convalescence from acute diseases it is of marked benefit. It should 
always be considered as a supplementary food, and if its use endangers the 
appetite for other food it should be abandoned. 

The administration of this valuable agent is a serious matter, as many 



MOSCHUS. 



301 



patients cannot overcome their repugnance to its taste and smell. Various 
emulsions are on the market, but they are objectionable because in no case 
do they conceal the taste, and the efficacy of the oil is seriously impaired 
by the processes used in their preparation. Moreover, the temptation is 
very great to employ an inferior grade of the oil or to adulterate it with 
other fish-oils in the manufacture of these preparations, and when the 
commercial spirit of gain is remembered one can never be sure of the 
quality of the oil so prepared. The oil itself is the best form for use, in 
small doses, say a teaspoonful thrice daily for an adult, after meals, in 
black cofTee, beer or lemon-juice. The essential Oil of Eucalyptus in the 
proportion of 1 part to 100 of cod-liver oil will effectually extinguish the 
odor and taste to many persons. Alkaline stomachics given before meals, 
the oil after, and a teaspoonful of the " Liquor Pancreaticus" given half 
an hour afterwards, would be a good routine in most cases, the latter 
agent preventing the fishy eructations which often give so much trouble. 
Extemporaneous emulsions may be prepared with Glyconin, (see anfe, 
page 300), White of Egg, Mucilage of Tragacanth, Extract of Malt, or 
any syrup, and flavored with Lemon, Cinnamon or Bitter Almond. The 
addition of r^iv of Ether to each 3 of the oil promotes its digestion by 
stimulating the pancreatic secretion, and enables a patient to take it with 
whom it had previously disagreed. 

Inunction by Cod-liver Oil is a method of value is the wasting diseases 
of children. A tablespoonful may be rubbed into the skin of the abdo- 
men twice a day, and covered with a flannel binder with oiled silk or 
mackintosh-cloth outside. It readily passes through the skin and is 
absorbed, producing valuable and lasting results. 



MOSCHUS, Musk, — is the dried secretion from the preputial follicles of Moschus 
moschiferus (the Musk Deer), an animal inhabiting the mountainous region of Central 
Asia. It occurs in irregular, unctuous grains, of a reddish-brown color, peculiar and 
penetrating odor and bitterish taste, contained in oval sacs about 2 inches in diameter, 
membranous on one side, hairy on the other. About 10 per cent, is soluble in alcohol, 
50 per cent, in water. Chinese Musk in the pods or sacs is the most valuable, but all 
varieties are much adulterated, the price of the drug being very high. The odor is 
destroyed by drying, but returns again on the addition of moisture. Trituration with 
Camphor or Hydrocyanic Acid also destroys it. The odorous principle has not been 
isolated, but is probably a product of decomposition which is constantly being formed. 
The constituents of Musk are a bitter resinous substance, ammonia, fat, cholesterin, etc. 
Dose, gr. ij-x. 

Tinctura Moschi, Tincture of Musk ', — 5 per cent. Dose, TT\xx-gjss. 

Musk is a very diffusible stimulant, acting directly on the nervous and circulatory 
systems, but without much energy. It is also an antispasmodic, and is employed with 
benefit in general prostration of the system with nervous agitation or irregular muscular 
action. It has been used with advantage in laryngismus stridulus, insomnia, the collapse 
of typhoid and typhus fevers, spasmodic affections of the stomach, obstinate hiccough and 
convulsions of children due to intestinal spasms. The pure Musk is very difficult to 
obtain, and its high price makes it an extremely expensive medicine, so that it is seldom 
used except as a perfume. 



302 MYRCI/E OLEUM MYRISTICA. 

MYRCIA OLEUM, Oil of Myrcia,< (Oil of Bay),— is a volatile oil distilled 
from the leaves of Myrcia acris, or Bayberry, a tree of the nat. ord. Myrtaceae, native of 
the West Indian Islands. It is a yellowish brown liquid, of aromatic odor, pungent 
taste, slightly acid reaction, and soluble as a slightly turbid solution in an equal weight 
of alcohol. It contains a hydrocarbon and Eugenic Acid. Used as a perfume. 

Spiritus Myrciae, Spirit of Myrcia, Bay Rum, — contains Oil of Myrcia 16, Oil of 
Orange-peel i, Oil of Pimenta i, Alcohol 1220, Water to 2000. Used as a wash or per- 
fume. 

The Oil of Bay is an agreeable perfume used to prepare bay-rum and in other cosmetic 
preparations. The spirit, known as " Bay-rum," is used principally as a refreshing per- 
fume, and is thought to relieve headache, faintness, etc., by application to the forehead or 
to the nostrils. 



MYRISTICA, Nutmeg, — is the seed of Myristica fragrans de- 
prived of its testa. The Nutmeg-tree is cultivated extensively in the East 
and West India Islands, belongs to the nat. ord. Myristicaceae, and is a 
native of the Banda Islands in the Malayan Archipelago. The nutmeg 
is about an inch long, oval or roundish-ovate, reticulately furrowed, inter- 
nally pale-brown or grayish-red with dark-brown veins, having a strongly 
aromatic, odor and a somewhat bitter taste. It contains 4 to 9 per cent, 
of the official Volatile Oil, and 30 per cent, of a concrete oil, commonly 
called " Oil of Mace," which is a compound of fluid glycerides of Oleic 
and Butyric Acids, and the solid glyceride of Myristic Acid, some resin 
and volatile oil. Dose, gr. v-xx. 

Macis, Mace, — is the arillode (or fleshy covering) of the seed of 
Myristica fragrans, the Nutmeg-tree. It occurs in narrow bands about 
an inch long, branched and lobed, of brownish-orange color, fragrant odor, 
warm and aromatic taste. It yields a fixed oil by pressure and a volatile 
oil by distillation, the latter being probably identical with Oil of Nut- 
meg. Dose, gr. v-xx. 

Preparations. 

Oleum Myristicae, Oil of Nutmeg, — is the volatile oil, and consists chiefly of a ter- 
pene and an oxygenated oil, Myristicol. It is colorless or pale-yellow, of hot, spicy taste 
and neutral reaction, and is soluble in alcohol. Dose, TT\j-v. 

Spiritus Myristicae, Spirit (or Essence) of Nutmeg, — is a 5 per cent, solution of the 
oil in alcohol. Dose, ^j-ij. 

Nutmeg is an ingredient of Acetum Opii, Pulvis Aromaticus, Tr. Lavandulae Co., 
Trochisci Cretae, and Trochisci Sodii Bicarbonatis. 

Physiological Action and Therapeutics. 
Nutmeg is an aromatic stomachic of agreeable flavor. In'small doses 
it stimulates the production of gastric juice, and thus promotes digestion 
and increases appetite. It also relieves intestinal spasm and flatulence. 
In large doses it is powerfully narcotic, acting directly on the cerebrum, 
and producing stupor and delirium. It is used chiefly for flavoring 
purposes, and generally in substance, grated as required, but has been 
employed as a carminative, anodyne and astringent in diarrhoeas and dys- 
entery, as well as to relieve nausea and vomiting. Strangury is efficiently 



MYRRHA NAPHTALINUM. 303 

treated by small doses of powdered nutmeg given several times a day ; 
and the same remedy is often used in the south of Germany to relieve the 
uncomfortable feeling experienced after drinking an excessive quantity of 
new beer. The Volatile Oil is decidedly rubefacient when used exter- 
nally, and has narcotic powers if used internally in sufficient quantity. 
It is occasionally employed as an external stimulant in paralysis and 
chronic rheumatism. 

Mace is stimulant, carminative and aromatic. It is used solely as a 
spice or condiment. 



MYRRHA, Myrrh, — is a gum resin obtained from Commiphora 
Myrrha, an Arabian tree of the nat. ord. Burseracese, collecting sponta- 
neously upon the bark, and occurring in roundish tears, having a waxy 
fracture, a balsamic odor, and an acrid and bitter taste. Triturated with 
water it yields a brownish-yellow emulsion ; with alcohol it yields a 
brownish-yellow tincture which turns purple on the addition of nitric 
acid. It contains 60 per cent, of gum, 35 per cent, of Myrrhin, a resin, 
and about 2 per cent, of an oxygenated ethereal oil, Myrrhol, C 10 H n O. 

Dose, gr. x-xxx. 

Preparations. 
Tinctura Myrrhse, Tincture of Myrrh,— 20 per cent. Dose, nrx-xxx. 
Myrrh is also contained in Mist. Ferri Co., Pil. Aloes et Myrrhae, Pil. Rhei Co., and 
Tr. Aloes et Myrrha. 

Physiological Action and Therapeutics. 

Myrrh in small doses stimulates thegastro-intestinal mucous membrane ; 
in large doses it is an irritant thereunto, producing vomiting and purging. 
It quickens the action of the heart and diminishes the bronchial secretion. 
It is a uterine stimulant and emmenagogue, a stimulant expectorant, and 
is thought to increase the number of leucocytes in the blood. Locally it 
is stimulant and disinfectant to mucous membranes and ulcerated surfaces. 

Mryrh is used internally in the various combinations noted above for 
anaemia and amenorrhcea, bronchial catarrh, etc. It has been supposed 
to diminish excessive secretion from the mucous surfaces of the uterus, 
vagina, bladder, and bronchi, and to have an especially beneficial influ- 
ence on chronic pharyngitis. Locally, the tincture has a good tonic ac- 
tion on diseased mucous surfaces, and is applied to spongy gums, relaxed 
throat, aphthous patches and unhealthy ulcers. The tincture diluted with 
water makes an excellent disinfectant and stimulant gargle in ulcerated 
sore-throat. Myrrh has long been used as an ingredient of dentifrices. 



NAPHTALINUM, Naphtalin, {Naphthalene), C 10 H 8 ,— is a hy- 
drocarbon product formed during the manufacture of ordinary coal gas. 



304 NAPHTALINUM. 

Chemically, it is one of the benzene derivatives, being formed by the 
union of two benzene groups in an overlapping ring. (See ante, page 
195). When redistilled, it crystallizes in colorless, rhomboid plates, of 
slightly tarry but strong odor, and burning, aromatic taste : insoluble in 
water, soluble in 15 of alcohol, very soluble in boiling alcohol, ether, 
chloroform, carbon disulphide, and fixed or volatile oils. It is seen 
frequently in the form of moulded blocks, under such names as Ala- 
bastrine and Camphylene, for preserving furs and flannels from moths, 
and for placing in urinals for disinfectant purposes. 

The dose of Naphtalin is from gr. ij to gr. viij, up to gr. lxxx per diem 
for adults ; — and for children gr. j to gr. iij, every three hours. Being quite 
insoluble in water it must be given in emulsion, or as a powder with sugar 
in wafers or capsules. It is best flavored with oil of bergamot. 

Derivatives. 

Naphtol, Beta-{or Iso-)naphtol, C 10 H 7 OH, — a phenol occurring in coal-tar, but 
usually prepared artificially from Naphtalin. It is one of several naphtols, and occurs in 
colorless, shining, crystalline laminae, or a whitish, crystalline powder, of faint, phenol- 
like odor, and sharp taste. Soluble at 59 F. in ^ of alcohol, and in about 1000 of 
water, in 75 of boiling water, and very soluble in boiling alcohol, in ether, chloroform, 
olive oil and petrolatum. Used as ointment, I to 5 for adults, but for children should be 
not over 2 per cent, strength. 

Hydronaphtol, C 16 H 7 OH, (Unofficial), — glistening, micaceous scales, sparingly solu- 
ble in water, freely soluble in alcohol, oils, etc. Used as an antiseptic, and in ointment 
or powder locally, diluted with oxide of zinc, I to 50. 

Naphtolum Camphoratum, Camphorated JVaphlot, Naphtot Camphor (Unofficial), 
— is prepared by heating carefully one part of beta-naphtol with two of camphor ; the 
product being a homogeneous, oily fluid, which is insoluble in water, and decomposes 
readily on exposure to light and air. Used as parenchymatous injection, the undiluted 
fluid being well borne, or in Olive oil, in doses of mjj-v. 



Physiological Action. 
Naphtalin is destructive to all forms of low life, and hence is anti- 
septic in a high degree, but must be intimately mixed with the substances 
upon which it is to act. Internally it is a stimulant expectorant of decided 
power, and disinfects the contents of the intestinal canal. Being so 
sparingly soluble, but little of it is absorbed, and hence it does no injury 
to the organism. What is taken up by the blood is excreted by the 
urine, partly unchanged, partly as naphtol and perhaps some as phenol. 
Naphtol is more easily absorbed, and causes vomiting, hematuria, con- 
vulsions and unconsciousness. Hydronaphtol is a powerful and non- 
irritating antiseptic, non-poisonous, non-corrosive, freely soluble in alco- 
hol, glycerin, fixed oils, etc., in cold water, 1 to 2000; and in hot water 
1 to 100, precipitating as the water cools, but leaving a saturated solution 
of 1 to 1000, which is perfectly inhibitive of the germs of putrefaction in 
all putrescible fluids (Levis). The claims made for it are that it is 12 
times as effective as carbolic acid, 30 times as potent as salicylic acid, 60 



NUX VOMICA. 305 

times as efficient as boric acid, 600 times as antiseptic as alcohol, and 
that it is entitled, as a true antiseptic, to stand next to mercuric chloride 
in the comparative tables (Levis). 

Therapeutics. 
Naphtalin is employed as an antiseptic for the intestinal canal in 
typhoid fever, diarrhoea, both acute and chronic, tubercular diarrhoea, 
dysentery, etc. It renders the urine aseptic and may be employed in 
vesical catarrh. It is also used internally for humoral asthma, verminous 
affections, and the chronic pulmonary catarrh of the aged. It has recently 
come into prominence as an all-round anthelmintic, having been given 
for all kinds of intestinal worms, with prompt and complete results invari- 
ably obtained (Mirowicz). In pertussis the best possible results have been 
obtained from the burning of this agent in the patient's room ; giving 
force to the belief that the well-known benefit resulting from taking 
children to gas-works for whooping-cough, is due to the naphtalin fumes 
rather than to the gas-tar. Locally, Naphtalin has high value as an anti- 
septic for indolent ulcers, sloughing wounds, open cancers, pus cavities, 
etc. Painted over organic remains it effectually prevents the ravages of 
insects. Naphtol is employed like tar for therapeutic action upon the 
skin in hyperidrosis, scabies, eczema and local sweating, in ^ to 5 per 
cent, alcoholic solution, or as a 10 per cent, ointment. Hydronaphtol 
is also highly esteemed for antiseptic purposes generally by those who 
have used it, and is of benefit as an external application in many skin 
diseases. Its non-toxic and non-irritant qualities render it the most useful 
and most generally available of the three. 

Camphorated Naphtol has been employed hypodermically in tuberculous adenitis, 
with permanent improvement in nine cases, and improvement in six others, out of a series 
of 32 cases so treated by Reboul, of Marseilles. In five cases of tuberculosis of the testis, 
so treated by the same observer, very gratifying results were obtained ; the injection 
appearing to be perfectly harmless, and to act beneficially, both locally and generally. It 
has also been extensively used in the irrigation of joints, bony cavities, tendinous sheaths, 
cold abscesses in the pleural and uterine cavities, and also in tuberculosis of the bladder : 
all which localities seem to bear the undiluted fluid well. (Squibb.) 



NUX VOMICA, — is the seed oi Strychnos Nux-vomica, an East 
India tree of the nat. ord. Loganiacese, having white, funnel-shaped 
flowers, and a fruit about the size of an orange, with many seeds in a 
juicy pulp. The seeds are flattened and nearly circular, about one inch 
in diameter, ashy-gray in color, covered with short, satiny hairs, internally 
translucent, tough and horny, with a large cavity, inodorous, taste in- 
tensely bitter. It contains two alkaloids, Strychnine, 0.2 to 0.5 per cent., 
and Brucine, 0.1 to 1.0 per cent., with 0.1 crystalline acid, Igasuric or 



306 NUX VOMICA. 

Stiychnic Acid, and a yellow coloring matter, a concrete oil, gum, starch, 
wax, earthy phosphates, etc. A third alkaloid, Igasurine, is claimed to 
exist by some authorities and is denied by others. 

Preparations. 

Extractum Nucis Vomicae, Extract of Nux Vomica, — has of total alkaloids 15 per 
cent. Dose, gr. ^$-j. 

Extractum Nucis Vomicae Fluidum, Fluid Extract of Nux Vomica, — has 1^ 
per cent, of total alkaloids. Dose, TT^j-v. 

Tinctura Nucis Vomicae, Tincture of Nux Vomica, — has 0.3 per cent, of total 
alkaloids. Dose, Tl\,v-xxx. 

Strychnina, Strychnine, C 21 H 22 N 2 2 ,— is an alkaloid prepared from Nux Vomica, 
Ignatia, and other plants of the order Loganiacese ; crystalline, intensely bitter even in I 
to 700,000 solution, of alkaline reaction, soluble in 7 of chloroform, no of alcohol, 6700 
of water, almost insoluble in ether. It is a constituent of Ferri et Strychninae Citras, and 
of Syrupus Ferri Quininse et Strychninae Phosphatum. Dose, gr. eV^V 

Strychninae Sulphas, Strychnine Sulphate (C 21 H 22 N 2 2 ) 2 H 2 S0 4 *+5H 2 0, — crystal- 
line, efflorescent, odorless, of intensely bitter taste even in I to 700,000 solution, neutral 
reaction, soluble in 50 of water and 109 of alcohol at 59 F. Dose, gr. B V"sV' 

Brucina, Brucine, C 23 H 26 N 2 4 (Unofficial), — colorless prisms, pearly flakes, or masses, 
soluble in water, less so in alcohol ; as compared with Strychnine it is less bitter, 12 times 
weaker and three times slower physiologically. Is thought to be a compound of strych- 
nine and resin, corresponding with the other alkaloid both physiologically and therapeu- 
tically. Is seldom used. Dose, gr. ^-\. 

Physiological Action. 

The action of Nux Vomica is that of its alkaloid Strychnine. In 
small doses, it is a bitter tonic, stimulates respiration, secretion, appetite 
and digestion, and sharpens the vision. It increases peristalsis, stimulates 
both the motor and the inhibitory apparatus of the heart, and raises the 
arterial tension by stimulating the vaso-motor centres, thus contract- 
ing the arterioles, though by full doses the arterioles are relaxed. By 
a full dose (Strychnine, gr. yL), the pupils are dilated, the limbs jerk, 
respiration becomes spasmodic and the lower jaw stiff; a sensation of 
cerebral tension, sudden shuddering and anxiety follow, the face wearing 
an unmeaning smile. A toxic dose (Strychnine gr. ^ for an adult) on 
an empty stomach quickly produces heightened reflexes ; tonic spasms, 
especially of the extensor muscles, on the least irritation quickly succeed 
each other with intervals of repose, resulting after two or three hours at 
most in death by asphyxia, from tetanic fixation of the muscles of res- 
piration, consciousness being preserved until carbonic acid narcosis 
sets in. 

Strychnine exalts all the functions of the spinal cord, — reflex, motor, 
vaso-motor and sensory, — the latter being the least affected. It has a 
selective action on the large multipolar ganglia in the anterior columns, 
which it first stimulates and then paralyzes by over-stimulation. A large 
dose destroys the spinal functions as by one blow. It does not affect the 
brain directly. Thebaine, one of the alkaloids of Opium, is a powerful 
spinal exaltant and acts very similarly to Strychnine. 



NUX VOMICA. 



307 



From the spasms of tetanus those of Strychnine may be differentiated 
by their intermittency, the former being constant. Moreover, the mean- 
ingless smile, the less marked trismus, the absence of a wound, and the 
rapid course of the symptoms, all point to the action of Nux Vomica. 

The excretion of Strychnine takes place very slowly, and by the urinary, 
salivary and cutaneous channels. Rapidly absorbed but very slowly 
excreted, it accumulates in the system if even a small dose be frequently 
repeated. 

On the eye Strychnine has marked effects, augmenting the excitability 
of the retinal elements, increasing the sharpness of vision and enlarging 
the visual field. 

Antidotes, Antagonists and In compatibles. 

The antidote is Tannic Acid to form the very insoluble tannate, or a soluble salt of 
Iodine. Then emetics or the stomach pump, followed by perfect quiet, which is very im- 
portant. Antagonists are Chloral, Tobacco, Chloroform or Ether inhalations, and Potas- 
sium Bromide, the latter being almost too slow of action to be of much use in practice. 
The Oil of Chamomile should prove of value, owing to its power over reflex excitability. 
Hydrastinine has been used successfully, in doses of gr. j of the hydrochlorate, hypoder- 
mically. The bladder must be frequently evacuated to prevent re-absorption of the 
poison, and artificial respiration maintained as necessary. 

Incompatibles are Bromides, Chlorides and Iodides in the same solution, the Strychnine 
being precipitated as hydrobromate, hydriodate, etc. 

Therapeutics. 
Nux Vomica and its chief alkaloid, Strychnine, are exceedingly useful 
remedies, having a wide range of therapeutic efficacy. They are chiefly 
employed as stomachic tonics, and as stimulants to the heart and the 
respiratory apparatus, as also to the muscular and nervous systems. As the 
quantity of Strychnine in Nux Vomica varies greatly, it is best to use the 
alkaloid when its physiological action is desired, as more definite dosage 
may thus be obtained. The tincture in 5-drop doses is excellent in atonic 
dyspepsia and gastric catarrh, especially in drunkards, and in constipation 
from atony of the bowels it may be given in 10-drop doses with good 
results, not as a purgative but to increase peristalsis. The extract is much 
used in laxative pills for habitual constipation. In the vomiting of preg- 
nancy the tincture is frequently an efficient remedy, and in the vomiting 
of phthisis Strychnine is one of the very best agents. In the condition 
clinically known as that of torpid liver, where the stools are of pale color 
and very offensive odor, showing absence of bile therein, the tongue 
coated with a thick, perhaps yellowish fur, and the patient complaining 
of headache, lassitude, anorexia, and a bad taste in the mouth ; small 
doses of Strychnine (gr. -^) twice or thrice daily, will frequently act as 
well as a mercurial, restoring the bile to the stools, and correcting the 
other symptoms. Epidemic diarrhoea and dysentery are often controlled 
by Strychnine, and in anaemia and chlorosis it is an invaluable remedy, 
especially when combined with iron and quinine. In intermittents, as 



308 NUX VOMICA. 

an adjunct to quinine, it is always useful ; and in neuralgias, especially 
visceral neuralgia, and tetanus of the idiopathic type, it is highly efficient. 

Nux Vomica is a most valuable remedy in impending cardiac failure 
from almost any cause. Even with the pulse imperceptible, the extremities 
cold and death apparently imminent, the administration of a minim of 
the tincture, in a teaspoonful of water every five minutes, has often 
brought about a renewal of the cardiac contractions after five or six 
doses, with eventual recovery. In bronchial and other forms of asthma, 
especially those of neurotic origin ; in dyspnoea with palpitation of the 
heart, due to functional cardiac disturbance in hysterical subjects; in 
irregular cardiac action and overaction of the heart, in hypochondriasis, 
and for the nervous movements accompanying the pregnant state, similar 
small doses of Nux Vomica, frequently repeated, are remarkably efficient. 

The undoubted action of Nux Vomica on the pneumogastric makes it 
a most valuable remedy in all sorts of coughs, whether due to bronchitis 
or pneumonia, phthisis, emphysema, etc., but it is particularly efficient in 
coughs of neurotic origin, such as periodical cough, night-cough, and 
paroxysmal laryngeal cough without lung or bronchial symptoms, and 
characterized by a persistent tickling sensation in the throat. In these 
affections drop-doses of the tincture frequently repeated will be found to 
be much more satisfactory than larger doses at longer intervals. 

Local paralyses of various forms are well treated by the hypodermic 
injection of Strychnine into the affected muscles, and diphtheritic par- 
alyses are almost invariably cured by its internal administration. It is an 
excellent remedy in hemiplegia when degeneration has not yet set in, and 
when the paralyzed muscles are completely relaxed ; but it is of no avail 
in recent cases, nor when the muscles have lost electrical contractility. 
In amaurosis from lead, tobacco or alcohol, it has proved remarkably 
useful, and in the dyspnoea of pulmonary affections it may be employed 
with benefit as a respiratory stimulant. Strychnine is a physiological 
antagonist to Chloral, Physostigmine and Morphine, and may be care- 
fully administered in poisoning by these substances, while the ordinary 
methods are also employed. 

In many eye diseases Strychnine is injected into the tissues about the 
temple with great benefit, especially in amblyopia due to functional dis- 
order of the retina without lesions, and in atrophy of the optic nerve. 
Used in the same manner it is highly recommended in infra-orbital neu- 
ralgia, and in other neuralgiae characterized by debility and anaemia. 

Strychnine is undoubtedly of great service in the treatment of alco- 
holism, as has been shown by the published evidence of Russian, English 
and French practitioners for many years. Administered hypodermically, 
in doses of gr. 8 x 6 - 2 1 fl of the nitrate four times daily, and less frequently 
after the first week, it removes the craving for stimulants, and counteracts 



NYMPHjEA ODORATA OLIV^E OLEUM. 3O9 

the vaso-motor paralysis to which most of the injurious effects of alcohol 
are due. It is probably a true antagonist to the action of alcohol on the 
human system, and is the really efficient constituent of the innumerable 
" cures " which are advertised so extensively of late years for dipsomania. 

The following extracts, from a letter in the author's possession, written by Dr. Portu- 
galoff, of Samara, Russia, under date of Sept. 2, 1891, are interesting evidence of the 
above statements. 

" I have first and foremost to state that the use of Strychnine in the treatment of 
alcoholism is no discovery of mine. In all the articles that I have ever written upon the 
subject I have always pointed out that the credit of the discovery belongs to the English 
and French Doctors Lutton, Dujardin and Beaumetz. (sic.) 

. . . . " Convinced that all forms of drunkenness are but forms of disease, with 
perhaps a basis of vice, I have, during a period of five years treated about 500 patients, 
suffering from various forms of alcoholism, entirely by hypodermic injections of strych- 
nine. ... I prepare the solution by taking one grain of strychnine, and dissolving 
it in 300 drops aquae destillatae, and commence by injecting hypodermically 10 drops of 
this solution morning and evening in the vicinity of the liver or stomach. I do not order 
the patient at once to discontinue drinking. I prefer that he should voluntarily leave it 
off, and that alcohol should become distasteful to him. It not infrequently happens that 
I make from one to five injections during the first two days without results ; but I 
patiently wait, convinced that in two or three days the desired effect will be produced. 
If the patient, after two or three days' treatment, voluntarily gives up drinking and states 
that he has no desire for it any longer, I continue the injections but only once a day, in 
the morning. The total number of injections range from 12 to 20, and decrease in 
strength from 10 drops to 5. This is the whole treatment. To a colleague I freely con- 
fess that I have had cases where patients, in spite of daily injections having been con- 
tinued for 5 or 6 days, nevertheless continued to drink as much as ever. In such cases 
I have discontinued the treatment altogether; but I have always felt sure that if in such 
obstinate cases the patient could be isolated, and all possibility of obtaining alcohol 
removed, — which would be easy in a " Home for Inebriates," — cure would certainly 
follow. 

" Then I have cases of relapse. Patients who once a year return to their old bad habits, 
but who, on such occasions, always come to me for a repetition of the treatment, which 
invariably sets them right again for another year. ... So you see after all, my dear 
colleague, that there is nothing peculiar or mysterious about it. ... I have no 
knowledge of the English language, and am able to answer your letter through the kind- 
ness of an English friend of mine, Mr. Bezant, who has translated this letter from the 
original Russian. 

" In conclusion, I would strongly advise you to give this treatment a trial, nothing fearing, 
and your efforts will, I know, be crowned with success. With sentiments of high regard, 
I remain, my dear colleague, yours very fraternally, Portugaloff." 



NYMPHiEA ODORATA, Sweet-scented Water-lily, (Unofficial),— is a well- 
known American plant of the nat. ord. Nymphaeaceae, the root of which is very bitter and 
highly astringent, containing much Gallic and Tannic Acids, to which its actions and 
uses are due. A decoction of ^j to the pint may be used in doses of ^ss-j, or a fluid 
extract in doses of gss-j. For the physiological actions and therapeutics of this vege- 
table astringent see Tannic Acid, ante, page 81. 



OLIV^ OLEUM, Olive Oil {Sweet Oil, Salad Oil), is a fixed 
oil expressed from the ripe fruit of Olea europaa, the olive tree (nat. ord. 
Oleaceae), which is cultivated in southern Europe, California and Austra- 
lia. It is a pale-yellow or greenish-yellow, oily liquid, of nutty, oleagin- 



310 OPIUM. 

ous taste, and neutral reaction, sparingly soluble in alcohol but readily- 
soluble in ether. Sp. gr. about 0.916. 

Olive Oil consists of 72 per cent, of Olein (a fluid oil) and 28 per cent, of Palmitin 
(a solid oil or stearopten), which are compounds of the base Glyceryl, C 3 H 5 , with Oleic 
Acid, C 19 H 34 2 , and Palmitic Acid, C n H 31 2 , respectively. It is frequently adulterated 
with cheaper fixed oils, especially poppy oil, lard oil, and cotton-seed oil, quantities of 
the latter being exported every year to Italy, whence it is returned to us' as Olive Oil 
ui\der a French label. (See Gossypium.) It is an ingredient of Ceratum Cetacei, Em- 
plastrum Plumbi, and Unguentum Diachylon, and is the source of the official Soap. 
Dose, ^ ss-j. 

Physiological Action and Therapeutics. 

Externally used Olive Oil is a good protective from the air, and ren- 
ders the skin soft and flexible. If rubbed into the integument it is ab- 
sorbed by the lymphatics and is directly nutritive in effect. Internally it 
is also nutritious and mildly laxative, and in quantity acts as a protective 
to the mucous membrane against acrid or poisonous substances. Like 
other oils it is partly emulsified, partly saponified in the intestines, its gly- 
cerin being set free and its fatty acids combining with the free alkalies to 
form soap, which with the emulsion forms the molecular basis of the chyle, 
entering the blood through the lacteals and being finally oxidized into 
carbonic acid and water, though an excess will appear unchanged in the 
urine. Oils are therefore a food within certain limits, increase the fat of 
the tissues, furnish heat and force, and save the waste of nitrogenous 
tissue, but are unable of themselves to support life. 

Olive Oil possesses no very marked therapeutic power above any other 
bland oil or fat. It is a good laxative for infants administered internally, 
and may be used as an enema followed by warm water. Its chief employ- 
ment is as a local application. Applied to burns and acute inflammations 
of the skin it is an excellent protective, coating the surface and excluding 
the air; and as an ingredient of liniments it acts as a diluent for more 
active agents. It is used to facilitate friction over enlarged or stiff joints, 
and in the desquamative stage of scarlet fever is a very useful and grateful 
application. As an antidote in corrosive poisoning it acts mechanically by 
protecting the mucous membrane of the stomach and preventing absorp- 
tion. In pharmacy its bland, unirritating qualities have procured its 
common employment as an ingredient of liniments, plasters, ointments 
and cerates, but the foreign article is so frequently adulterated with infe- 
rior oils that Cotton-seed Oil is now directed in its place in many official 
preparations. 



OPIUM, — is the concrete, milky exudation, obtained by incising the 
unripe capsules of the White Poppy, Papaver somniferum, an annual herb 
of the nat. ord. Papaveracese, indigenous to Western Asia but cultivated 



OPIUM. 



311 



extensively elsewhere. Its capsules are globular, two or three inches in 
diameter, and are crowned by a sessile, stellate stigma, which distin- 
guishes them from Colocynth and Bael fruits. Opium occurs in irregular 
lumps or cakes, of dark-brown color, sharp, narcotic odor, and bitter 
taste ; and in its normal, moist condition should yield not less than 9 per 
cent, of Morphine when assayed by the official process. 

Composition of Opium. 
Opium contains 17 alkaloids, 2 neutral substances and 2 organic acids, 
together with sugar, gum, resin, pectin, extractives, odorous principles, 
water and other constituents of plants. Its most important alkaloids are 
the following : — 

Morphine, C 17 H 19 N0 3 , — 5 to 20 per cent. — the principal alkaloid, occurring in the 
drug in the form of the tribasic meconate. Its properties are anodyne, hypnotic and nar- 
cotic. From it by a process of dehydration by heat and hydrochloric acid is prepared the 
artificial alkaloid Apomorphine, a powerful emetic. (See ante, page 122.) 

Codeine, C 18 H 21 N0 3 , — 0.3 to 0.5 per cent., — is calmative and when pure a not very 
active alkaloid, but is frequently contaminated with other alkaloids. Apomorphine may 
be prepared also from it. 

Narcotine, C 22 H 23 N0 7 , — 2 to 10 per cent., — is antiperiodic and a tetanizer, but wholly 
devoid of narcotic properties. 

Thebaine or Para7norphine, C 19 H 21 N0 3 , — 0.15 to 0.20 per cent., — is a powerful spinal 
exaltant and tetanizer, resembling Strychnine in its action. 

Narceine, C 22 H 29 N0 9 , — 0.02 per cent., — closely resembles Morphine in action, but is 
probably more hypnotic, and is not followed by many of the disagreeable after-effects of 
Morphine. It is extremely difficult to obtain this alkaloid pure. 

Papaverine, C 21 H 21 N0 4 , — 1 per cent., — is reported inert on man by some observers, 
a narcotic and convulsant by others. 

Other Alkaloids at present acknowledged are — Cryptopine, Pseudomorphine, Protopine, 
Hydrocotarnine, Laudanine, Codamine, Rhoeadine, Meconidine, Laudanosine, Lanthopine 
and Gnoscopine. Many of them are probably to be regarded as derivatives of Morphine. 

Besides the above-named alkaloids the most important of the constitu- 
ents of Opium are the following acids and neutral principles, viz.: — 

Acids are — Meconic Acid, C 7 H 4 7 , 4 per cent., and Lactic Acid, C 3 H 6 3 , 1% per 
cent., which exist in combination with the alkaloids as meconates, bimeconates, etc. The 
second acid is generally called Thebolactic, but has been recently shown to be identical 
with lactic acid. 

Neutral Principles are — Meconin, C 10 H 10 O 4 , 0.01 per cent., is white, crystalline, 
neutral, but very acrid ; Meconoiosin, C 8 H 10 O 2 , also crystalline, and Porphyroxin, which 
is now said not to be a proximate principle but a very complex combination of several 
alkaloids. 

Smyrna, Turkey or Levant Opium is the best grade. Constantinople 
Opium is of uncertain quality, while of the other varieties in the market 
Egyptian, Persian and Indian samples are those most frequently met with. 
All varieties are more or less adulterated with fruits and leaves of other 
plants, starch, pitch, clay, wax, gum, liquorice, etc. 

Preparations of Opium. 

Opii Pulvis, Powdered Opium, — is Opium dried at a temperature not exceeding 185 
F., and reduced to a very fine powder. It should contain not less than 13 nor more than 



312 OPIUM. 

15 per cent, of crystallized Morphine, when assayed by the official process. Dose, gr. 
ss-iij, an average adult dose being about I grain. 

Opium Deodoratum, Deodorized Opium (Denarcotized Opium), — is powdered Opium 
freed from the constituents thereof which are soluble in Ether, namely Narcotine and the 
odorous principles, which are supposed to cause the unpleasant after-effects of the drug. 
It should yield 14 per cent, of Morphine, and is a good preparation, being a purified 
opium with a fixed morphine standard. The proprietary article named Svapnia is a 
similar preparation. Dose, gr. ss-iij ; an average adult dose being about I grain. 

Extractum Opii, Extract of Opium, — an aqueous extract containing 18 per cent, of 
Morphine. It is freed from some disturbing principles which are insoluble in water. 
Dose, gr. ^-ij. 

Pilulae Opii, Pills of Opium, — each contains about gr. j of powdered Opium, with 
Soap. Dose, j-iij. 

Tinctura Opii, Tincture of Opium [Laudanum), — Opium-strength 10 per cent., 
average Morphine-strength gr. vj (equaling gr. vijss of the Sulphate) to the fl !| . Has 
about gr. xliv of Opium to the % . rr^xj (gtt. xxij) = gr. j of Opium or gr. y$ of Mor- 
phine Sulphate. Sixty minims yield on the average 120 drops. Dose, TTLv-xxx, as per 
effect desired. 

Tinctura Opii Deodorati, Tincture of Deodorized Opium, — an aqueous extract is 
prepared and shaken with ether, which being separated the residue is dissolved in water, 
and enough alcohol is added to preserve it. An excellent liquid preparation, being freed 
from all the noxious and useless ingredients, soluble in alcohol and ether. McMunn* s 
Elixir is a similar preparation, so also is a recent nostrum named Papine. Opium- 
strength 10 per cent., average Morphine-strength gr. vj to the fl^ . Dose, as Tinct. Opii. 
Drops of this preparation nearly equal minims. 

Vinum Opii, Wine of Opium [Sydenham* s Laudanum), — Opium-strength 10 per 
cent., with the aromatics Cinnamon and Cloves of each 1 per cent., in Alcohol and White 
Wine. A vinous tincture decreased somewhat in strength from the wine of 1870. Dose, 
as Tinct. Opii. Drops of this preparation are larger than those of the tincture. 

Acetum Opii, Vinegar of Opium [Black Drop), — Opium-strength 10 per cent., with 
Nutmeg and Sugar in Dilute Acetic Acid. Is now l /$ weaker than formerly, having the 
same strength and dose as Tinct. Opii. 

Tinctura Opii Camphorata, Camphorated Tincture of Opium [Paregoric), — has of 
Powdered Opium 4, Benzoic Acid 4, Camphor 4, Oil of Anise 4, Glycerin 40, Diluted 
Alcohol to 1000. ^ss contains nearly one grain of powdered Opium, and is about ^th 
the strength of Laudanum. Dose, for an infant gtt. v— xx, for an adult gj-iv. Is an 
ingredient of Mistura Glycyrrhizae Composita. 

Emplastrum Opii, Opium Plaster, — Extract of Opium 6, Burgundy Pitch 18, Lead 
Plaster 76, Water 8. 

Pulvis Ipecacuanhae et Opii, Powder of Lpecac and Opium [Dover's Powder), — 
has of Ipecac 10, Powdered Opium 10, Sugar of Milk 80, rubbed together into a very 
fine powder. Dose, gr. v-xv ; ten grains equalling I grain each of Ipecac and Opium. 

Tinctura Ipecacuanhae et Opii, Tincture of Lpecac and Ophim, — has of Tincture of 
Deodorized Opium 100, evaporated to 80, Fluid Extract of Ipecac 10, Diluted Alcohol 
to 100. Is intended to represent Dover's Powder in liquid form. Dose, IT^ v-xv. 

Trochisci Glycyrrhizae et Opii, Troches of Glycyrrhiza and Opium, — each troche 
contains of powdered Opium gr. T L, with Extract of Glycyrrhiza, Acacia, Sugar and Oil 
of Anise. Dose, j-iv. 

Liquor Opii Compositus, Compound Solution of Opium (Squibb), Unofficial, — has 
the same strength as the official tinctures, namely gr. vj of Morphine (equalling gr. vijss of 
the Sulphate) to each fluidounce. tt\,xvj = gr. % of Morphine Sulphate. 

Tinctura Opii Composita, Compound Tincture of Opium, Squibb 's Diarrhoea Mix- 
ture (Unofficial) — has of Tinct. Opii, Spt. Camphorae and Tinct. Capsici ^j of each, 
Purified Chloroform ^iij, Stronger Alcohol q. s. ad 5 v. Each fl^ or teaspoonful con- 
tains about 100 drops or tt\,xij of each of the first three ingredients and Tr^wss or 18 
drops of Chloroform. Dose, for infants gtt. j-x, for children gtt. x-xxx, for adults 3 j. 

[Note. — According to the U. S. Pharmacopoeia of 1890 the official dried Opium should 
contain 13 to 15 per cent, of Morphine instead of 10 per cent, as required by the Pharma- 
copoeia of 1870. The liquid preparations, except Paregoric, are now directed to be of 
the uniform Opium-strength of 10 per cent., and to yield, on being assayed, 1.3 to ij^ 
per cent, of crystallized morphine, making the Wine less strong by 2 per cent., the 
Acetum fully y£ less in strength, and the other liquid preparations stronger by x / 2 in Mor- 



OPIUM. 313 

phine than formerly. So that if the full anodyne dose of Tincture (1870) be taken at 
24 minims, equalling gr. y of Morphine Sulphate, the corresponding dose under the 
present system will be 16 minims.] 

Preparations of Morphine. 

Morphina, Morphine, C n H 19 N0 3 4- H 2 0, — white, prismatic crystals, or fine needles, 
or a crystalline powder, odorless, of bitter taste and alkaline reaction, almost insoluble in 
water, soluble in 300 of alcohol. Its comparative insolubility makes the salts preferable 
for use, and as a very small proportion of acid neutralizes it, the dosage is about the same for 
the alkaloid and its salts, viz., gr. ^5-gr. j. Gr. \-\ is about equal to one grain of Opium 
of medium Morphine-strength. [Compare Morphines Sulphas, below.] 

Morphinae Acetas, Morphine Acetate, — a white, crystalline or amorphous powder of 
faintly acetous odor, bitter taste, neutral or faintly alkaline reaction, soluble when fresh in 
2^ of water and in 47.6 of alcohol at 59 F. Dose, gr. ^5-j. 

Morphinae Hydrochloras, Morphine Hydrochlorate, — white, feathery crystals of silky 
lustre, of bitter taste and neutral reaction, soluble in 24 of water and in 62 of alcohol at 
59 F. Dose, gr. £rh 

Morphinae Sulphas, Morphine Sulphate, — white, feathery, acicular crystals of silky 
lustre, of bitter taste and neutral reaction, soluble in 21 of water and in 702 of alcohol 
at 59 F., and in 0.75 of boiling water. Contains about 80 per cent, of Morphine. Dose, 
S r - To~S r - J '■> tu~H being a small dose for an adult, ]4,-% a moderate one, %-%. a full 
dose, and y~j a large one. 

Pulvis Morphinae Compositus, Compound Powder of Morphine ( Tully's Powder), — 
has of Morphine Sulphate I part to 19 of Camphor and 20 each of Liquorice and Cal- 
cium Carbonate. A similar preparation to Dover's Powder minus the Ipecac. Dose, gr. 
v-xv, ten grains containing gr. y^ of Morphine Sulphate. 

Trochisci Morphinae et Ipecacuanhae, Troches of Morphine and Ipecac, — each 
troche contains gr. ^ of Morphine Sulphate with about gr. ^ of Ipecac, also Sugar, Oil 
of Gaultheria and Mucilage of Tragacanth. Dose, one every hour or so, cautiously with 
children. 

Injectio Morphinae Hypodermica, Hypodermic Injection of Morphine (B. P.), — 
is a solution of the Acetate, containing gr. j in each ten minutes, being thrice as strong as 
Magendie's solution. Dose, IT^ j-iij. 

Liquor Morphinae Sulphatis, Solution of Morphine Sulphate, Magendie's Solution 
(Unofficial), — has gr. xvj of Morphine Sulphate in each fl^ or gr. j in Tr^xxx, or gr. y 
in TT^vijss. If made with Benzoic Acid, the solution will not spoil, and is not irritant 
hypodermically. The same result is attained by adding of Carbolic Acid, TTL iij to the 1§ . 

Tinctura Chloroformi et Morphinae, Tincture of Chlo?-oform and Morphine, (B. 
P.), — a substitute for Chlorodyne. See ante, page 185, and also the table on Chlorodyne 
in the Appendix. 

Oleatum Morphinae, Oleate of Morphine (Unofficial), — Morphine-strength iopercent. 
with Oleic Acid 90. For local use. 

Apomorphine is described on page 122 ante. 

Preparations of Other Alkaloids. 

Codeina, Codeine, C 18 H 21 N0 3 -|-H 2 0, — white or yellowish-white, rhombic prisms, efflor- 
escent in warm air, of bitter taste and alkaline reaction, soluble in 80 of water at 59 F. 
and in 17 of boiling water, very soluble in alcohol, chloroform and ether. This alkaloid 
is official. Dose, gr. ss-ij, but gr. */£ has caused alarming symptoms in children. 

The Phosphate is sufficiently soluble for hypodermic use, and comparatively unirritant. 
One part in twenty of water forms the usual solution for hypodermic employment. 

Narcotinae Hydrochloras, Narcoline Hydrochlorate (Unofficial), — Dose, gr. ij-x, as 
an antiperiodic. 

Children bear Opium badly, and for them its proportionate dosage 
should be much below that for other agents. Morphine should not be 
given to children below 10 years of age, and never hypodermically to 
those beneath the age of 15. Opium given to a nursing mother will 
affect the child, being partly excreted in the milk. 



3 H opium. 

Reactions and Incompatibles. 

An aqueous or alcoholic preparation of Opium reddens litmus paper (free meconic 
acid) ; — gives a deep red color with Ferric Chloride (meconic acid) ; — forms precipi- 
tates with Lead Acetate and Subacetate, Silver Nitrate, Zinc, Copper, and Arsenic 
(meconates, sulphates and coloring matter) ; — forms a precipitate with tincture of Galls or 
astringent preparations (tannates of morphine and codeine) ; and becomes turbid with 
the fixed Alkalies, Carbonates, Alkaline Earths, and Ammonia (precipitated morphine 
and narcotine). 

Tests for Morphine. 

Nitric Acid produces a blood-red, turning orange, then yellow, then disappearing. 
Test-solution of Ferric Chloride gives a blue color changing to green with excess of the 
reagent, and destroyed by free acids or alcohol, but not by alkalies. Iodic Acid liberates 
Iodine which may be tested by starch. Vaughn has shown that certain intestinal ptomaines 
will give the same reactions with the same reagents. 

Physiological Action. 

Opium is analgesic, hypnotic, antispasmodic, diaphoretic and narcotic. 
It first stimulates and afterwards depresses the cerebrum, heart and respir- 
atory apparatus, and is classed among the cerebral depressants. 

In medium dose (gr. j) it arrests all the secretions except the milk and 
sweat, the latter being increased ; producing dryness of the mouth and 
throat, retarded digestion from stoppage of the gastric juice, and decided 
loss of appetite. The action of the heart is increased, arterial tension 
raised and the pupils slightly contracted. The cerebral faculties are 
stimulated by increased blood-supply to a pleasant activity, ideas follow 
each other rapidly through the mind, and an exhilaration bordering on 
mild intoxication is experienced, succeeded by a calm of variable length. 
Sleep generally follows, disturbed, however, by dreams, and after waking, 
headache, malaise, constipation, digestive disturbance and some depression 
result. The conductivity of the nerves is not affected. Frequently the 
stage of mental activity is absent, but in persons habituated to the use of 
Opium it is usually well marked. In some subjects a lengthened period 
of calm repose takes the place of sleep, in others neither calm nor sleep 
occurs, but the stimulant action of the drug prevails, the spinal functions 
as well as the cerebral are exalted, and great restlessness is the result. 

In full dose (gr. iij-v) the same symptoms are produced but in greater 
intensity ; the stage of stimulation is much shorter, digestion is arrested, 
nausea and vomiting produced, also profuse diaphoresis. The conduc- 
tivity of the nerves is more or less impaired, the heart and circulation 
depressed, oxidation being interfered with and the body-temperature 
lowered. The pupils are contracted by stimulation of the motor oculi 
through the basal ganglia, intense pruritus is produced, especially at the 
nose, and often spasmodic retention of the urine. Profound sopor soon 
comes on, with irregular and slow respiration, but in some subjects this is 
replaced by coma-vigil and delirium. After-effects are nausea, depression, 
constipation, racking headache, vertigo, anorexia, nasal pruritus, and fetid 
pathological secretions. 



OPIUM. 315 

A toxic dose produces cold and clammy sweat, very slow pulse, slow 
and stertorous respiration gradually becoming feeble and irregular, cya- 
nosed face, abolished reflexes, coma gradually deepening, the pupils 
minutely contracted but dilating as the end approaches, and finally death 
by paralysis of the respiratory centre due to direct action on the 
medulla. Post-mortem shows only a wet brain, congested lungs, and 
engorgement of the ven'ous trunks and of the right heart. 

The principal action of Opium is exerted upon the nervous system, 
first affecting the cerebral convolutions, which are briefly stimulated and 
soon depressed, — next the perceptive and sensory centres in the higher 
brain are more or less blunted, and the conductivity of the afferent nerves 
impaired, — soon the ganglia at the base of the brain are involved, evinced 
by the contraction of the pupils, vomiting, and slowing of respiration, — 
the cardiac, vascular and other centres are depressed, but to a less degree 
than the respiratory and perceptive, — the gray matter of the cord, at first 
stimulated, as shown by the increase of reflex excitability, is also 
depressed, and locomotion becomes difficult, the motor nerves becoming 
paralyzed from the centre outwards, but muscular irritability is never lost. 
Death generally occurs by paralysis of the respiratory centre, rarely by 
sudden cardiac failure. 

Metabolism is greatly reduced in activity by Opium, the quantity of 
urea excreted being markedly lessened, and the biliary and glycogenic 
functions of the liver being affected, resulting in whitish stools, perhaps 
jaundice, and certainly decided decrease of the sugar excreted by dia- 
betics, when the drug is given by the stomach. 

On the uterine and generative functions Opium exerts a marked influ- 
ence, stopping menstruation if its use be continued, and in men causing 
impotence. Both male and female functions, however, return as soon as 
the drug is discontinued, but the female organs of generation suffer 
atrophy from its long continued use. In one case, intra-uterine measure- 
ments, taken during a period of two years, showed a diminution in the 
size of the cavity from 5.1 to 1.9 inches. 

The hypnotic action of Opium is now believed to be produced by a 
double influence, (1) on the vascular system, causing anaemia of the brain, 
(2) on the cerebral cells, diminishing their activity, and consequently 
lessening their demand for blood. Its constipating action is shown 
experimentally to be produced by stimulation of the inhibitory nerves of 
the intestines through the splanchnics. 

Morphine acts similarly to Opium in general, being the principal alka- 
loid therein, but when used alone its influence is not complicated with 
that of the convulsant alkaloids (Thebaine, Codeine, Narcotine), which 
must affect to a considerable degree the action of Opium. Consequently, 
as compared with the latter, Morphine acts more quickly, and for a 



3 16 opium. 

shorter time, has less influence on the intestines and skin, is less constipa- 
ting, less stimulating, less convulsant and less diaphoretic, but more seda- 
tive, more anodyne and hypnotic and produces more intense pruritus. 
Its excretion commences quickly but may not be completed for as much 
as 48 hours, and is effected by most of the secretions, especially by the 
urine. It is probably retained in the system when the action of the 
kidneys is defective, and hence when given in renal disease may accumulate 
with fatal results. 

Codeine may chemically be considered a Methyl-morphine, and like 
all methyl compounds, has an action like that of Curare, viz., — a motor- 
paralyzant. It exalts the spinal cord more than Morphine and affects the 
cerebrum less, producing muscular tremor in excess of the sedative action. 
It is anodyne and analgesic, especially to abdominal and pelvic pain, 
also hypnotic with less general disturbance than is produced by Morphine. 
It markedly reduces the amount of sugar excreted by diabetics, and has 
a special sedative influence on the pneumogastric nerve. 

Narcotine should be named Anarcotine, as it has little or no narcotic 
power. It is a convulsant in animals and an antiperiodic in man. 

Narceine is said by some observers to be remarkably hypnotic, and 
free from convulsant action — by others equally deserving of credit it is 
considered almost inert. This alkaloid is difficult to obtain pure ; hence 
the samples heretofore used have probably been contaminated with other 
alkaloids. 

Thebaine is a powerful convulsant, exalting the spinal cord almost like 
Strychnine and Brucine. It is not used medicinally. 

Fatal Doses. 

In a child one day old Tt\J of Laudanum caused death. A medicinal dose given to a 
nursing mother proved fatal to the infant. A few drops of Paregoric have killed a child 
of nine months. In the adult gr. y^ of Morphine in one case, and gr. iv of crude Opium 
in another, have proved fatal. 

Antagonists and Treatment of Poisoning. 

Atropine antagonizes the cerebral action of Morphine, also its action on the pupils, 
respiration, heart and arterial tension, but if given too freely will endanger the case by 
substituting Belladonna-narcosis for Opium-narcosis. Gr. T L hypodermically every 15 
minutes for three doses, is generally sufficient. Caffeine is also physiologically antago- 
nistic, and is generally used in the form of strong black coffee frequently administered. 
Potassium Permanganate, in dose one-half greater than the dose of Morphine taken, is 
said to be a perfect chemical antidote to morphine in the stomach, destroying it by selec- 
tive chemical action. Dr. Moor, of New York, is reported to have swallowed 3 grains 
of morphine sulphate in the presence of several physicians, and then to have taken a 
solution of 4 grains of potassium permanganate in 4 ounces of water, with the result that 
no effects of morphine were noticed on him afterwards. The chief indications in Opium- 
poisoning are — to evacuate the stomach, maintain respiration and keep up the circulation. 
Faradization of the chest muscles, cold affusion, and artificial respiration are of great 
value, and evacuation of the bladder is important. Flagellation is a very dangerous pro- 
cedure, from the exhaustion which may be produced ; strong faradic currents are much 
more efficient. The anode should be placed over the lowest conjoined root of the phrenic 
nerve — the cathode three inches below the ensiform cartilage, and a little to the left of 
the median line. 



OPIUM. 317 

Strychnine is an efficient antagonist to the respiratory paralysis, and may be used in 
lieu of Atropine, or in connection therewith. Amy I Nitrite should also be used when the 
heart shows signs of failure. Capsicum, the tincture, 3 ss-j by injection into the rectum, 
is said to give almost instantaneous results in antagonizing the stupor of opium poisoning. 

Therapeutics. 
The chief indications for the use of Opium are (1) to relieve pain from 
any cause except acute inflammation of the brain, — (2) to produce sleep, 
particularly in the insomnia of low fevers with delirium, in which the 
combination of Morphine and Chloral is very efficient, — (3) to allay irri- 
tation in the various forms of acute nervous erethism, — (4) to check ex- 
cessive secretion, as in diarrhoeas, dysentery, diabetes, ptyalism, etc., — 
(5) to support the system in low fevers and other adynamic conditions, 
when sufficient food cannot be retained, — (6) as a sudorific, to produce 
sweating in coryza, etc. It is considered of especial value in any irrita- 
tion of the stomach, bladder or bronchi, in severe vomiting, both forms 
of diabetes, gastralgia, colic and muscular spasm. In diabetes mellitus 
Morphine per orem reduces the sugar promptly, but when used hypodermi- 
cally it has little or no effect thereon, even in the same case. In perito- 
nitis and inflammations of other serous membranes, used freely even to 
narcotism it has often saved life. In cerebro-spinal meningitis it is the 
one remedy if given early, before exudation has set in. Cholera morbus 
and dysentery are efficiently treated by Morphine and Atropine hypoder- 
mically (gr. -§- with gr. -^ny) after the ingesta have been removed by purg- 
ing. In acute uraemia its use in large doses is recommended by Loomis 
to control convulsions and promote diuresis, but here it is a dangerous 
agent. In muscular rheumatism and acute colds Dover's powder as a 
diaphoretic, conjoined with hot drinks and foot-baths, is old but excel- 
lent treatment. In chronic mania and melancholia, nervous prostration 
and the delirium of fevers, Opium is probably one of the best hypnotics. 
In acute mania it does not act nearly so well as Hyoscine, and in delirium 
tremens it should only be used in cases which show great prostration, and 
then for temporary effects alone, as a stimulant. In chronic melan- 
cholia small doses of Opium three times a day give better results than 
any other treatment. Severe pain from any cause (except cerebritis) is 
relieved by Opium with an efficiency possessed by no other drug, as the 
pain of sciatica, neuralgia, lumbago, cancer, renal and hepatic colic from 
calculi, etc. Cough of harassing and frequent character with but little 
secretion is best treated by Opium, but when there is profuse expectora- 
tion it should not be used, as the lowering of excitability of the respira- 
tory centre which it produces would in such a case be dangerous. In 
nearly all acute inflammations it is valuable, especially where it becomes 
advisable to lock up the bowels. Its tranquillizing power over the circu- 
lation makes it invaluable in the various forms of hemorrhage, while in 
that from uterine fibroids and cancer the implanting of the Opium-habit 



3 18 opium. 

is deserving of serious consideration as a most beneficial measure, as it 
checks and even stops the bleeding, as soon as established. Dyspnoea 
from any cause is relieved by Morphine, especially that of cardiac disease. 
" It gives the power to breathe" (Huchard). In cardiac disease, especially 
aortic stenosis or insufficiency, with dyspnoea, paroxysms of angina pec- 
toris, or signs of cerebral ansemia, — Morphine hypodermically presents the 
greatest advantages. 

Applications of the Various Preparations. 

Intense pain, as from the passage of calculi, is best met by hypodermic 
injection of Morphine Sulphate in full doses (gr. }(-%) with Atropine 
Sulphate (gr. yj-g-). Either the solution of Morphine or the liquid prepa- 
rations of Opium may be given by the mouth in corresponding doses for 
the same purpose. Severe pain enables the system to resist the action of 
Opium, which in such cases should be repeated at short intervals- for effect, 
regardless of dosage. 

Superficial pain is often alleviated by the Plaster or by extemporaneous 
liniments containing Laudanum or some other fluid preparation. It is, 
however, very doubtful whether such applications are of direct value, as 
Morphine is not absorbed by the unbroken integument ; but the Oleate 
of Morphine is said to be very penetrating. 

To produce sleep the most efficient preparations are the Tinctures, the 
Solution of Morphine, Pil. Opii and Dover's Powder, in doses corres- 
ponding to the degree of insomnia and restlessness present. 

Cough is relieved by the two Trochisci, the Tinctures, and by the Solu- 
tion of Morphine in small doses with Syrup of Wild Cherry or Syrup of 
Tolu ; also by Codeine in the last-named Syrup. Diaphoresis is obtained 
by the use of Dover's Powder in either of its forms. 

Sedative action is obtained by different preparations for different organs. 
The stomach is best affected by the Solution of Morphine in effervescing 
mixtures, the Extract in a small pill, or Morphine hypodermically over 
the epigastrium. The intestines may be influenced by Laudanum in a 
starch enema, or internally by Dover's Powder, Pulvis Opii, or Pil. Opii, 
especially the latter with or without Calomel, as an astringent when the 
bowel must be paralyzed, as in peritonitis, hernia, intussusception, etc. 
The rectum and other pelvic organs are promptly affected by a suppository 
of the Extract of Opium, gr. y± with gr. y 1 ^ of the Extract of Belladonna. 
The ovaries and the abdominal and pelvic organs generally are markedly 
susceptible to the analgesic action of Codeine in doses of gr. j to gr. ij 
for an adult in severe pain. 

Administration. 
Probably no drug in the Materia Medica is so useful as Opium, or has 
so wide a range of application. At the same time no drug requires such 



ORIGANUM PARALDEHYDUM. 3I9 

careful handling, by reason of the many influences which modify its action 
and uses. As before pointed out, children are extremely susceptible to 
its narcotic action, and women are more easily affected by it than men. 
Many persons are found with idiosyncrasies in respect to Opium, some 
being easily narcotized, others being remarkably insusceptible to its action, 
and many suffer from a decided shock after its hypodermic administra- 
tion, which may even produce alarming symptoms of collapse. In sub- 
jects of kidney disease it may accumulate and act more powerfully than 
expected, and generally it may be said to be contraindicated or to be used 
with great care in alcoholism, congestion of the brain, and advanced 
disease of the respiratory organs, heart and kidneys. 

The conjoint administration with opiates, of the Spiritus ./Etheris, 
Spiritus Athens Comp., or Spiritus .^Etheris Nitrosi, an equal part with 
Tinctura Opii Deodorati, will prevent the nausea often excited by the 
latter, and correct the " drying-up" effects of opium, due to its checking 
secretion. 

Some of the cerebral effects of Opium, as vertigo and mental confusion, 
are removed by a full dose of Potassium Bromide, others are antagonized 
by Quinine, and the general intra-cranial effects of the drug are to some 
extent opposed by Digitalis and Tartar Emetic. 

Morphine and Atropine are sufficiently antagonistic to each other to make their 
combination extremely valuable as a therapeutic measure, and their use as mutual anti- 
dotes in poisoning by either a most efficient procedure if employed with due precautions. 
When Morphine is given as a hypnotic or an anodyne, Atropine should always be admin- 
istered at the same time in the proportion of gr. xl^~TFo °f tne ' atter to g r - % °f tne 
former. By this means the anodyne and hypnotic qualities of Morphine are increased, 
while the nausea and depression with the subsequent dyspepsia and constipation due to 
it are avoided. Moreover, as in the doses above mentioned Atropine is a cardiac and 
respiratory stimulant, it will counteract the depressing tendency of Morphine on the 
heart and respiration in subjects who have undue susceptibility to its action. 



ORIGANUM, Wild Marjoram (Unofficial), — is the plant Origanum vulgare, a 
perennial herb of the nat. ord. Labiataa, native of Europe and America, having a stem 
branched above, petiolate leaves about an inch long and hairy beneath, pale purple 
flowers, aromatic, pungent, and bitterish. It contains a Volatile Oil, some tannin, resin, 
and a bitter principle. The oil was formerly much used and was official, but it is now 
entirely superseded by the Oil of Thyme. Origanum is an ingredient of Vinum Aro- 
maticum. Dose, gj-ij, in infusion. 

Origanum is gently tonic, also carminative, stimulant, and emmenagogue. It was 
formerly much employed as a diaphoretic, etc., but is now rarely administered. 



PARALDEHYDUM, Paraldehyde, C 6 H 12 3 , — a polymeric 
modification of Ethylic Aldehyde, (C 2 H 4 0), — is the colorless liquid (at 
ordinary temperatures), obtained by treating Aldehyde with dilute sul- 
phuric or nitric acid ; Aldehyde being the oxidation product of alcohol 
just preceding the formation of acetic acid. When cooled to 3 2° F. 



320 PAREIRA. 

Paraldehyde solidifies to a crystalline mass, which becomes liquid again at 
51 F. It is soluble in S}4 of water, and miscible, in all proportions, 
with alcohol, ether, and fixed or volatile oils. 

The dose of Paraldehyde may be placed at ^ss-gijss, but the latter quantity has fre- 
quently been exceeded without any ill effects, with no digestive or cerebral disturbances 
following, nor any unpleasant symptoms resulting, other than a disagreeable odor to the 
breath. Very few cases of poisoning therefrom, acute or chronic, are recorded. One 
case, under treatment by Dr. Mackenkie, of Douglas, in the Isle of Man, recovered from 
a dose of 3%, ounces, after 34 hours of sleep, furnishing "a striking testimony to the 
safety of Paraldehyde as a hypnotic." The average hypnotic dose for an adult is about 
gjss, given in ^j of simple elixir. 

Physiological Action and Therapeutics. 

Paraldehyde is a reliable hypnotic, equal in this respect to Chloral, 
though its hypnotic action is not so persistent as that of the latter drug, 
and it requires more frequent repetition to produce sustained sleep. It is 
also diuretic but not diaphoretic, and is unquestionably safer than 
Chloral, strengthening and slowing the heart's action, instead of weaken- 
ing it. Its administration is followed by a well-marked stage of excite- 
ment, after which it produces a sound sleep, which is described as 
" refreshing." It does not interfere with the appetite or digestion, but 
occasionally causes an erythematous eruption ; and may give rise to 
cerebral congestion and vaso-motor paralysis, if used for any long period 
of time. A toxic dose paralyzes the medulla and the respiratory centre 
therein. 

As a hypnotic Paraldehyde has been used with benefit in fevers, rheu- 
matism, acute mania, hysteria and insomnia from various causes. Several 
cases of tetanus have been treated successfully with it, and it has lately 
been found useful as a diuretic and hypnotic in a case of senile arterial 
degeneration with double aortic and mitral regurgitant murmurs, mental 
depression and very marked insomnia and restlessness. 



PAREIRA, Pareira {Pareira Bravo), — is the root of Chondoden- 
dron tomentosum, a climbing, woody vine of the nat. ord. Menispermacese, 
with very large leaves and grape-like fruit, inhabiting Peru and Brazil. 
Occurs in sub-cylindrical, tortuous pieces, 4 to 6 inches long, dark 
brownish-gray externally, with transverse ridges, fissures and furrows ; 
internally pale-brown, interior woody, porous, in concentric circles with 
medullary rays. It contains Pelosine or Cissampeline, an alkaloid identical 
with the Berberine of Nectandra and the Buxine of Buxus sempervirens 
(Boxwood). Several other Pareiras are on the market, that from the 
West Indies (Cissampelos Pareira) being the plant formerly official in 
the Br. Pharmacopoeia. 



PEPO PEPSINUM. 



321 



Preparations. 
Extractum Pareirse Fluidum, Fluid Extract of Pareira. — Dose, gss-gj. 
Infusum Pareirae, Infusion of Pareira (Unofficial), — 1 in 17. Dose, ^j-ij. 

Pareira is diuretic and laxative, stimulating peristalsis and the action of 
the kidneys. It is eliminated by the renal secretion, and passing over 
the mucous membrane of the genito-urinary tract, it acts thereon in a 
tonic and soothing manner, especially on the bladder. 

It is particularly useful in chronic cystitis, suppurative kidney diseases, 
gonorrhoea and gleet, but must be used internally, as when injected locally 
for gonorrhoea and cystitis it has not proved successful. Formerly 
Pareira was considered an efficient lithontriptic, and in Brazil it is used 
as a cure for bites of poisonous serpents, being employed both internally 
and locally to the wound. 

PEPO, Pumpkin-seed, — is the seed of Cucurbita Pefio, or common 
Pumpkin (nat. ord. Cucurbitacese), about ^ inch long, white, flat, oval, 
inodorous, bland and oily. The active principle is a resin contained in 
the endopleuron or envelope immediately surrounding the embryo. It 
also contains an alkaloid Cucurbiiine, a fixed oil, starch, sugar, etc. There 
are no official preparations. Dose, of the resin, gr. xv; of the seeds, 
3j-ij, beaten up into an emulsion with sugar and water. 

Pumpkin-seed is an efficient agent for the removal of tapeworm (a 
tseniafuge), and its use is not followed by unpleasant symptoms. The 
outer coat of the seed should be removed, and an emulsion then made by 
trituration with sugar and water. This, if taken on an empty stomach 
and followed by a brisk cathartic, will generally prove effective. Dr. 
Squibb maintains that the seeds should not be decorticated, but that husks 
and all should be swallowed. According to some observers the expressed 
oil is equally efficient in doses of §ss repeated twice or three times, and 
followed by a cathartic. 

PEPSINUM, Pepsin, — is a hypothetical name for the digestive 
principle of the gastric juice, and as a definite body is unknown, the 
various preparations, official and unofficial, being mere approximations, 
and varying much from each other. It is officially described as a proteo- 
lytic ferment or enzyme, obtained from the glandular layer of fresh 
stomachs from healthy pigs, and capable of digesting not less than 3000 
times its own weight of freshly coagulated and disintegrated egg albu- 
men, when tested by the official process. 

A fine, white, or yellowish-white, amorphous powder, or thin, pale-yellow translucent 
grains or scales, free from any offensive odor ; soluble in about 100 of water, more soluble 
in water acidulated with HC1, insoluble in alcohol, ether or chloroform. It usually has a 
slightly acid reaction, and may be neutral, but should never be alkaline. 

21 



322 PEPSINUM. 

The commercial Pepsin is usually obtained from a solution prepared by 
digesting the mucous membrane scraped from the rennet-bags of sheep or 
the stomach of the pig in acidulated water for several days. It is then 
precipitated by Chloride of Sodium (Scheffer), Acetate of Lead {Bou- 
daulf), or by drying the peptones on glass plates (Beale). It may also 
be precipitated by alcohol. By Scheffer's process it occurs as a tough, 
gray, leathery substance, partially soluble in water, one grain dissolving 
3000 grains of albumen in a few days. Jensen's "Crystal Pepsin," 
probably prepared after Beale's method, is in. yellowish, translucent scales, 
soluble in water, and reputed to be many times stronger than any other 

preparation yet obtained. 

Preparations. 

Pepsinuria Saccharatum, Saccharated Pepsin, — is Pepsin I, triturated with 9 of 
Sugar of Milk. One part should digest at least 300 parts of egg-albumen, wRen tested 
by the official process. Dose, gr. v-g j, shortly after meals. 

Liquor Pepsini, Liquid Pepsin (Unofficial), — contains of Saccharated Pepsin 40 
parts, Hydrochloric Acid 12, Glycerin 400, Water q. s. ad 1 000 parts. Dose, ^ij-iv, 
after meals. 

Lactopeptine (Unofficial), — claimed to contain Pepsin, Diastase or Ptyalin, Pancrea- 
tin, Lactic and Hydrochloric Acids, and that gj will digest ^viij-x of albumen, fibrin, 
casein, or gelatin, will emulsionize 3 xvj of cod-liver oil, and convert ^iv of starch into 
glucose. A proprietary preparation. Dose, gr. v-xv. 

[Every manufacturer of Pepsin has his own preparation, and his peculiar name there- 
for, such as "Liquid Pancreopepsine," "Lacto-peptine." " Gluco-pepsine," "Golden 
Scale Pepsin," " Peptogenic Milk Powder," etc. They vary considerably in their prop- 
erties, but all have the power in some degree of digesting albumen or fibrin.] 

Analogous Products. 
Pancreatinum, Pancreatin, — is officially described as a mixture of 
the enzymes naturally existing in the pancreas of warm-blooded animals, 
usually obtained from the fresh pancreas of the hog (Sus scrofa). It 
occurs as a yellowish-white or grayish, amorphous powder, of faint odor, 
and meat-like taste ; slowly soluble in water, insoluble in alcohol. It 
consists of four ferments, viz : (1) Trypsin, the proteolytic ferment, (2) 
Pancreatic Diastase, the amylolytic ferment, (3) a fat-emulsifying, and 
(4) a milk-curdling ferment. Besides the above-described official form it 
is marketed in various preparations, as Pancreatic Emulsion, and the fol- 
lowing — 

Liquor Pancreaticus, Pancreatic Solution (Unofficial), — prepared by digesting a 
finely-chopped pig's pancreas with 4 times its weight of dilute alcohol. It is a nearly 
clear alcoholic solution, with little taste or smell. Dose, £j- Jss. 

Ingluvinum, Ingluvin (Unofficial), — is obtained from the gizzard 
of the domestic fowl, and owes its activity to a peculiar, bitter principle, 
and not to any ferment corresponding with pepsin. Dose, gr. x-xxx. 

Papain, Papaiva (Unofficial), — is a vegetable ferment obtained from 
the milky juice of Carica Papaya, a S. American fruit-tree of the nat. 
ord. Papayacese. It is soluble in water but not in alcohol, and has active 



PEPSINUM. 



323 



digestive powers. It is composed essentially of a mixture of vegetable 
globulin, albumoses and peptone, with which are associated the ferments 
characteristic of the preparation. It is marketed under the name Papoid. 
Dose, gr. j-iij. 

Papaw Milk is the milky juice of the fruit, coagulating into two parts, a pulpy mass 
and a liquid serum. When mixed with alcohol an amorphous powder is precipitated, 
which when dried forms Papain. 

Physiological Action and Therapeutics. 

Pepsin is not a solvent, but a ferment, and is a normal constituent of 
the gastric juice, converting albuminoids (casein, albumen, fibrin, etc.) 
into peptones for assimilation, with the aid of the Lactic and Hydro- 
chloric Acids associated with it. This it will do out of the body or in 
cavities, as the rectum, if warmth, acidity and moisture be present. Pan- 
creatin, on the other hand, is destroyed by acids and requires an alkaline 
medium in which to exercise its powers. As the food passes out of the 
stomach in 2 or 3 hours, Pepsin should be administered within, and 
Pancreatin after that period, to be effective. Alcohol destroys the activity 
of Pepsin, Alkalies and many mineral salts precipitate it. 

Dyspepsia in its various forms is the malady for which Pepsin is chiefly 
employed, but it is also extremely useful in the apepsia of infants, gas- 
tralgia, anaemia, chlorosis, gastric ulcer and cancer, the diarrhoea of 
infants and vomiting of pregnancy. It is added to nutritive enemata, 
the rectum not being a digestive organ, and is injected into the substance 
of morbid growths which are homologous to the tissues, particularly fatty 
tumors, for the purpose of arresting their growth and promoting their 
absorption. It has been injected into the bladder to break down a blood- 
clot, and has been suggested as an atomized inhalation in diphtheria and 
croup to digest the membrane without injuring the living tissues. 

Pancreatin digests albuminoids and converts starch into sugar and 
proteids into peptones, also emulsifies fats in the presence of an alkaline 
solution (Pepsin requiring an acid one). Prolonged contact with mineral 
acids renders it inert. It is digested by pepsin, and hence probably 
never passes into the duodenum in its own character. Pancreatin is used 
to partially digest (peptonize) milk, gruel, soups, and other foods, before 
their administration in cases of great digestive debility. These peptonized 
foods may be administered per orem vel rectum, and are valuable in intes- 
tinal dyspepsia, wasting diseases, and convalescence from acute affections. 
A teaspoonful taken after the administration of Cod-liver Oil will prevent 
the disagreeable eructations which are so offensive to some patients, and 
will aid in the digestion of the oil. 

Trypsin, unlike Pepsin, will dissolve mucin, and like Pepsin it is inert towards nuclein, 
horny tissues, and amyloid matter. Used as a spray on diphtheritic membrane it has 
proved a very efficient solvent. It affects albuminoids even in a slightly acid solution. 



324 PETROLATUM PHENACETINUM. 

Ingluvin is particularly useful against vomiting and has been found exceptionally 
efficient in the vomiting of pregnancy, given in 20-grain doses before meals. 

Papain, (Papoid), has the power of digesting to a greater or less extent all forms of 
proteid or albuminous matter, both coagulated and uncoagulated. It is peculiar in that 
its digestive power is exercised in either acid, alkaline or neutral media, in which respect 
it differs greatly from the other digestive ferments. It acts more rapidly than Pepsin and 
at higher temperatures. It is a rapid solvent of false membranes and intestinal worms; 
and has been injected into neoplasmic tumors, dissolving their tissues in its immediate 
vicinity, but with much pain and considerable febrile reaction. Papoid has been used as 
a paste locally in diphtheria, to destroy and remove the false membrane; internally, in 
gastric and gastro-intestinal catarrh, the diarrhoea of infancy, and various dyspeptic condi- 
tions, with very great success. Its power over both gastric and intestinal indigestion 
renders it much more useful than either pepsin or pancreatin in cases of doubtful diag- 
nosis, in which it is difficult to decide as to the location of the trouble. 

Papoid may be obtained in powder or tablets, either alone or in combination with 
Sodium Bicarbonate, Boracic Acid, and Nux Vomica; also as a glycerole, which is said 
to be a permanent liquid preparation. The dose of Papoid is from I to 3 grains, but 5 
grains or more may be given in special cases. 



PETROLATUM, Petrolatum,— is a mixture of hydrocarbons, 
chiefly of the marsh-gas series, obtained from Petroleum, by distilling off 
the lighter portions and purifying the residue. It is colorless or yellowish 
in color, and in the latter case is more or less fluorescent ; amorphous, 
odorless and tasteless, of neutral reaction, insoluble in water or alcohol, 
soluble in ether, chloroform, benzin, fixed and volatile oils, etc. Com- 
mercially it is known as Cosmoline, Vaseline, Petroleum Ointment, etc., 
and is largely prepared from residuums or sediments deposited in tanks 
containing crude petroleum. It is official in the following three forms, 
all of which, when heated, give off a faint odor of petroleum, viz : — 

Petrolatum Liquidum, Liquid Petrolatum, — an oily, transparent fluid, of sp. gr. 
0.875 t0 °-945- 

Petrolatum Molle, Soft Petrolatum, — a fat-like mass, of the consistence of an oint- 
ment, sp. gr. about 0.820 to 0.840, melting-point between 104 and 113 F. 

Petrolatum Spissum, Hard Petrolatum, — a fat-like mass, of about the consistence 
of a cerate, sp. gr. 0.820 to 0.850, melting-point between 113 and 125 F. 

Petrolatum is a valuable protective dressing, and an excellent basis for 
ointments, having no acridity and no liability to become rancid. It is 
readily miscible with many active agents, as the alkaloids, phenol com- 
pounds, etc., but it does not penetrate the skin as readily as animal fats 
and fixed oils. Uncombined, it forms an excellent bland application in 
all irritated conditions and injuries of the skin. 



PHENACETINUM, Phenacetin, Oxy-ethyl-acetanilid, (Para- 
acet-phenetidiii) C 10 H 13 NO 2 , (Unofficial), — is a crystalline substance, 
closely allied in chemical composition to Acetanilid, and produced by 
the action of glacial acetic acid on para-phenetidin, a body obtained 
from phenol. It occurs in colorless, tasteless, inodorous, glistening, scaly 



PHENOCOLL HYDROCHLORIDE. 325 

crystals, sparingly soluble in cold water, more freely in boiling water, also 
in about 16 fluid parts of alcohol. Dose, gr. ij-xx; — as an antipyretic, 
gr. viij-x hourly or every two hours, in powder or tablets ; against neu- 
ralgia and rheumatism, gr. xv, repeated if necessary up to gjss in 24 
hours. 

Physiological Action and Therapeutics. 

The physiological action of Phenacetin is analogous to that of Acet- 
anilid. It is probably the safest of the new synthetical antipyretics, 
reducing pyrexia gradually and causing perspiration without producing 
collapse. It is also anodyne and hypnotic, soothing pain and inducing 
sleep. 

Phenacetin has been given with benefit, in 2-grain doses with y 2 grain 
of Caffeine Citrate, for migraine ; also in epidemic influenza, both as a 
prophylactic and as a remedy. As an antipyretic it is extensively em- 
ployed in phthisis, peritonitis, polyarthritis, etc., also in endocarditis, 
typhus and typhoid fevers ; and as an antineuralgic in vaso-motor neu- 
roses, for the lancinating pains of locomotor ataxia, and in neuralgia and 
hemicrania. It is highly praised in whooping-cough, rheumatic and 
other fevers, and, though slower in action than Antipyrin or Acetanilid, 
is deemed fully as efficient in reducing pyrexia, while usually free from 
the depressant after-effects of these latter agents. 

Methacetin, Oxy-methyl-acetanilid (Unofficial), — derives its name from its analogy 
to Phenacetin, from which it differs only in containing a methyl group in place of an 
ethyl one. From Acetanilid it differs in the substitution of the oxy-methyl group for a 
hydrogen atom. It occurs as lustrous, scaly, colorless, odorless crystals; soluble in 12 of 
hot water, in alcohol, chloroform, glycerin and fatty oils; scarcely soluble in cold water. 
Dose, gr. iij-v, or more. 

Methacetin was introduced as an antipyretic for children and feeble persons, and 
promised at one time to supersede phenacetin. It is well borne, and no malaise, tinnitus, 
cardiac weakness or exanthem follow its ingestion ; but it often gives rise to a violent and 
exhausting perspiration. 

It has been used successfully in typhoid fever, all forms of rheumatism, neuralgias, 
pneumonia, and in most forms of pyrexia, but has not as yet equaled the results obtained by 
either phenacetin or antipyrin. Its employment in phthisis was not favorable, chiefly by 
reason of the profuse sweating induced by it. Its advantages, over all the other anti- 
pyretics of its class, are its lack of toxic properties, and its comparatively ready solubility 
in water, being five times more soluble than its rival, phenacetin. 



PHENOCOLL HYDROCHLORIDE (Unofficial),— is another 
synthetical antipyretic, closely allied to Phenacetin, both chemically and 
medicinally, and distinguished by its comparatively free solubility. It is 
produced by the interaction of Phenetidin and Glycocoll (amido-acetic 
acid), and occurs as a white, micro-crystalline powder, soluble in about 
16 of water, therein forming a neutral solution. The pure base, Pheno- 
coll, is precipitated from the solution by ammonia, the fixed alkalies and 
their carbonates. 



326 PHOSPHORUS. 

Phenocoll Hydrochloride may be looked upon as a soluble Phenacetin, 
15 grains dissolving readily in §j of water. With decided antipyretic, 
antirheumatic and analgesic powers, it possesses-a marked advantage, over 
the other members of its class, in that it has no injurious effect upon the 
blood corpuscles, even when in direct contact with them. It is promptly 
absorbed, readily excreted, and reduces the hyperpyrexia of fever without 
producing very profuse sweating, or other unpleasant by-effects. The 
fall in temperature is very decided, and occurs within an hour after the 
administration of the drug ; being due to great diminution of heat-pro- 
duction, without any alteration of heat-dissipation. In ordinary doses it 
has no effect on the circulation, but large doses diminish the blood-pres- 
sure and reduce the pulse-rate, by stimulating the cardio-inhibitory cen- 
tres. 

This drug has been employed, with marked success, as an antipyretic 
in hectic, malarial, typhoid, and other fevers : also in acute rheumatism, 
neuralgia, epidemic influenza, and for the neuralgic pains of the latter 
affection. In combination with Piperazin, 15 grains of each daily, in a 
pint or more of carbonated water, it has rendered excellent service in 
gouty and rheumatic affections, especially when accompanied with pain 
and fever. The same combination has proven of service in a case of ob- 
stinate gastric irritability with uncontrollable vomiting, which had re- 
sisted every known remedy. The dose is gr. v-xxx, an average dose 
being about 12 grains, thrice or four times a day. 



PHOSPHORUS, Phosphites and Phosphates,— are best 
studied together, as the supplying of the element Phosphorus to the body 
is the aim of the administration of these agents. 

Phosphorus, P, — is a non-metallic element obtained from bones, and 
occurs as a translucent, nearly colorless solid, of waxy lustre, and usually 
the consistence of beeswax, insoluble in water, soluble in 50 parts of any 
fatty oil, in 80 of absolute ether, 350 of absolute alcohol, and freely in 
carbon disulphide. It has a disagreeable odor and taste, melts at in° 
F., is luminous in the dark, ignites in the air, and should be kept under 
water in a cool place, protected from light. It usually contains Arsenic 
and sometimes Sulphur, the limits of which are fixed by the pharma- 
copceial tests. Dose, gr. j^-j^, thrice daily. 

Preparations of Phosphorus. 

Pilulse Phosphori, Pills of Phosphorus, — each contains gr. yi^ of Phosphorus, dis- 
solved in Chloroform, mixed with Akhsea and Acacia in Glycerin and Water, and coated 
by shaking with a solution of Balsam of Tolu in Ether. Dose, j-v. 

Oleum Phosphoratum, Phosphorated Oil, — has of Phosphorus I part, Ether and 
Expressed Oil of Almond to 100. Dose, rt\J-v thrice daily. 

Acidum Phosphoricum and Acidum Phosphoricum Dilutum, — are described on 
page 78, ante. 



PHOSPHORUS. 



327 



Acidum Hypophosphorosum Dilutum, Diluted ' Hvpophosphorous Acid, — a liquid 
composed of about 10 per cent, of the absolute acid (HPH 2 2 ), and about 90 per cent, 
of water. Used in the preparation of Syrupus Hypopbosphitum. 

Spiritus Phosphori, Spirit of Phosphorus, ( Tincture of Phosphorus) -has of Phos- 
phorus 1.2, dissolved in Absolute Alcohol 1000. 

Elixir Phosphori, Elixir of Phosphorus, — has of the preceding 210, Oil of Anise 2, 
Glycerin 550, Aromatic Elixir to 1000. Each cubic cm. represents about % milligramme 
of phosphorus (each % equals about gr. J^). Dose, ^ss-^ss. 

Tinctura Phosphori {Thompson's"), Unofficial, — Phosphorus gr. j, Absolute Alcohol 
£v, Glycerin 5J>£, Alcohol gij, Spt. Mentha Piperita? H\xl. Of this 3J contains gr. 
j 1 of Phosphorus. Dose, gss-gjss. 

Tinctura Phosphori (Bellevue Hospital), Unofficial, — Phosphorus gr. xxxij, Absolute 
Alcohol 3 xlvj, Essence of Vanilla 3 j, Oil of Orange spij, Alcohol q. s. ad ^xlviij. Of 
this 3J contains gr. ^ of Phosphorus. Dose, jjjss-j. 

Zinci Phosphidum, Zinc Phosphide, Zn 3 P 2 , — crystalline fragments or a gray-black 
powder, insoluble in water or alcohol, but completely soluble in hydrochloric or sulphuric 
acids with evolution of hydrogen phosphide. Is very irritant to the stomach. Dose, gr. 

Preparations of Phosphites. 

Calcii Hypophosphis, Calcium Hypophosphite, Ca(PPI 2 2 ) 2 , — colorless prisms, or 
thin, pearly scales, of nauseous taste, soluble in 6.8 of water, insoluble in alcohol. Is an 
ingredient of the Syrupus Hypopbosphitum. Dose, gr. x-xxx. 

Ferri Hypophosphis, Ferric Hypophosphite, Fe 2 (H 2 P0 2 ) 6 , — a white or grayish-white 
powder, odorless and tasteless, slightly soluble in water, freely so in hydrochloric acid or 
a solution of sodium nitrate. Dose, gr. v-x. A ferruginous tonic. 

Potassii Hypophosphis, Potassium Hypophosphite, KH 2 P0 2 , — white masses, or a 
white, granular powder, deliquescent, odorless, of saline taste and neutral reaction. Sol- 
uble in 0.6 of water and in 7.3 of alcohol at 59 F. Dose, gr. v-x. 

Sodii Hypophosphis, Sodium Hypophosphite, NaPH 2 2 -J- H 2 0, — small plates, or a 
white, granular powder, deliquescent, odorless, of sweetish, saline taste, and neutral reac- 
tion. Soluble in 1 of water and 30 of alcohol at 59 F. Dose, gr. v-x. 

Syrupus Hypophosphitum, Syrup of Hypophosphites,— -has of Calcium Hypophos- 
phite 4^, of Potassium and Sodium Hypophosphites lj4, each, per cent. Dose, Jjj-^ss. 

Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with Iron, — has 
of Ferrous Lactate 1, Potassium Citrate 1, in Syrup of Hypophosphites to 100. Dose, 

Preparations of Phosphates. 

Calcii Phosphas Praecipitatus, Precipitated Calcium Phosphate, Ca 3 (P0 4 ) 2 , — a 
light, white, amorphous powder, odorless and tasteless, insoluble in water or in alcohol. 
Dose, gr. ij-x. 

Syrupus Calcii Lactophosphatis, Syrup of Calcium Lactophosphate, — has ot the 
preceding 2^ per cent. The Calcium Phosphate is dissolved by Lactic and Phosphoric 
Acids, but does not form the chemical combination suggested by the title. Dose, ^j-^ ss. 

Sodii Phosphas, Sodium Phosphate, Na 2 HP0 4 -J- I2H 2 0, — large, colorless, mono- 
clinic prisms, efflorescent, of saline taste and alkaline reaction ; soluble in 6 of water, 
insoluble in alcohol. Dose, 3J-^j. 

. Sodii Pyrophosphas, Sodium Pyrophosphate, Na 4 P 2 7 -j- loH 2 0, — colorless, mono- 
clinic prisms, of saline taste and alkaline reaction; soluble in 12 of water, insoluble in 
alcohol. Dose, % ss— ^ ss. 

Syrupus Ferri, Quininae et Strychninae Phosphatum, Syrup of the Phosphates 
of Iron, Quinine and Strychnine, — has of Soluble Ferric Phosphate 2,' Quinine Sulphate 
3, Strychnine -^, Phosphoric Acid 4.8, Glycerin 10, Water 5, Syrup to 100. A power- 
ful tonic. Dose, gj-iij. 

Syrupus Phosphatum Compositus, Compound Syrup of Phosphates. Parrish's 
Chemical Food (Unofficial), — has in each 3 , of Ferric Phosphate gr. 2^, Calcium 
Phosphate gr. j. Dose, gj-iij. 

Ferri Phosphas and Ferri Pyrophosphas are described under Ferrum, ante, page 
236. 

Physiological Action. 
Phosphorus in small doses stimulates the brain and circulation, the 
functions of the stomach and the genital organs, and the growth of bones. 



328 PHOSPHORUS. 

It aids digestion by irritating the end-organs of the gastric nerves, and 
produces eructations of Hydrogen Phosphide. Its fumes cause necrosis 
of the upper or lower maxillae, especially in those whose teeth are decayed, 
but this may be "prevented by the inhalation of fumes from old acid tur- 
pentine. In poisonous doses it is a powerful irritant of the gastrointes- 
tinal tract, causing vomiting and purging with great depression of the 
vital forces. Reaching the blood as Phosphorus, it is partly oxidized at 
the expense of the oxygen of the red corpuscles, causes acute hemorrhages 
from fatty degeneration of the arterial walls, rapid steatosis of the stomach, 
liver and heart, with deep jaundice, — then delirium, convulsions, coma 
and death usually from gradual failure of the respiration and cir- 
culation. Acute yellow atrophy of the liver resembles acute phosphorus 
poisoning so much that it is generally impossible to distinguish between 
them. 

Its effect on metabolism is to increase the nitrogenous products, to 
diminish the excretion of carbonic acid, reduce the glycogen of the liver 
to almost nothing, and to raise the temperature. While generally increas- 
ing metabolism it so influences that process as to arrest it at the stage of 
conversion of proteids into urea and oil, instead of allowing it to proceed 
to the final oxidation of oil into carbonic acid and water, hence leading 
to fatty degeneration of epithelial, glandular and muscular protoplasm 
throughout the body. 

Calcium Phosphate is an essential ingredient of all the tissues and 
fluids of the body, and forms more than 50 per cent, of the bones. Lactic 
and Hydrochloric acids dissolve it in small quantities. It increases the 
alkalinity of the blood as well as its power of holding carbonic acid, and 
diminishes the excretion of urea. 

Sodium Phosphate acts on the blood and on the excretion of urea 
similarly to the calcium salt. It increases secretion generally, especially 
of the bile, being an excellent cholagogue and thereby aiding in the 
digestion of fats. In ounce doses it is laxative. It is a normal constitu- 
ent of the blood, and possesses the property of increasing the capacity of 
any fluid to hold carbonic acid in solution. 

The Hypophosphites are generally tonic, and are supposed to consti- 
tute a safer form in which to administer Phosphorus than in the un- 
oxidized state. They are probably converted into phosphates in the 
stomach. 

Antidotes and Antagonists. 

Antidotes are Hydrated Magnesia, Lime-water, powdered Charcoal, Copper Sulphate 
and old acid Turpentine. Sulphate of Copper is the best emetic, forming a comparatively 
insoluble phosphide of copper; 3-grain doses should be given every 5 minutes in dilute 
solution until emesis occurs. Hydrated Magnesia as a quickly- acting purgative. Lime- 
water or Charcoal to prevent the action on the tissues. Crude French Acid Turpentine 
is the best antidote, which may be given rapidly in an emulsion of gum. Opium to 
counteract the depression of the heart and system. Transfusion has proved efficient 



PHOSPHORUS. 



329 



where the blood is affected. No oils or fats should be used, as they dissolve Phosphorus 
and promote its absorption. 

Therapeutics. 
Phosphorus is chiefly used to promote the nutrition of osseous and 
nervous tissue. It is useful in chronic nervous exhaustion when the nerve 
centres are implicated, in osteomalacia, rachitis and progressive locomotor 
ataxia. In threatened cerebral softening it affects the nerve centres as no 
other drug does, and in paraplegia of myelitic origin from excessive 
venery it is often very efficient. Progressive pernicious anaemia has some- 
times been arrested by Phosphorus in very small doses, while in impo- 
tence of functional character there is no remedy so effective. In wake- 
fulness of the aged and that due to cerebral anaemia small doses of the pill 
or tincture are sometimes remarkably beneficial. In certain skin diseases 
(acne, psoriasis, lupus), it is an excellent substitute for Arsenic. Neural- 
gia is often cured by Phosphorus, but large doses are necessary, at least 
gr. y 1 ^- every four hours. 

The solution of Phosphorus in Retinol is very stable, and is strongly recommended for 
the external and internal use of that substance. 

Calcium Phosphate and the Hypophosphites are used with benefit 
in all diseases of mal-nutrition, and where the repair or development of 
the bones is required. They are particularly useful in protracted suppu- 
ration, osteomalacia, rachitis, caries, scrofulosis, chronic phthisis, and in 
the anaemia and bone-softening of lactation. The Hypophosphites are 
much employed in nervous and general debility and in chronic lung dis- 
eases, and are supposed to act in the same manner as free Phosphorus, but 
without irritation. They are probably converted into Phosphates in the 
stomach, and hence may be expected to promote the growth and healing 
of bones, to stimulate the hepatic and intestinal secretions, and to affect 
the lymphatic glands and adenoid tissue. The Compound Syrup of the 
Hypophosphites is an excellent remedy in acne indurata. 

Sodium Phosphate in drachm-doses thrice daily for adults, gr. x- 
xxx for children, is extremely useful as a laxative in conditions depend- 
ing on catarrh of the bile-ducts and duodenum, as headache, jaundice, 
chalky stools, etc. Gall-stones may be prevented from forming by 
scruple or drachm doses before meals for months at a time. It is also an 
efficient agent in obesity, hepatic diabetes, incipient hepatic sclerosis, 
chronic infantile diarrhoea, cerebral debility, bilious sick-headache, and 
the pasty, white stools of ill-conditioned children. Vichy-water contains 
this salt in the proportion of gr. ^ to the pint, and is considered a val- 
uable water in hepatic colic and kindred conditions. Finally for the con- 
dition of the system producing a crop of boils, Sodium Phosphate is 
probably the best remedy. 



330 PHYSOSTIGMA. 

PHYSOSTIGMA, Calabar Bean,— is the seed of Physostigma 
venenosum (nat. ord. Leguminosse), a woody creeper of Calabar, West 
Africa, where it is used by the natives as an ordeal for witches, etc., vom- 
iting after its ingestion being held to establish the innocence of the 
accused. It is about an inch long, irregularly kidney-shaped, with two 
flat sides and a furrow along its convex margin ending in an aperture near 
one end. It contains an alkaloid, variously named Pserine, Physostig- 
mine and Calabarine, C 15 H 21 N 3 02, which is obtained as a crystalline, an 
amorphous or a syrupy body. Some authorities apply the abflve names 
to different bodies, but acknowledge that they agree in physiological 
action though not in physical qualities. 

Preparations. 

Extractum Physostigmatis, Extract of Physostigma, — an alcoholic extract, of which 
the dose is from gr. y^ to gr. j. 

Tinctura Physostigmatis, Tincture of Physostigma, — strength 15 per cent. Dose, 
TTL v-xx. 

Physostigminae Salicylas, Physostigmine Salicylate, (Eserine Salicylate), — colorless, 
columnar crystals, of bitter taste and neutral reaction, soluble in 150 of water and in 12 
of alcohol. Dose, gr. xinnsV 

Physostigminae Sulphas, Physostigmine Sulphate {Eserine Sulphate), — a white, 
micro-crystalline powder, of bitter taste, very deliquescent in moist air, very soluble in 
water and in alcohol. Dose, gr. x^o~oV 

Physiological Action. 
Physostigma is a direct spinal paralyzer, producing complete general 
paralysis, and abolished reflexes, but not affecting muscular irritability or 
the cerebral functions. It stimulates secretion, excites nausea and vomit- 
ing, salivation and diaphoresis, and is laxative by stimulating the muscular 
coat of the intestines to increased peristalsis as well as by increasing the 
intestinal secretions. It first lowers then raises arterial tension, increases 
the frequency of the heart-beat, but depresses the power of the cardiac 
muscle though not destroying it. It produces dyspnoea by a tetanic ac- 
tion on the respiratory muscles, causing carbonic acid narcosis and death 
by paralysis of respiration. It contracts the pupil (how, is disputed), and 
the ciliary muscle, producing marked myosis. It is eliminated chiefly by 
the kidneys, the urine of the animal affected poisoning another. 

Antagonists and Incompatibles. 

Atropine is antagonistic as to the effects on the respiration, heart and pupils. Chloral 
is also antagonistic, and over a greater field of action, but to be effective must be admin- 
istered before the ingestion of the Physostigma. The vegetable astringents, Tannic Acid 
and the caustic alkalies are chemically incompatible. 

Therapeutics. 
The applications of Physostigma are not many. It is efficient in con- 
stipation due to torpor of the bowels, in which condition it is usually 
combined with Belladonna and Nux Vomica. In tetanus it has been used 



PHYTOLACCA. 



331 



with advantage to diminish reflex excitability in grain-doses of the extract 
repeated every 2 hours and the dose modified according to the effect pro- 
duced. Progressive paralysis of the insane is apparently retarded by it, 
and while antagonistic theoretically in atropine and strychnine poisoning, 
practically it is not of much value. 

Physostigmine (Eserine) is used locally by ophthalmologists for many 
purposes in affections of the eye. In a solution of gr. ij to the ^ of water 
dropped into the eye, it is efficient in breaking up or preventing adhesions 
of the iris, diminishes intraocular tension, prevents suppuration after 
operations, contracts the pupil, diminishing the entrance of light in pho- 
tophobia, etc., and empties the vessels of the eye. It is very useful in 
keratitis, glaucoma, strumous ophthalmia, and neuralgia of the eye-ball. 
The salts of Physostigmine in neutral solution may be used for these pur- 
poses, as well as to counteract the effects of Atropine on the pupil. 
Gelatin disks medicated therewith may be obtained in the shops, and are 
a convenient form in which to use the drug for ophthalmic purposes. 



PHYTOLACCA, Poke,— is official under two forms, the fruit and 
the root of Phytolacca decandra, a plant of the nat. ord. Phytolaccacese, 
found in all parts of the United States. It contains a neutral principle 
Phytolaccin, and an acid Phytolaccic Acid, also tannin, starch, fixed oil, 
etc. The official titles are as follows, viz. — 

Phytolaccae Fructus, Phytolacca Fruit, {Poke Berry), — a depressed- 
globular, dark purple, compound berry, about y$ inch in diameter, com- 
posed of ten carpels, each containing one lenticular, black seed ; juice 
purplish-red ; inodorous, taste sweet, slightly acrid. Dose, gr. x-xxx. 

Phytolaccae Radix, Phytolacca Pool, {Poke Root), — large, conical, 

branched, fracture fibrous, wood-bundles in concentric circles, inodorous, 

sweetish and acrid. Dose, as emetic, gr. x-xxx, — as an alterative, gr. 

j-v. 

Preparations. 

Extractum Phytolaccae Radicis Fluidum, Fluid Extract of Phytolacca Root. — 
Dose, Tty-xxx. 

Tinctura Phytolaccae, Tincture of Phytolacca (Unofficial). — Dose, rt^x-^]. 

Physiological Action and Therapeutics. 
Phytolacca is an emeto-cathartic, acting slowly but persistently, with 
great nausea and considerable depression. It lowers the rate of respira- 
tion and of cardiac action, and is a motor depressant, paralyzing the 
spinal cord and the medulla, death occurring from paralysis of respira- 
tion, preceded by tetanic convulsions. Several cases of poisoning by this 
plant have occurred. Its action is antagonized by Alcohol, Ether, Opium, 
Digitalis, etc. 



33 2 PICHI PICROTOXINUM. 

Alterative powers have been ascribed to Phytolacca, and competent 
observers have reported curative results from its use in malignant tumors, 
varicose and other ulcers, obstinate eczema, sycosis, favus and other 
skin affections, employing it both internally and externally. It is a very 
serviceable remedy in chronic rheumatism, and given internally has 
undoubtedly cured cases of granular conjunctivitis. Mastitis is some- 
times aborted and suppuration of the breasts prevented by the use of the 
fluid extract internally while a solid extract is locally applied to the seat 
of the impending inflammation. In tonsillitis and diphtheritic sore throat, 
also in chronic follicular pharyngitis, it has been much used with good 
results, especially when there is high fever and pains in the head, back 
and limbs. In true adynamic diphtheria it will do little good. 

Phytolacca has long been known to promote the absorption of adipose 
tissue, and was suggested as a remedy for obesity as early as 1858. A 
resinoid preparation of the berries is on the market as an " anti-fat" 
remedy, under the name Phytoline, the dose of which is n^x six times a 
day, before and after each meal. 



PICHI, Pichi (Unofficial), — is the shrub Fabiana imbricata, a member of the nat. 
ord. Solanacese, and a native of S. America. Among the Chilians it has been much 
prized as a remedy in cystitis with calculi and gravel, and in chronic catarrh of the blad- 
der. It seems to have considerable power over the hematuria and pain of renal calculus. 
It is also highly praised in dyspeptic disorders. Its medicinal virtues reside in oleo- 
resinous constituents which are insoluble in water. An extract is prepared from the 
leaves, of which the dose is gr. v-x in capsules. Dose of the fluid extract, gj, but it 
should not be added to water. 



PICROTOXINUM, Picrotoxin, Picrotoxic Acid, C 30 H 34 O 13 ,— is a 
poisonous, neutral principle obtained from the seeds contained in the 
berries {Cocculus Indicus, Fish-berries), of Anamiria paniculata (Anamirta 
Cocculus, Menispermum Cocculus), a climbing shrub of the nat. ord. 
Menispermaceae, a native of the East Indies. The berries are somewhat 
kidney-shaped, of blackish-brown color, wrinkled, brittle, inodorous and 
nearly tasteless, except the shrivelled embryo, which is bitter. They con- 
tain, besides Picrotoxin, a large quantity of fixed oil and other substances 
of less interest. In the shell are found Menispermin, an alkaline principle, 
Paramenispermin, which is neutral and crystalline, and Hypopicrotoxic 
Acid. There are no official preparations. 

Picrotoxin occurs in colorless, flexible crystals, of prismatic form, 
bitter taste and neutral reaction, soluble in 240 of water and in 9 of al- 
cohol, also in acids and in alkaline solutions. Dose by the stomach gr. 
&~A » ca utiously. For hypodermic use a solution in water of gr. ij in 
gj may be used, in doses of gr. •^•"TO' °f tne principle, n^ iv equalling 
gr. tnr- 



PICROTOXINUM. 3-33 

Unofficial Preparations of Cocculus. 

Tinctura Cocculi, Tincture of Cocculus, — I in 8. Dose, TTLij-xv. 
Extractum Cocculi Fluidum, Fluid Extract of Cocculus. — Dose, n\J-iij. 
Planat's Tincture of Cocculus, — I in 4. Dose, rr\J-v. 

Physiological Action. 

Picrotoxin is a cerebrospinal exaltant, affecting especially the centres 
in the medulla oblongata, and in its action representing the combined 
action of Belladonna and Nux Vomica. It stimulates all the secretions, 
especially the cutaneous, the salivary and intestinal ; produces nausea and 
vomiting, and slows the heart and the respiration after transiently accelera- 
ting both. It causes muscular twitching, incoordination, stupor, delirium, 
epileptiform convulsions, tonic spasms of the flexor muscles alternating 
with clonic ones, exalted reflexes and trembling, — then coma, insensibil- 
ity and death by paralysis of the heart, which is arrested in diastole. 
The action of the drug is on the spasm and vagus centres in the medulla, 
and on Setchenow's inhibitory centre, as well as on the cerebellum and 
spinal cord, paralyzing the first-named centres and stimulating the reflex 
centres in the cord. It is eliminated by all the excretory channels, 
chiefly by the kidneys. 

The spasms caused by Picrotoxin are choreic and chiefly affect the flexor 
muscles, — those from Strychnine are tetanic, affecting principally the 
extensors. The order, succession and character of the phenomena pro- 
duced by Picrotoxin resemble in marked degree those of the epileptic 
paroxysm. 

Cocculus berries are used to stupefy fish, being thrown into ponds con- 
taining them. They are also employed to adulterate beer and porter in 
order to make these drinks more intoxicating. 

Antagonists. 

Chloral 'is antagonistic to its cerebral and spinal actions, but synergistic to its depressant 
power over the heart and the respiration. Acetic Acid gives relief in overdosing, and 
may have some antidotal power. Anesthetics antagonize its spasm-producing action. 

Therapeutics. 
Picrotoxin is used chiefly in nervous diseases. Epilepsy is amenable to 
it, especially when the attacks are nocturnal, and in anaemic cases and 
those attributable to onanism. Paralyses of several forms have been 
greatly benefited by it, especially paralysis of the sphincters, hemiplegia 
from cold, glosso-labio-laryngeal paralysis, and paralysis agitans. Chorea 
is well treated by it but requires full doses. It is remarkably efficient in 
controlling the night sweats of phthisis, and in flatulent colic, also in dys- 
pepsia with flatulence and severe epigastric pain, and in vomiting with 
giddiness, headache and intolerance of light and sound. Dysmen- 
orrhoea is often benefited by Cocculus administered for two days before 



334 PILOCARPUS. 

the period; and leucorrbcea, when the discharge is sero-purulent, with 
lumbar pains, is frequently controlled by it. Parasitic skin diseases are 
well treated by an ointment of Picrotoxin (gr. x. to the g), which will 
also kill pediculi, but it must be used cautiously and with special care to 
avoid an abraded surface. The tincture of Cocculus may be used as a 
wash to kill body-lice, undiluted. 



PILOCARPUS, Jaborandi, — the leaflets of Pilocarpus Selloanus, 
and of Pilocarpus Jabora?idi, Brazilian plants of the nat. ord. Rutacese. 
They are about 4 inches long, ovate-oblong, coriaceous, pellucid-punc- 
tate, mostly smooth, somewhat pungent and bitter, and contain two alka- 
loids, — Pilocarpine, C n H 16 N 2 2 , soft and viscous, slightly soluble in water 
but soluble in alcohol, ether and chloroform ; Jaborine, isomeric with 
Pilocarpine, to which it is antagonistic in action ; also a Volatile Oil and 
probably a peculiar acid. 

Preparations. 

Extractum Pilocarpi Fluidum, Fluid Extract of 'Pilocarpus. — Dose, rr^v-sjj. 

Pilocarpine Hydrochloras, Pilocarpine Hydrochlorate, C n H 16 N 2 2 H CI,— small, 
white, deliquescent crystals, odorless, of faintly bitter taste ; very soluble in water and in 
alcohol, almost insoluble in ether or chloroform. Dose, gr. y&-}£. 

Physiological Action. 

Pilocarpus is a paralyzer of the vaso-motor system, and a stimulant of 
the peripheral terminations of nerves supplying glands and involuntary 
muscular fibre, subsequently paralyzing the latter. It is therefore a power- 
ful diaphoretic and sialogogue, a cardiac depressant by stimulation of the 
vagus ends, — also myotic, emetic, and under some circumstances aborti- 
facient. Its taste is hot and pungent. It causes prompt and profuse 
perspiration (^ix-xv, in quantity) and salivation (^x-xxvij), after a pre- 
liminary flushing of the skin. The nasal, bronchial and lachrymal secre- 
tions are much increased ; sometimes watery diarrhoea occurs ; the action 
of the heart, at first increased, is afterwards lowered, the arterial tension 
is reduced, and the temperature falls from i° to 4 . Drowsiness, pallor, 
chilliness and debility succeed, and last several hours ; the pupil is con- 
tracted and accommodation impaired. The elimination of urea is 
greatly increased, but not the quantity of urine. The respiratory power 
is lowered, and apnoea may occur, from increase of the bronchial 
mucus. 

Pilocarpus is rapidly diffused, and is eliminated by the skin and the 
salivary glands. Its effects pass off usually in from three to six hours. 
Children are less affected than adults, by proportionate doses. It causes 



PILOCARPUS. 335 

contractions of the bladder, uterus and spleen, in the latter case whether 
the organ is enlarged or of normal size. 

Pilocarpine is the principle to which the foregoing actions are due, 
but Jaborine, though chemically identical, is perfectly antagonistic 
thereto in its effects on the heart, pupils, lungs and salivary glands, acting 
precisely like Atropine on these organs. The difference is probably due 
to a different molecular arrangement. 

Antagonists and Incompatible*. 

Atropine is the antagonist to Pilocarpine in dose of gr. T ^ for gr. i of the latter. The 
antagonism between these two alkaloids extends over the whole range of their action, 
and is the most complete known to physiological experimentation. Conversely Pilocar- 
pine is exactly antagonistic to Atropine, but Jaborine acts similarly to the latter drug. 
Morphine controls the nausea and vomiting. Caustic alkalies, the persalts of Iron and 
salts of the metals generally, are chemically incompatible. 

Therapeutics. 

Jaborandi is used with great benefit in dropsies, especially the renal 
form, also in eclampsia of renal origin, in uraemia, pleuritis, meningitis 
and other inflammations of serous membranes, but it is contraindicated 
when from any cause there is weak heart. In diabetes insipidus it reduces 
the quantity of urine remarkably, relieving the kidneys by throwing the 
work on the skin. In the acute and chronic forms of Bright's disease it 
has been used with advantage, but being so depressant it must be em- 
ployed with great caution in this disorder. For alopecia it is the most 
efficient remedy known, stimulating the skin and improving the color and 
condition of the hair. In agalactia it stimulates the secretion of the 
milk, and it often gives prompt relief in parotitis. Ptyalism is frequently 
relieved by minute doses of Pilocarpine (gr. -g^), which, acting specifi- 
cally on the same gland, may correct the morbid action thereof; and 
similar doses used thrice daily will check profuse perspiration. The hy- 
podermic use of Pilocarpine will arrest a paroxysm of spasmodic asthma, 
and is equally efficient in hiccough. Atropine-poisoning is best combated 
by the use of Pilocarpine hypodermically. 

Ophthalmologists employ Pilocarpine with most excellent results in the 
amblyopia of alcoholism and that from the abuse of tobacco, in detach- 
ment of the retina, chronic iritis, keratitis, glaucoma, hemorrhage into 
the vitreous, atrophic choroiditis, white atrophy, to promote resolution 
and absorption in inflammatory conditions with exudation, and instead of 
Physostigmine as a myotic. 

Erysipelas and diphtheria are diseases in which Pilocarpine has recently 
proved very efficient, but its depressant action on the heart and respira- 
tion must not be lost sight of. In the writer's experience the fluid extract 
is one of the best agents for breaking up a common cold. It may be 
given in doses of nvx-^j, according to age, at bedtime. Children bear 
the drug well in respect to all its physiological actions. 



336 PIMENTA — PIPER PIPERAZIN. 

PIMENTA, Allspice, — is the nearly ripe fruit of Pimento, officinalis, a West Indian 
tree of the nat. ord. Myrtacese. The berries are nearly globular, about ^ inch in diam- 
eter, crowned with the remnants of the calyx, two-celled, each cell containing one reni- 
form seed, odor and taste pungent and aromatic. They contain a Volatile Oil which is 
official, a green fixed oil, fat, tannin, gum, resin, etc. Dose, gr. x-xl. 

Oleum Pimentae, Oil of Pimento, — the volatile oil, colorless or pale yellow, of 
aromatic odor, pungent taste and slightly acid reaction. Is a constituent of Bay Rum 
(Spt. Myrcise). Dose, nyj-vj. 

Allspice is a warm, aromatic stimulant, very useful as a condiment, improving digestion 
by increasing the vascularity of the gastric mucous membrane, and by stimulating the 
salivary secretion. The oil is an agreeable remedy for flatulence, nausea, and intestinal 
colic, and is used to prevent the griping of purgatives and to cover the taste of nauseous 
medicines. 



PIPER, Pepper, {Black Pepper), — is the unripe fruit of Piper nigrum, or Pepper- 
vine, a perennial plant of the nat. ord. Piperaceae, growing in India, Siam, Java, Borneo, 
etc. It is about ye inch in diameter, of globular shape, reticulately wrinkled, aromatic, 
of pungent, spicy taste, and contains a principle, Piperin, which is official,, also a green, 
acrid, concrete oil, a balsamic volatile oil, starch, lignin, gum, extractive, etc. Dose, 
gr. v-xx. 

Oleoresina Piperis, Oleoresin of Pepper, — contains almost all the volatile oil and acrid 
resin extracted by ether, with little of the Piperine. Dose, Tr^^-j. 

Piperinum, Piperin, C 17 H 19 N0 3 , — a neutral principle prepared from Pepper, and 
occurring also in other plants of the natural order Piperaceae. Occurs in colorless or 
pale-yellowish prisms, of neutral reaction, almost insoluble in water, slightly so in ether, 
but soluble in 30 of alcohol. Dose, gr. j-x. 

Physiological Action and Therapeutics. 

Pepper when applied to the skin acts as an irritant ; internally its effects are similar to 
those of other aromatics, being a warm carminative and stimulant, increasing slightly the 
action of the heart, stimulating the kidneys somewhat, and toning up the mucous mem- 
brane of the urinary and intestinal passages, by which channels it is eliminated. It has 
been thought to possess antiperiodic powers, and was formerly much employed in inter- 
mittents. Its chief medicinal use is to correct flatulence, and to excite action of the 
stomach, being very commonly taken as a condiment with food. It is Occasionally 
employed in gleet, but more extensively in hemorrhoids and other diseases of the rectum. 
Its active constituents are the concrete oil or resin and the volatile oil, Piperin having very 
slight action on the system, except as an antiperiodic and antipyretic, qualities which it 
certainly possesses. 



PIPERAZINUM, Piperazin, CJi 10 N 2 (Unofficial),— is a syntheti- 
cal basic compound which is formed by the action of Ammonia upon Ethy- 
lene Bromide or Chloride ; and occurs as a white, crystalline powder, 
readily soluble in water, and liquefying when exposed to the air, from 
which it greedily absorbs water and carbon dioxide. Dose of the base 
or its hydrochloride, gr. v-x. It may be injected hypodermically in 3 to 
5 per cent, solution. 

Piperazin possesses the valuable property of forming with uric acid a 
very soluble compound, the piperazin urate formed being seven times 
more soluble in water than is lithium urate, the former requiring but 50 
parts and the latter 368 parts of water for solution. It is non-toxic, and 



piscidia. 337 

devoid of powerful physiological effects, being well borne without ill 
results, even when administered for prolonged periods. It is non-irritant 
to mucous membranes, is readily absorbed from the stomach, and circu- 
lates in the blood unchanged, reaching the parts affected by gouty deposits 
in a condition in which it readily neutralizes and dissolves the latter, thus 
facilitating their removal from the body. 

The administration of Piperazin in gout promptly reduces the redness 
and swelling of the affected joints, and is frequently followed by a dis- 
charge of gravel. The minimum daily dosage for this purpose is about 
15 grains, which should be dissolved in half a pint of water, and the 
solution should be added to a pint or more of any convenient carbonated 
water, and be taken in divided doses through the day. When there is 
much pain and fever present, an equal quantity of Phenocoll Hydro- 
chloride may be added, — but in preparing them, each agent should be 
dissolved separately and then mixed together, otherwise a precipitate will 
form in the solution. It gives marked relief in the pruritus of the uric 
acid diathesis due to the irritation of imperfect nitrogenous elimination. 
In solution it may be introduced into the bladder in order to dissolve 
vesical calculi of the uric character, and in gout it may be locally em- 
ployed by hypodermic injection. A one per cent, solution, applied locally 
to open gouty sores, relieves the pain and reduces the inflammation. It 
should be tried in rheumatic arthritis of difficult diagnostic differentia- 
tion. 

As a solvent for uric acid and urate concretions Piperazin is far superior 
to all other agents. Its extremely high price prevents its general use, 
though its cost has recently been reduced. 



PISCIDIA, Jamaica Dogwood (Unofficial), — is the bark of the root of Piscidia 
erythrina, a tree of the nat. ord. Leguminosae, growing in the West Indies. It occurs as 
a tough, fibrous bark, externally blackish, internally greenish, of a heavy, narcotic odor, 
and a bitter, acrid and astringent taste, containing a yellowish, resinoid substance named 
Piscidin. Its active principle has not yet been isolated. A fluid extract is on the 
market, of which the dose is ^ss-j, carefully increased. 

Physiological Action and Therapeutics. 

Piscidia has a narcotic effect on many animals, and has been used in Jamaica for many 
years to stupefy fish, that they may be easily taken. It produces muscular relaxation, 
incoordination of movement, lowered sensibility, increased action of the heart and increase 
of the arterial tension by stimulation of the vaso-motor centre. Soon, however, the 
heart is weakened, vascular tension falls, and a tetanoid state results from stimulation of 
the spinal cord, with reduced reflex action. On the brain its effects resemble those of 
Opium, causing deep sleep without any unpleasant after results. It relieves pain in less 
degree, however, than Opium does, but its hypnotic action is greater. It also relieves 
cough and spasm, produces diaphoresis and salivation, and dilates the pupil. From toxic 
doses death occurs by asphyxia in animals. In man its action is probably the same, but 
in decidedly less marked degree. 

Piscidia is used chiefly as a general nervous sedative. Its hypnotic and anodyne 
22 



338 pix. 

powers are somewhat uncertain, but have in many cases been very decided. It is useful 
in whooping-cough and spasm, and has proved almost specific in many cases of neuralgia, 
while in others it has caused great gastric distress without the least anodyne effect. 



PIX, Pitch, — is a resinous exudation from the stem of certain trees 
of the genera Pinus (Pines) and Abies (Firs and Spruces); and may also 
be obtained by the evaporation of wood-tar. [See Pix Liquida below.] 
The first two of the following varieties are official. 

Pix Burgundica, Burgundy Pitch, — the prepared resinous exudation 
of Abies excelsa or Norway Spruce (nat. ord. Coniferae), a native of 
Europe and Northern Asia. Occurs in hard, brittle, opaque or translu- 
cent mass, with a shining, conchoidal fracture, reddish-brown color, taste 
aromatic and somewhat empyreumatic, not bitter ; almost entirely soluble 
in glacial acetic acid. It is very fusible, and at the body-heat it softens 
and becomes adhesive. Used for plasters. 

Pix Liquida, Tar, — is an empyreumatic oleo-resin obtained by the 
destructive distillation of the wood of Pinus palustris and other species 
of Pinus, (nat. order Coniferse). Is thick, viscid, semi-fluid, blackish- 
brown, of acid reaction, terebinthinate odor, and sharp, empyreumatic 
taste, slightly soluble in water, soluble in alcohol, oils, and in solution of 
potassa or of soda. By distillation it yields an acid liquor named Pyro- 
ligneous Acid and an empyreumatic oil called Oil of Tar, (see Ol. Picis 
Liquids, below), the residue being pitch. Its granular appearance is 
due to crystals of Pyrocatechin, C 6 H 4 (OH) 2 , which occur either in the 
Pyroligneous Acid or in the tarry mixture. Dose, gj-ij daily, in ten- 
grain doses. 

Pix Canadensis, Canada or Hemlock Pitch ( Unofficial ), — is the 
prepared resinous exudation of Abies canadensis (nat. ord. Coniferas), 
the Hemlock Spruce of the U. S. and Canada. Its properties are much 
the same as those of Burgundy Pitch. 

Preparations. 

Emplastrum Picis Burgundicae, Burgundy Pilch Plaster, — has of Burgundy Pitch 
80, Olive Oil 5, Yellow Wax 15. 

Emplastrum Picis Cantharidatum, Cantharidal Pitch Plaster, Warming Plaster, 
— has of Cerate of Cantbarides 8, Burgundy Pitch to 100. 

Oleum Picis Liquidae, Oil of Tar, — a volatile oil distilled from Tar. Dark, reddish- 
brown (almost colorless when fresh), of tarry odor and taste, and acid reaction, readily 
soluble in alcohol. Contains a great variety of compounds, including Hydrocarbons, 
Phenols, Paraffin, etc., among the phenols being Creosote and Carbolic Acid. Is used 
locally and as an atomized inhalation. 

Syrupus Picis Liquidae, Syrup of Tar, — has of Tar 7^ per cent. ; and is a sweet- 
ened Tar-water. Dose, gij-^ss. 

Unguentum Picis Liquidae, Tar Ointment, — contains of Tar 50, Yellow Wax 12^, 
Lard 37^. 

Infusum Picis Liquidae, Tar Water (Unofficial), — made by shaking Tar I with 
Water 4 frequently during 24 hours, decanting and filtering. Is stimulant and diuretic. 
Dose, Oj-ij daily. 



I.I 



PIX. 



339 



Vinum Picis Liquidae, Wine of Tar (Unofficial),— Tar 3 xvj, Glycerin, White Wine, 
Honey, aa ^viij, Acetic Acid j| j, Boiling Water Ovj, shaken together and digested in a 
close vessel for two hours at 150 to 160 , then macerated for a few days, frequently 
shaken, strained and filtered. 

Oleum Pini Sylvestris, Oil of Seo/e/i Fir (Unofficial), — a colorless, fragrant oil, dis- 
tilled from the leaves of Pinus Sylvestris, resembling Turpentine in action. Used by 
inhalation (.^ss to Oj of boiling water), or locally. 

Retinol, Resinol (Unofficial), — obtained by the distillation of Burgundy pitch, occurs 
as a yellowish, oily liquid, boiling at temperatures above 536 F. Used as a solvent for a 
number of the newer remedies, as Cocaine, Aristol, Iodol, also Carbolic acid, Creosote, 
Phosphorus and many alkaloids. 

Concentrated Extract of Pinus Canadensis (Unofficial), — is an aqueous, non- 
irritant astringent, prepared from the Abies Canadensis or Hemlock Spruce. It is said to 
have a specific tonic action upon mucous membranes. Two kinds are sold, one being 
called the " White " Extract, — in reality a golden yellow, — and the other the " Dark " 
Extract, — the former intended for use when it is desirable to avoid staining the linen. 
This preparation received the endorsement of Dr. J. Marion Sims, and has been exten- 
sively employed both locally and internally, as a topical application in uterine and vaginal 
catarrhs, and as a systemic remedy in catarrhal inflammation of the gastro- intestinal and 
broncho-pulmonary mucous membranes. 

Physiological Action and Therapeutics. 

Pitch is a gentle rubefacient when applied to the skin, but in some 
constitutions the Burgundy variety causes a vesicular and pustular inflam- 
mation if used extensively. It is generally employed as a basis for 
plasters, and is of benefit in lumbago, rheumatism, chronic pleurisy, pain- 
ful joints, superficial neuralgise, etc., protecting the part from variations 
of temperature, and perhaps by the gentle pressure exercised stimulating 
the lymphatics and promoting absorption. It is supposed to have a 
special influence on the rectum, and in pill with Tar has been employed 
as a remedy for hemorrhoids. In applying adhesive plasters the hair 
should first be shaved off, and when about to be removed the plaster 
should be warmed, and a little Oil of Turpentine inserted between its 
edge and the skin. 

Canada Pitch is too soft for plasters, but is employed for the same 
purposes as the preceding. A volatile oil obtained from the same tree 
(Oil of Spruce, Oil of Hemlock) has been used for abortifacient pur- 
poses, endangering the life of the subject. 

Tar is a complex mixture of resins and hydrocarbons, containing 
Creosote and Carbolic Acid, which give to it irritant qualities. Internally 
it is expectorant, and produces gastro-intestinal irritation, sometimes 
severe headache, giddiness and febrile phenomena. It is eliminated by 
the kidneys chiefly, which it stimulates, and may cause their congestion 
and increased diuresis. Externally it is a decided stimulant to the skin, 
often giving rise to considerable irritation and pain. It is also antiseptic, 
and in most of its effects it resembles the turpentines. 

Tar is used as a local application in chronic scaly skin diseases, 
especially psoriasis and chronic eczema. As an atomized inhalation it is 
of decided benefit in bronchitis, pharyngitis, laryngitis and winter cough. 
Internally it may be employed with advantage in these affections, in 



34-0 PLANTAGO PLUMBUM. 

hemorrhoids, bronchial catarrh, and phthisis. The best preparation for 
internal administration is the syrup, which is a sweetened tar-water, the 
sugar forming with the Tar a soluble compound. 



PLANTAGO, Plantain (Unofficial), — is the leaf of Plan t ago major, and Plantago 
lanceolata (nat. ord. Plantaginaceae), the common " Ribbed Grass." The pounded leaves 
applied as a paste, or the dry leaf powdered, are actively hemostatic, stopping hemor- 
rhages speedily. Among the ancients it had a good reputation as a remedy for toothache 
and earache, which still adheres to it in Switzerland and other parts of Europe. In many 
other painful affections it is extremely efficient, especially in mastitis, rhus-poisoning, 
erysipelas, burns, scalds, wounds and bruises. A poultice of the leaves may be applied 
to the affected part, and an infusion administered internally. A fluid extract is sold in the 
shops, of which the dose is rr^v-xv. 



PLUMBUM, Lead, Pb, — is not official, but several of its salts are, 
namely, — the Acetate, Carbonate, Iodide, Nitrate and Oxide, of which 
the Acetate is the only one administered internally, the solutions of the 
Subacetate are the only liquid preparations, the Oxide (Litharge) is used 
as Emplastrum Plumbi, the Nitrate is used as a local stimulant or escha- 
rotic, the Iodide as an ointment for absorbent purposes, and the Carbonate 
as an astringent locally to inflamed surfaces. The metal occurs in nature 
chiefly as a Sulphide named Galena, also as an Oxide rarely, and in vari- 
ous saline combinations. 

Official Salts of Lead. 

Plumbi Acetas, Lead Acetate {Sugar of Lead), Pb (C 2 H 3 2 ) 2 -f 3H 2 0, — colorless, 
shining, prismatic crystals or scales, efflorescent, of faintly acetous odor and acid reaction, 
and a sweetish, astringent and metallic taste. Soluble in 2.3 of water and in 21 of alcohol 
at 59 F., in 0.5 of boiling water and in 1 of boiling alcohol. Dose, gr. ss-v. 

Plumbi Carbonas, Lead Carbonate {White Lead), (PbC0 3 ) 2 Pb(HO) 2 , — a heavy, 
white, opaque powder, odorless, tasteless and insoluble in water or alcohol, but soluble 
with effervescence in acetic or in diluted nitric acid. Used locally as ointment, powder, 
or white paint. 

Plumbi Iodidum, Lead Lodide, Pbl 2 , — a heavy, bright citron-yellow powder, odor- 
less and tasteless, fusible and volatilizable by heat, soluble in about 2000 of water at 59 
F., and in about 200 of boiling water. Used externally as an ointment. May be given 
internally in doses of gr. i twice daily. 

Plumbi Nitras, Lead Nitrate, Pb(N0 3 ) 2 , — colorless, opaque, octahedral crystals, 
odorless, of sweetish, astringent and metallic taste and acid reaction, soluble in 2 of water 
at 59 F., almost insoluble in alcohol. Used locally as an astringent and deodorizer in 
solutions up to 1 per cent., also as an escharotic and a disinfectant. 

Plumbi Oxidum, Lead Oxide {Litharge), PbO, — a heavy, yellowish, or reddish- 
yellow powder, odorless, tasteless and insoluble in water or alcohol, but almost wholly 
soluble with slight effervescence in dilute nitric acid. When heated in contact with char- 
coal it is reduced to metallic lead. Used as Lead-Plaster and sometimes with oil as an 
external application. 

Preparations. 

Liquor Plumbi Subacetatis, Solution of Lead Subacetate {Goulard's Extract), — 
an aqueous solution containing about 25 per cent, of the salt, prepared from Acetate of 
Lead 170, Oxide of Lead 100, and Distilled water to 1000. It is a clear, colorless liquid, 
of sweetish, astringent taste and alkaline reaction, of sp. gr. 1.195, and when added to a 
solution of acacia it produces a dense, white precipitate. Used locally as an astringent 
and cooling lotion, diluted usually with an equal quantity of water. 



PLUMBUM. 34I 

Liquor Plumbi Subacetatis Dilutus, Diluted Solution of Lead Subacetate {Lead 
Water), — has of the preceding 3, in Distilled Water to 100. Used locally as a mildly 
astringent and cooling lotion. 

Ceratum Plumbi .Subacetatis, Cerate of Lead Subacetate, [Goulard's Cerate), — 
has of the same solution 20 parts with 80 of Camphor Cerate, freshly prepared, as it 
becomes rancid easily. Used as an astringent and protective application. 

Emplastrum Plumbi, Lead Plaster [Diachylon Plaster), — Oxide of Lead 32, Olive 
Oil 60, rubbed together and boiled with 10 parts of water. Is white, pliable and tena- 
cious, free from greasiness or stickiness, and should be entirely soluble in warm Oil of 
Turpentine. A good protective in abrasions and bed-sores, and the basis of many other 
plasters. 

Unguentum Diachylon, Diachylon Ointment, — has of Lead Plaster 50, Olive Oil 49, 
Oil of Lavender Flowers 1. Used locally in eczema and other cutaneous disorders. 

Unguentum Plumbi Carbonatis, Ointment of Lead Carbonate, — has of the Carbon- 
ate in very fine powder 10, Benzoinated Lard 90. Used as a dressing for burns. 

Unguentum Plumbi Iodidi, Ointment of Lead Lodide, — has of the Iodide in very 
fine powder 10, Benzoinated Lard 90. Used locally to promote absorption of glandular 
tumors. 

Oleatum Plumbi, Oleate of Lead (Unofficial), — a 20 per cent, solution of Oxide of 
Lead in Oleic Acid. A soft, yellowish ointment, for local use. 

Physiological Actions. 

Lead-salts are all more or less poisonous, but metallic Lead is inert 
until converted into a soluble salt by the acids of the stomach. The 
Acetate in large doses is emetic, so that acute lead-poisoning is rare. Its 
chief phenomena are intense gastro-intestinal irritation, vomiting, paraly- 
sis, coma and collapse. 

Chronic lead-poisoning (plumbism) has its principal sources in pure 
water conveyed by leaden pipes, the use of hair dyes, handling of print- 
ing-type, working in the smelting of lead ores, etc. It produces loss of 
appetite, emaciation, pallor and constipation, followed by slowing of the 
heart's action, and accompanied by violent colic (enteralgia), muscular 
impairment evinced by paralysis of the extensor muscles of the forearm 
(drop-wrist), impaired sensibility and albuminuria. Occasionally apho- 
nia, vertigo, gastralgia, headache, stupor and convulsions are manifested. 
Rheumatism without fever or tenderness in the joints, which however are 
red and swollen, is a frequent symptom. A blue line (sulphide) is seen 
along the margin of the gums in those who do not clean their teeth. 
Neuralgic troubles may arise, and amaurosis often occurs from impairment 
of the optic nerve. The metal becomes deposited in the affected muscles 
and other tissues, and probably acts by impairing the isolating power of 
the nerve-fibres, thus enfeebling the nerve-currents. It also produces con- 
traction of the smaller vessels, and may affect any muscles of the body, 
also the brain, producing delirium, coma, and convulsions. Abortion is 
a frequent result, either through an influence on the muscular tissue of the 
uterus, or from a toxic action on the foetus. Death may occur from ex- 
tension of the paresis to the muscles of respiration, from gradual impair- 
ment of nutrition, or from convulsions and coma, a form of disease known 
as Lead- encephalopathy. 

Astringency is the chief quality of the lead salts ; they lessen secretion, 



342 PLUMBUM. 

contract muscular tissue and then destroy its contractile power, slow both 
the heart and the respiration, and in time destroy the red blood-corpus- 
cles. Lead enters the blood as an albuminate, in which form also it is 
retained by the tissues. It is slowly excreted by the liver, kidneys, skin 
and mammary glands. That which escapes by the bile is reabsorbed by 
the bowel, and is again excreted by the intestinal glands, escaping with 
the faeces as a sulphide. It lessens the excretion of uric acid. 

Antagonists and Incompatibles. 

In acute poisoning, as by the Acetate, the antidotes are Sodium or Magnesium Sulphate 
and Sodium Phosphate. The stomach should be evacuated, and albuminous drinks and 
Opium given to allay irritation. Chronic poisoning is best treated by Atropine and 
Iodides, the latter to saturation of the system. Sulphurated Potassa Baths ( |jj or more 
in water) are also very useful. Incompatibles are Mineral Acids and their salts, vegetable 
acids, alkalies, vegetable astringents, Potassium Iodide, albuminous solutions, Opium, and 
all natural waters containing Lime, Sulphates, Carbonates, and Carbonic Acid. 

Therapeutics. 

Lead salts are chiefly used as astringents and hemostatics. The solu- 
tion of the Subacetate diluted with 4 parts of glycerin and water is locally 
employed in many skin-diseases, especially in eczema, lichen, impetigo, 
and erythema; also in catarrhal discharges of muco-purulent character 
from the ear, vagina, and urethra, particularly in gonorrhoea and leu- 
corrhcea. Inflammations of external parts are constantly treated by the 
lotion of "Lead water and Laudanum" (Liquor Plumbi Subacetatis Di- 
lutus, 7 parts to 1 of Tinctura Opii). Though the constituents of this 
lotion are chemically incompatible, it is a valuable sedative and astringent. 
The Acetate, in 5 -grain doses every three hours, is an efficient internal 
styptic in various hemorrhages, particularly in hemoptysis, hematemesis, 
and gastric ulcer, lowering the action of the heart and constringing the 
vessels. Its astringent action is well manifested in bronchorrhoea and 
other pulmonary affections with excessive secretion. It is well used in 
diarrhoeas, gr. ij with gr. j of pulverized Opium in choleriac diarrhoea, 
and smaller doses for the summer complaint of children. In caseous 
pneumonia the Acetate is highly recommended as the best remedial agent, 
combined with Opium and Digitalis ; and in cardiac hypertrophy it may 
be often used to lower the action of the heart. It is also serviceable in 
whooping-cough with profuse bronchial secretion, and in humid asthma. 

The Carbonate is only used externally, to protect irritated surfaces, as 
erythema, erysipelas, intertrigo, etc., in which it may be dusted over the 
surface if unbroken. The official ointment, or white paint mixed with 
linseed oil, is an excellent application to burns or scalds, but if applied 
on the broken cuticle it may prove rapidly poisonous. 

The Iodide is employed externally as an ointment to enlarged lym- 
phatic glands and enlarged spleen, also to chronic eczema and psoriasis. 
It has been used internally to reduce a malarial spleen. 



PODOPHYLLUM. 



343 



The Nitrate is an efficient application to fissured nipples, gr. x to gj 
of glycerin. In powder, dusted over unhealthy granulations, and sanious 
ulcers resulting from onychia, it gives prompt relief after a brief period 
of pain. It is said to have cured cases of epithelioma when used in the 
same manner. In solution (gr. x to the 3) it is a most efficient deodor- 
izer against the fetor from gangrenous sores, ozsena and other offen- 
sive discharges. Pharmaceutically it is used in the preparation of the 
Iodide. 

The Oxide is used in the preparation of plasters, and most of the other 
salts of lead. It is not employed internally, but may be used as an exter- 
nal application mixed with sweet oil in superficial burns, but care should 
be taken that it is only applied to the unbroken skin. 



PODOPHYLLUM, May Apple,— is the rhizome and rootlets of 
Podophyllutfi peltatum (Mandrake), an herbaceous perennial of the nat. 
ord. Berberidese, growing in the woodlands of Canada and the U. S., 
having a pale-green stem about a foot high, with a single white flower at 
its summit. The rhizome is horizontal, \ inch thick, consisting of joints 
about 2 inches long, of orange-brown color externally, white and mealy 
internally, inodorous, taste bitter and acrid. Its active principle is a 
Resin which is official, and is a compound of several resins. It probably 
contains the alkaloid Berberine, which is also found in Berberis, Hydras- 
tis and several other plants. Dose, gr. v-xx. 

Preparations. 

Extractum Podophylli, Extract of Podophyllum. — Dose, gr. v-x. 

Extractum Podophylli Fluidum, Fluid Ext. of Podophyllum. — Dose, rry-xxx. 

Resina Podophylli, Resin of Podophyllum^ (Podophyllin), — is precipitated from a 
concentrated tincture by acidulated water. Soluble in alkaline liquids and partly so in 
ether. Contains Podophylloloxin, Picropodophyllin, Podophyllinic and Protocatechuic 
Acids. Dose, gr. y%-), in pill. Is an ingredient of Pil. Cathartica? Vegetabiles. 

Podophyllum is a tonic-astringent and resin-bearing purgative, having 
action similar to that of Jalap but slower, like Calomel taking 6 to io 
hours to produce its cathartic effect. It increases the intestinal secretions 
and the flow of bile, causing copious watery stools, with considerable 
griping pain and some nausea. The powder is irritant to the respiratory 
passages and to the skin. 

The Resin is an excellent purgative in cases of habitual constipation or 
portal congestion, and is a useful cholagogue. Laxative effects are pro- 
duced by small doses (gr. }&-%), but grain-doses are necessary for its 
full action. It should be combined with Hyoscyamus, Belladonna or 
Cannabis Indica, in order to counteract its griping tendency. It is an 
efficient derivative in cases of catarrhal or malarial jaundice, and is 
recommended in very small doses for prolapse of the rectum, remittent 



( 






344 POLYGONUM — PONGAMIA — POTASSIUM. 

fevers of children, dyspepsia, hepatic derangement, bilious vomiting and 
headache, and in the vomiting and diarrhoea of gastro-enteritis. 



POLYGONUM, Smart- Weed, Water-pepper (Unofficial), — is the plant Polygonum 
Hydropiperoides, nat. ord. Polygonaceae, indigenous to the U. S., having narrow, lance- 
olated leaves and slender spikes of whitish flowers. It contains Tannin and an active 
principle, Polygonic Acid, which is green, crystallizable, insoluble in water, but soluble 
in alcohol, ether, and chloroform. 

Extractum Polygonum Fluidum, Fluid Extract of Polygomim (Unofficial). — 
Dose, n\x-3j. 

Extractum Polygoni, Extract of Polygonum (Unofficial). — Dose, gr. j-v. 

Smart-weed has a pungent, acrid taste, producing a sensation of heat in the stomach, 
and a peculiar tingling throughout the system. It stimulates the action of the heart, raises 
the arterial tension, increases the warmth of the surface, promotes the cutaneous, bronchial 
and renal secretions and the menstrual flow. It is an efficient diuretic, emmenagogue and 
aphrodisiac. The juice applied to the skin excites inflammation and vesication. 

Amenorrhcea from functional inactivity of the uterine system is remarkably benefited by 
this remedy in 3 ss doses of the fluid extract four times daily for a week before the ex- 
pected period. It has considerable influence over functional impotence, but produces 
aching pains in the hips and loins, and a sense of weight and fullness within the pelvis. 
It has also been used with benefit in diarrhoea, dysentery and gravel ; and locally in mer- 
curial salivation and the sore mouth of nursing women. 



PONGAMIA, Kurung Oil (Unofficial), — is a yellow oil expressed from the seeds of 
Pongamia glabra, an Indian tree of the nat. ord. Leguminosae. It has been used for many 
years in India for skin affections, and in professional hands has proven an excellent appli- 
cation in pityriasis versicolor, rubbed in twice daily. It promises to be a valuable remedy 
in parasitic diseases of the skin, is not irritating and does not discolor the surface to 
which it is applied. 



POTASSIUM, Kalium, K, — is represented by a number of official 
salts, which are colorless or white, sometimes anhydrous, and generally 
soluble readily in water. The metal itself is not official. The chief 
source of its salts is the ash remaining after the combustion of plants or 
trees, which contains the Carbonate, from which most of the other salts 
are prepared. There are also two subsidiary sources, viz. — the Nitrate, 
which is found native ; and the Bitartrate, which, under the name of 
Crude Tartar or Argol, is deposited during the fermentation of wine. It 
is distinguished from all other bases (except Magnesium, Sodium and 
Ammonium) by not being precipitated by Ammonium Sulphide or Am- 
monium Carbonate. It is positively known by the violet color it imparts 
to flame, by its very sparing solubility when converted into the Bitartrate, 
and by its precipitation by Platinum Perchloride. 

Potassium Salts and their Preparations. 

Potassa, Potassium Hydrate, Caustic Potash, KOH, — a very deliquescent, white, 
hard and dry solid, of very acrid and caustic taste and strongly alkaline reaction, soluble 
in 0.5 of water and in 2 of alcohol. It is a powerful and deeply-acting escharotic, and 
should be kept in well-stoppered bottles made of hard glass. 



POTASSIUM. 



345 



Potassa cum Calce, Potassa with Lime {Vienna Paste), — a grayish-white, deliques- 
cent powder, consisting of equal parts of Potassa and Lime rubbed together. A milder 
and more manageable caustic than the preceding. 

Liquor Potassae, Solution of Potassa, — contains about 5 per cent, of Potassium Hy- 
drate, and is prepared by dissolving Potassium Bicarbonate 85, in 400 of Distilled Water, 
40 of Lime in the same quantity of Distilled Water, boiling, mixing the solutions gradu- 
ally, again boiling, and when cold adding Water up to 1000 parts, straining, settling, and 
decanting the clear solution. Or, by dissolving 56 of Potassa in 944 of Distilled Water. 
Is a clear, colorless, odorless liquid, of acrid and caustic taste, and strongly alkaline 
reaction. Dose, TT^v-gss, well diluted with water. 

Potassii Acetas, Potassium Acetate, KC 2 H 3 2 , — a white, satiny, crystalline mass, 
or a granular powder, very deliquescent, odorless, of pungent, saline taste, and a neutral 
or faintly alkaline reaction, soluble in 0.4 of water and in 1.9 of alcohol at 59 F. Dose, 

g r - v-3J- 

Potassii Carbonas, Potassium Carbonate, K 2 C0 3 , — a white, crystalline or granular 
powder, very deliquescent, odorless, of alkaline taste and reaction, soluble in 1.1 of water 
at 59 F., insoluble in alcohol. Dose, gr. ij-xx. 

Potassii Bicarbonas, Potassium Bicarbonate, KHC0 3 , — colorless prisms of saline 
and alkaline taste and alkaline reaction, soluble in 3.2 of water at 59 F., decomposed by 
boiling water, almost insoluble in alcohol. Dose, gr. v-xxx. 

Potassii Chloras, Potassium Chlorate, KC10 3 , — colorless prisms or plates, of pearly 
lustre, of cooling, saline taste and neutral reaction, soluble in 16.7 of water at 59 F. and 
in 1.7 of boiling water; slightly soluble in mixtures of alcohol and water, insoluble in 
absolute alcohol. Dose, gr. v-xx. 

Potassium Chlorate should be kept in glass-stoppered bottles, and great caution should 
be observed in handling the salt, as dangerous explosions are liable to occur when it is 
mixed with organic matters (cork, tannic acid, sugar, etc.), or with sulphur, antimony 
sulphide, phosphorus, or other easily oxidizable substances, and either heated directly or 
subjected to trituration or concussion. It should not be mixed with glycerin in the 
presence of a free acid. 

Trochisci Potassii Chloratis, Troches of Potassium Chlorate, — each troche contains 
about 4^ grains of the salt, with sugar, tragacanth, and spirit of lemon. Dose, j-iij, 
slowly dissolved in the mouth. 

Potassii Citras, Potassium Citrate, K 3 C 6 H 5 7 -(- H 2 0, — a white granular powder, or 
transparent, prismatic crystals, odorless, of cooling, saline taste, and neutral reaction, 
soluble in 0.6 of water, very soluble in boiling water, sparingly soluble in alcohol. Dose, 
gr. x-xxx. 

Potassii Citras Effervescens, Effervescent Potassium Citrate, — consists of Pot. 
Bicarb. 90, Citric Acid 63, Sugar 47, powdered, mixed to a paste, dried and again 
powdered. Dose, gj-ij, in a glass of water, as an effervescent drink. 

Liquor Potassii Citratis, Solution of Potassium Citrate (Mistura Potassii Citratis), 
— contains about 9 per cent, of the anhydrous salt, together with small amounts of citric 
and carbonic acids. Prepared by dissolving Citric Acid 6, and Pot. Bicarb. 8, each in 
water 40, filtering the solutions separately, and adding in each case enough water to bring 
to 50 parts, then mixing the two together. Dose, J;ss-^j or more. 

Potassii Nitras, Potassium Nitrate {Saltpetre, Nitre), KN0 3 , — colorless, transparent 
prisms of a crystalline powder, of pungent, cooling and saline taste and neutral reaction; 
soluble in 4 of water at 59 F. and in 0.4 of boiling water ; almost insoluble in alcohol. 
Is a constituent of Argenti Nitras Dilutus. Dose, gr. v-xx, well diluted. 

Charta Potassii Nitratis, Potassium Nitrate Paper, — is unsized paper immersed in 
a solution of 20 parts of the salt in 80 of distilled water, and dried. Used for inhalation, 
the fumes from the burning paper being inhaled in asthma. 

Potassii Sulphas, Potassium Sulphate, K 2 S0 4 , — colorless, hard, rhombic prisms, of 
sharp, saline and bitter taste and neutral reaction, soluble in about 9.5 of water at 59 
F., and in 4 of boiling water, insoluble in alcohol. Dose, gr. xx-^ss, well diluted. 

Potassii Bitartras, Potassium Bilartrate, Acid Tartrate of Potash {Cream of 
Tartar), KHC 4 H 4 6 , — colorless rhombic crystals, or a white, gritty powder, of acidulous 
taste and acid reaction ; soluble in about 201 of water at 59 F., and in about 16.7 of 
boiling water, very slightly soluble in alcohol. Is a constituent of Pulvis Jalapae Com- 
positus. Dose, gr. xx-^ss. 

Potassii et Sodii Tartras, Potassium and Sodium Tartrate {Rochelle Salt), 
KNaC 4 H 4 6 -f- 4H 2 0, — colorless, rhombic crystals, or a white powder, of cooling and 
slightly saline and bitter taste, and neutral reaction; soluble in 1. 4 of water at 59 F., very 






346 POTASSIUM. 

soluble in boiling water, almost insoluble in alcohol. Is a constituent of the following 
preparation. Dose, ^ss-j. 

Pulvis Effervescens Compositus, Compound Effervescing Potvder {Seidlitz Pow- 
der), — each powder has of the preceding salt 120 grains, of Sodium Bicarbonate 40 grains, 
mixed in one paper; and of Tartaric Acid 35 grains in another paper. Dose, I or 2 pair, 
dissolved separately in water and the solutions poured together. 

Potassii Silicas, Potassium Silicate, Soluble Glass, K 2 Si0 3 (Unofficial), — is used in 
solution of a syrupy consistence for the preparation of immovable dressings for fractured 
limbs, etc. (See under Silicates.) 

The Arsenite is described under Arsenic, — the Bromide under Bromum, — the 
Bichromate under Acidum Chromicum, — the Iodide under Iodum, — the Cyanide 
and Ferrocyanide under Acidum Hydrocyanicum, — the Hypophosphite under 
Phosphorus, — the Permanganate under Manganum, — the Nitrite under Amyl 
Nitris, — and Sulphurated Potassa under Sulphur. 

Physiological Action. 

Caustic Potash, like other caustic alkalies, destroys the tissues by 
combining with their water, dissolving the albumen and saponifying the 
fats, converting the tissue to which it is applied into a moist,, gray slough, 
with considerable surrounding inflammation. Internally it acts as a 
powerful corrosive poison, destroying the mucous membrane of the parts 
with which it comes in contact, and giving rise to intense pain, diarrhoea, 
convulsions and delirium. Unless speedily rejected or neutralized it 
causes death from inflammation of the larynx, from the gastro -intestinal 
lesions, or after some time from stricture of the oesophagus. Liquor 
Potass^e, containing over 5 per cent, of the pure Potash, possesses in a 
degree the same caustic properties, and should never be administered 
undiluted. It neutralizes the acids in the stomach, and in the blood 
exists chiefly as the Carbonate, being eliminated with the urine, which it 
renders alkaline. If its use be continued too long it impairs the blood, 
and renders the subject anaemic. 

Potassium Salts in large doses are cardiac poisons, muscular para- 
lyzers, poisonous to protoplasm, especially nerve tissue, and destructive to 
the ozonizing functions of the blood. They increase the saliva, promote 
oxidation and stimulate retrograde metamorphosis ; and are therefore 
waste-producers. In small doses on an empty stomach they promote the 
formation of acid gastric juice by favoring the outward osmosis of its con- 
stituents from the blood ; in larger doses they act chemically on the 
stomach contents, neutralizing its free acids, and disordering digestion. 
The Bicarbonate, given on an empty stomach, enters the blood un- 
changed, meets the neutral phosphate of sodium and is decomposed, acid 
phosphate of sodium being formed, which renders the urine more acid. 
On a full stomach it is decomposed by the acids of the gastric juice, in- 
creases the alkalinity of the blood and makes the urine less acid. The 
Salts of Potassium with Vegetable Acids (Acetate, Citrate, Tartrate, etc.) 
enter the blood in their own form, are there decomposed, forming free 
C0 2 , and are converted into alkaline carbonates, in which form they are 
eliminated, alkalinizing the blood and the urine. They are diuretics also, 



POTASSIUM. 347 

increasing the urinary water and solids, but decreasing the uric acid by 
causing increased oxidation. The Mineral Salts (Nitrate, Chlorate, etc.) 
are not decomposed in the blood, but are eliminated in their own form, 
the Nitrate being a most active diuretic, the Chlorate irritating the kid- 
neys, depressing the heart, causing albuminuria, and impairing the ozon- 
izing function of the blood. In large doses these salts decompose the 
red blood-corpuscles and paralyze the motor ganglia of the heart. The 
Chlorate does not part with its oxygen in the system, as generally be- 
lieved. The Sulphate is chiefly purgative in its action, but acts harshly, 
and in overdoses has caused death. 

The action of the remaining Potassium salts is described under the 
titles of their acid and other constituents, to which their effects are chiefly 

referable. 

Antagonists and Incompatibles. 
Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as vinegar, cider, 
lemon-juice; — then demulcent drinks and oils to protect the mucous membrane, and 
the usual measures to support vitality. The Alkalies and their Carbonates are incompati- 
ble with the acids and also with metallic salts, and the Caustic Alkalies decompose most 
of the alkaloids. 

Therapeutics. 

Caustic Potash is used locally to destroy morbid or cicatricial tissue, 
to cauterize the wounds resulting from bites of animals or stings of insects, 
to form issues or to open deep-seated abscesses, and to destroy chancres, 
malignant pustules, nsevi, warts, etc. Its action is deep and severe, and 
it is best employed in the form of Potassa cum Calce, which is far more 
manageable. 

Liquor Potass^e is used internally as a free alkali to neutralize excess 
of acid in the stomach, blood and secretions, as an antilithic in the uric 
acid diathesis, also for acne, boils, and obesity. Locally it is employed 
to soften the nail in in-growing toe-nail, and diluted to relieve pruritus 
and remove scales in various skin -diseases. In small doses with a vegetable 
bitter tonic before meals it acts well in atonic dyspepsia, increasing the 
flow of the gastric juice by direct stimulation of the gastric mucous mem- 
brane. If given after meals in acid dyspepsia large doses are necessary 
for temporary alleviation by neutralizing the food acids. These remarks 
concerning acidity and dyspepsia apply equally well to the Bicarbonate, 
which is used for the same purpose, and while possessing all the virtues of 
the potassium salts, is without any corrosive or irritant action. It is also 
useful in simple gastralgia or cardialgia; and in cystitis, gonorrhoea, etc., 
where there is acid urine, it renders the urine less irritating and soothes 
the inflamed surfaces. Acute and chronic rheumatism and rheumatoid 
arthritis are much benefited by an alkaline treatment in patients of suffi- 
cient bodily vigor to stand its lowering effects. The Bicarbonate is also 
used to alkalinize the blood and secretions in lithsemia, jaundice, many 
cutaneous eruptions, and in diabetes ; also locally as a lotion for fetid 



348 POTASSIUM. 

perspiration of the feet and axillae, acne and acute eczema. The Car- 
bonate is diuretic, antacid and antilithic, but is seldom used internally, 
being too irritant, and the Bicarbonate having all its virtues without its 
objectionable qualities. Locally a solution (3J to the §) is said to be 
effectual as a remedy for pruritus vulvas, and one of half the above strength 
is used in freckles, sunburn and tan of the epidermis, in moist eczema 
and the itching of urticaria. 

The Acetate, Citrate and Tartrate are good purgatives in doses of 
3ij to ^iv, and in smaller doses are much employed as alkalinizers of the 
blood and urine, diuretics, etc. Of these vegetable potassium salts the 
Acetate is the most certain diuretic, the Bitartrate is the most active ca- 
thartic, while the Citrate is the most reliable diaphoretic and the best 
agent to use to alkalinize the urine for any length of time, it having the 
least injurious effect on the blood or on the digestion. In lithaemia these 
salts are given to promote oxidation, and by keeping the urine alkaline 
they may reduce small calculi of the uric acid variety. In acute rheuma- 
tism and fevers they act as antacids in the blood, as febrifuges by promot- 
ing diaphoresis, and as sedatives to the general nervous system. As an 
agreeable laxative no preparation surpasses the Bitartrate in 2 to 4 drachm 
doses made into a paste with orange marmalade or any other conserve. 
It is also used in Infusion of Juniper as a diuretic in general cardiac dropsy, 
and without the Juniper in acute desquamative nephritis. In cases of 
acute dysentery with scorbutic symptoms, as seen among miners, sailors, 
etc. , a full purgative dose of this salt (^ss or more), has acted most bene- 
ficially as a preliminary to other treatment ; and in many cases has proven 
to be the only remedy required. 

Potassium Chlorate is much employed locally in solution (^ss to the 
3) as a deodorizer and detergent wash in inflamed, ulcerated and aphthous 
conditions of the mouth. On unhealthy mucous membranes generally it 
exercises an alterative action for the better, but if too long used it will 
keep up a state of chronic irritation. In mercurial salivation it is of great 
benefit, and in dilute solution (gr. x to the ^) it is an efficient application 
to unhealthy sores and ulcers, as a wash for foul sinuses or cavities, and as 
an injection in chronic affections of the bladder. The powdered salt may 
be applied to aphthae, and dusted over epithelioma will alter the action, 
diminish the pain, check the growth and promote cicatrization. Inter- 
nally this salt has been administered in the mistaken idea that it parts 
with its oxygen in the system, but it is now shown that it is excreted un- 
changed. Setting up congestion and irritation of the kidneys it is highly 
dangerous in large doses or if used for any length of time, but is constantly 
administered in diphtheria, chronic bronchitis, purpura, hematuria, ova- 
rian tumor, pseudo-membranous laryngitis, scarlatina, typhoid fever, 
chronic cystitis, etc. When used internally it should be given in small 



PRINOS PRUNUM. 



349 



doses (gr. xx in 24 hours for an infant, gr. xxx in 24 hours for a child of 
2 to 4 years, and giss for an adult in the same time), and the action of 
the heart and the kidneys should be carefully watched. It should never 
be prescribed with Potassium Iodide lest the poisonous Iodate be formed, 
nor with the Syrup of the Iodide of Iron, lest it liberate the Iodine, 
and cause severe gastritis. Strong acids and acid sulphates decompose 
it, and it forms explosive compounds with easily oxidizable substances, as 
Sugar, Sulphur, Tannin, Sodium or Potassium Hypophosphites, Catechu, 
Glycerin, etc. 

For the combination of Potassium Chlorate with the Tincture of the 
Chloride of Iron, as a gargle, see under Chlorum. 

The Nitrate has been much employed as a refrigerant diaphoretic and 
diuretic in febrile and inflammatory affections, especially in inflammation 
of the trachea and bronchi, pneumonia and rheumatism, but its action is 
uncertain and it is now giving place in these disorders to more efficient 
agents. The fumes of burning nitre paper (Charta Potassii Nitratis) are 
a useful inhalation in some forms of spasmodic asthma. 

The Sulphate is used in teaspoonful doses in water as an hepatic 
stimulant and a mild cathartic, increasing the secretions of the intestinal 
glandular apparatus. Its action is sometimes harsh, and death has resulted 
from overdoses. 

Potassium and Sodium Tartrate, or Rochelle Salt, is the chief 
aperient agent in Seidlitz Powders. In doses of gss-j it is a gentle and 
cooling laxative, and in drachm doses frequently repeated it is used to 
render the urine alkaline, and as an antilithic. 

The therapeutics of the other Potassium Salts are described as noted on 
page 346. 



PRINOS, Black Alder (Unofficial), — is the bark of Prinos verticillatus, or Winter- 
berry, a shrub of the nat. ord. Aquifoliaceae, indigenous in Canada and the U. S., having 
small, white flowers, and a globose, six-seeded, bright-red berry, which grows in clusters 
and is persistent all winter. The bark occurs in thin, slender fragments, of a brownish- 
ash color externally, and a pale-green or yellow internally; taste bitter and slightly 
astringent. It contains an amorphous, yellow and bitter principle, also tannin, sugar, 
starch, wax, resin, etc. The bark may be given in substance in doses of gss, or a decoc- 
tion ( sjij in Oiij boiled to a quart) in doses of ^j-ij. 

Black Alder is astringent and tonic, and has been used in intermittent fever, diarrhoea, 
and chronic cutaneous diseases. In the latter class of disorders it may be applied locally. 



PRUNUM, Prune, — is the fruit of Primus domestica, the Plum tree (nat. ord. 
Rosacese), indigenous to Western Asia, but cultivated in most countries of temperate 
climate. The dried fruit (Prune) is oblong, shrivelled, of blackish-blue color, having an 
almond-shaped seed. Prunes contain sugar, pectin, albumen, malic acid and salts. They 
are a constituent of Confectio Sennas. 

Prunes are laxative and nutritious, and are freely used as a food and sweetmeat, but in 
excess may give rise to flatulent colic from the indigestibility of their skins. Stewed 
prunes is an excellent dish for constipation in children, and may be made more effective 
by the addition of a little Senna. 



350 PRUNUS VIRGINIANA PULSATILLA. 

PRUNUS VIRGINIANA, Wild Cherry, — is the bark of 
Prunus serotina, or Wild Cherry, a large forest tree of the nat. ord. 
Rosacese, growing in Canada and the U. S. The bark should be col- 
lected in autumn from the large branches only, and comes in curved 
pieces y 1 ^ inch or more thick, of greenish or, yellowish-brown color exter- 
nally, and astringent, aromatic and bitter taste. On maceration in water 
it develops a distinct odor of bitter almonds. It contains tannin, gallic 
acid, resin, starch, etc., also Amygdalin and \Emulsin, which by their 
mutual reaction in the presence of water, produce Hydrocyanic Acid and 
a Volatile Oil resembling that of Bitter Almond. [See ante, under 
Amygdala and Acidum Hydrocyanicum.] Dose of the powdered bark, 

gss-j. 

Preparations. 

Extractum Pruni Virginianae Fluidum, Fluid Extract of Wild Cherry. — Dose, 

3 S H- 

Infusum Pruni Virginianae, Infusion of Wild Cherry, — 4 per- cent. Dose, ^ss-ij. 
Should be made with cold water. 

Syrupus Pruni Virginianae, Syrup of Wild Cherry, — 15 per cent. Dose, ^j-iv. 

Physiological Action and Therapeutics. 

Wild Cherry is an aromatic bitter tonic, increasing appetite, aiding 
digestion, and thus promoting the constructive metamorphosis. The 
presence of a volatile oil gives it a local stimulating action on the 
alimentary canal in common with Serpentaria, Cascarilla and other mem- 
bers of the same class. Hydrocyanic Acid being yielded by it in the 
presence of cold water, results in imparting a sedative action to its prepa- 
rations, calming irritation and diminishing nervous excitability. Very 
large doses reduce the action of the heart. 

The preparations of Wild Cherry are used in catarrhal conditions of 
the bronchial mucous membrane, in the hectic of phthisis and scrofula, 
with palpitation of the heart, and a debilitated stomach ; a collection of 
symptoms often observed in consumptive subjects, to whom it is a very 
useful palliative. Cough is supposed to be especially amenable to its in- 
fluence, and hence it has become a matter of daily routine to prescribe 
the syrup as an ingredient of cough-mixtures. The infusion is an excel- 
lent stomachic tonic, and may be administered with great benefit in 
dyspepsia and in convalescence from acute disease. 



PULSATILLA, Pasque-flower (Meadow Anemone), — is the herb, 
collected soon after flowering, of Anemone Pulsatilla and Ane7none 
pratensis (Pulsatilla nigricans), small herbal plants of the same natural 
order (Ranunculacese) to which Aconite belongs. They inhabit Europe 
and Siberia, have large, purple flowers and are inodorous and very acrid. 
Pulsatilla contains a very acrid yellow oil, which in the presence of water 



PULSATILLA. 35 I 

is gradually changed to Anemonin, C 15 H 12 6 , a volatile, crystallizable, 
camphoraceous principle, soluble in chloroform, nearly insoluble in ether 
or water ; and Anemonic Acid, C 15 H u 7 , a white, crystalline, tasteless 
powder, which may be formed also by the action of alkalies on Anemonin. 

Anemone patens (Pulsatilla Nuttaliana), an inhabitant of the United States, which some- 
times has whitish-colored flowers, was an official Pulsatilla in the U. S. P. 1880. 

There are no official preparations, but a tincture may be made according to the phar- 
macopceial directions for Tincturse Herbarum Recentium (1 in 2), of which the dose is 
Tr^-L-tTLx. The imported homoeopathic tincture has equal parts of the expressed juice 
and alcohol, and is generally a very good preparation. 

Anemoninum, Anemonin (Unofficial), — the active principle. Dose, gr. j^-ij in pill. 

Physiological Action. 
Pulsatilla is a local irritant, the fresh juice producing numbness and 
tingling in the part to which it is applied, and may excite violent inflam- 
mation of the skin with vesicular or pustular eruption, and if swallowed 
severe irritation of the gastro-intestinal mucous membrane. On the 
tongue it produces symptoms like those from Aconite, viz. — tingling and 
burning, followed by numbness. Internally it lowers the heart and 
arterial tension, reduces respiration and temperature, dilates the pupils, 
produces nausea and vomiting, diaphoresis and diuresis, and paralyzes the 
motion and sensibility. Stupor, coma and convulsions may be caused by 
a toxic dose. Most of these effects have been observed on rabbits. The 
active principle (Anemonin) is volatile, hence the herb must be fresh to 
be suitable for medicinal use. 

Antagonists and Incompatibles. 

Alcohol, Opium and Digitalis are the physiological antagonists. Incompatibles are 
the caustic alkalies, Tannic Acid and the metallic salts. 

Therapeutics. 
Pulsatilla is a very efficient remedy if a fresh preparation be employed. 
It was highly praised by Storck for amenorrhcea, corneal opacities, cata- 
ract, paralyses, rheumatism, old ulcers, constitutional syphilis and scaly 
skin diseases. On the generative organs it seems to have a specific action, 
and is an excellent remedy in functional amenorrhcea, dysmenorrhcea, 
menstrual suppression from fright or chill, and leucorrhceal discharges 
with back-pains and nervous depression. Epididymitis and orchitis are 
often controlled and even dissipated by very small doses (wixV - /^) everv 
2 hours. It quickly relieves dyspepsia or subacute gastritis, with white- 
coated tongue, no taste or a greasy sensation in the palate, nausea, flatu- 
lence, heartburn, etc. Many acute inflammations of mucous surfaces 
with mucous or muco-purulent discharges, as coryza, otitis (externa and 
interna), rhinitis, bronchitis, conjunctivitis, etc., are greatly benefited by 
5 to 10-drop doses every 4 hours and locally gj-ij of tincture to §iv of 
water as a lotion. A similar use of this remedy has proven of great bene- 



352 PYRETHRUM — QUASSIA. 

fit in many cutaneous affections, especially eczematous eruptions, syphil- 
ides, and ulcers of indolent character. It is also said to be efficiently 
employed in acute cerebral and spinal meningitis, subacute rheumatism 
of the small joints, rheumatic gout, chronic vesical and nasal catarrhs, 
the gastro-enteric symptoms of remittent fever and measles, ophthalmia 
neonatorum, strumous ophthalmia with profuse but bland discharge, 
acute and subacute inflammations of the middle ear, and in left-sided 
clavus, hemicrania and infra-mammary pain. An extract of the root 
has proved efficient against tapeworm. 

Coughs which are loose by day but dry and tickling on lying down at 
night are greatly benefited by Pulsatilla. Anemonin in doses of gr. *^-j 
has been found extremely useful in whooping-cough and other coughs of 
irritative character. 



PYRETHRUM, Pellitory, — is the root of Anacyclus Pyrethrum, a plant of the 
nat. ord. Compositae, native of Northern Africa, but cultivated in Europe. The root is 
2 to 4 inches long, ]/ z inch thick, annulate above, wrinkled below, externally a dark 
grayish-brown, internally brownish-white; the bark thick, containing two circles of resin- 
cells surrounding slender wood bundles and medullary rays; inodorous, pungent and 
acrid. It contains an alkaloid, Pyrethrine, also inulin, tannin, mucilage, etc., with a 
brown Resin and two fixed oils. Dose, as a masticatory, gss-j. 

Pyrethrum Roseum, Persian Pellitory (Unofficial), — is indigenous to Western Asia, 
and resembles Chamomile in appearance. The flower-heads are used in powder to kill 
insects, 4 grains killing a fly in a vial in 2 or 3 minutes. 

Tinctura Pyrethri, Tincture of Pyrethrum, — 20 per cent. Not used internally. 

Physiological Action and Therapeutics. 

Pellitory is an irritant sialogogue. When chewed it causes a pricking sensation in the 
tongue and fauces, with heat, acridity, pungency and a copious flow of saliva and buccal 
mucus. Large doses may cause bloody diarrhoea, tetanoid spasms, accelerated pulse, and 
profound stupor. Applied to the skin it acts as a rubefacient, the powder inhaled as a 
sternutatory. It stimulates the local nerves and vessels of the mouth and salivary glands 
by direct irritant action, but soon depresses the nerves and blunts their sensibility. 

Pellitory is chewed as a masticatory and sialogogue in paralysis of the tongue, rheu- 
matic and neuralgic affections of the head and face, and pain from carious teeth. Its 
powder has been recommended as a sternutatory in chronic catarrh of the frontal sinuses. 
As a gargle or lotion ( % iij to Oj) it is very useful for relaxed uvula and as a mouth-wash. 
When used for toothache a few drops of the tincture should be inserted into the cavity on 
cotton or wool. Used as a sialogogue it is an efficient agent to secure the rapid elimina- 
tion of Iodine from the system in chronic poisoning thereby. 



QUASSIA, — is the wood of Picrcena excelsa, a large tree of the nat. 
ord. Simarubese, indigenous to Jamaica and other West Indian islands. 
Surinam Quassia, used in Europe, is the wood of Quassia amara. Both 
varieties, as met with in the shops, are in the form of chips or raspings, 
of a yellowish-white color, inodorous but of intensely bitter taste. The 
wood is also turned into cups, which are sold under the name of quassia- 



QUERCUS ALBA. 353 

or bitter-cups. It contains a bitter principle, Quassin, C 31 H 42 9 , which is 
crystalline, soluble in hot alcohol and in chloroform, slowly in cold water, 
faster in alkaline or acidulated water. Dose of the powdered wood, gr. 

xx-xxx. 

Preparations. 

Extractum Quassise, Extract of Quassia, — aqueous. Dose, gr. j-iij. 

Extractum Quassias Fluidum, Fluid Extract of Quassia. — Dose, 3 ss— j . 

Tinctura Quassiae, Tincture of Quassia, — strength 10 per cent. Dose, X\ v-3 j. 

Infusum Quassia;, Infusion of Quassia (Unofficial), — made with cold water £ x, 
Quassia chips %], macerated for y 2 hour and strained. Or water poured into a quassia- 
cup and left standing will give a good infusion. Dose, 3 j-iij. 

Physiological Action and Therapeutics. 

Quassia is a simple bitter, having no flavor, but is intensely bitter and 
less agreeable than either Gentian or Chiretta. It is fatal to flies and fish, 
and makes an excellent anthelmintic enema against the thread-worm. A 
concentrated preparation is poisonous to rabbits and dogs, and has pro- 
duced very alarming narcotic symptoms in a four-year old child. As usually 
administered its action is that of a bitter stomachic tonic, as described 
under Calumba. 

The preparations of Quassia contain no tannin and hence may be pre- 
scribed with salts of Iron. It is chiefly employed in atonic dyspepsia with 
pain after eating, and vomiting or regurgitation of food, also in atonic 
diarrhoea depending on indigestion or an irritable condition of the intesti- 
nal mucous membrane. It is useful in convalescence to promote the 
appetite and digestion, and with Sodium Bicarbonate in gastric vertigo. 
As an enema the strong infusion is an effective remedy for ascarides of the 
rectum. It has been used as a feeble antiperiodic, and in hysteria its 
repulsiveness is an aid to its medicinal action. 



QUERCUS ALBA, White Oak,— is the bark of Quercus alba, 
the White-oak tree (nat. ord. Cupuliferse), and occurs in nearly flat pieces 
deprived of the corky layer, of pale-brown color, tan-like odor, and 
strongly astringent taste; or as a coarse, fibrous powder, which does not 
tinge the saliva yellow. It contains a variety of Tannin named Querci- 
tannic Acid, C 28 H 24 12 , also Pectin and a bitter principle named Quercin 
but no Gallic Acid. There are no official preparations but a decoction 
(^j ad Oj) may be used in doses of gss— j. 

Quercus Tinctoria, Black Oak Bark, — was formerly official. It contains a coloring 
principle Quercitrin, which stains the saliva yellow when the bark is chewed, also Quer- 
citannic Acid, etc. 

Quercus Lusitanica is the source of Galls (see under Galla). 

Physiological Action and Therapeutics. 
Oak-bark is astringent and tonic, but is seldom used internally. Its 
action and uses are those of Tannic Acid. The decoction is much used 
23 



354 QUILLAJA RESINA. 

in country practice as a cheap astringent application for injection, in 
leucorrhcea, prolapsus ani, hemorrhoids, etc., and as a gargle in faucial 
inflammation and prolapsed uvula. It has also been used as an injection 
into dropsical cysts, and as a lotion for flabby ulcers and suppurating 
wounds. The powdered bark as a poultice has proved an excellent appli- 
cation in gangrene, and in finely pulverized state it is a useful ingredient 
of tooth-powders. A concentrated fluid extract is used in the Heaton- 
Warren operation for the radical cure of hernia, by injection into the 
tissues around the margin of the ring, with the object of exciting inflam- 
mation and occlusion of the opening. 



QUILLAJA, Soap Bark, — is the inner bark of Quillaja Saponaria, a tree of the 
nat. ord. Rosacese, indigenous to Peru and Chili. It occurs in large, flat pieces, about \ 
inch thick, of a brownish- white color externally, very acrid and sternutatory, but inodor- 
ous. It contains Calcium Sulphate crystals, starch, and the glucoside, Saponin, C 32 H 54 18 , 
a white, amorphous, sternutatory powder, soluble in water and in dilute alcohol. The 
Infusion of Quillaja foams like soap-water. The only official preparation is the tincture. 

Tinctura Quillaja, Tincture of Quillaja, — 20 per cent. Dose, X\ v-xxx. 

Quillaja in powder is sternutatory and causes the water in which it is macerated to 
froth, making emulsions of oils, and being used instead of soap for washing purposes in 
various affections of the skin, and to stimulate the growth of the hair in alopecia. Its 
properties are due to the glucoside Saponin, which is found also in Senega and in a 
number of other plants, and is a violent irritant of the respiratory passages, a local anaes- 
thetic, an antipyretic, a powerful paralyzant of the heart and respiration, and a poison to 
the voluntary muscles. It has not been made use of in practical medicine. 

A decoction of the bark (5 to 200) has been employed in doses of ^j-ij according to 
age, as a substitute for Senega in the treatment of diseases of the respiratory organs 
where a pleasant expectorant is indicated. Its expectorant properties are well established, 
and children take it readily. It does not provoke diarrhoea or vomiting, and has a sweet- 
ish, agreeable taste. 



RESINA, Resin, {Colophony), C 44 H 62 4 ,— is the residue left after 
distilling off the volatile oil from Turpentine. It is a transparent, amber- 
colored substance, of sp. gr. 1.070 to 1.080, hard and brittle, with a 
glossy and shallow conchoidal fracture, and a faintly terebinthinate odor 
and taste, soluble in alcohol, ether, fixed or volatile oils, and in its own 
weight of oil of turpentine. Chemically it is considered as the Anhydride 
of Abietic Acid, C 44 H 64 5 , into which acid it is converted by agitation with 
warm diluted alcohol. Silvic, Pinic, and Palmaric Acids are decomposi- 
tion products, not constituents of the resin as formerly taught. Other 
official resins are Resina Copaib^e, Resina Jalap^e, Resina Podophylli 
and Resina Scammonii, which are severally described under the titles of 
the plants forming their respective sources. 

Preparations. 

Ceratum Resinse, Resin Cerate {Basilicon Ointment), — consists of Resin 35, Yel- 
low Wax 15, and Lard 50 parts. It forms 65 per cent, of Turpentine Liniment. 

Emplastrum Resinae, Resin Plaster {Adhesive Plaster), consists of Resin 14, Lead 



RESORCINUM. 355 

Plaster 80, Yellow Wax 6 parts. Is the common adhesive plaster of surgery, and an 
ingredient of the official Arnica, Belladonna and Capsicum Plasters. 
Resin itself is an ingredient of Cantharides Cerate. 

Resin gives consistence and adhesiveness to plasters and cerates, and 
generally acts as a mild local stimulant, but the writer has seen persons 
with so susceptible a skin that the ordinary adhesive plaster would pro- 
duce on them a high degree of cutaneous irritation. It is never employed 
internally, but in chronic bronchial catarrh the fumes from boiling resin 
are inhaled with considerable advantage. Resin Cerate is one of the most 
commonly used applications to promote the healing of indolent ulcers, 
blistered surfaces, burns, scalds, chilblains, etc. 



RESORCINUM, Resorcin (Resorcinol, Me fadioxy benzol), C 6 H 4 - 
(OH) 2 — is a diatomic phenol, isomeric with Pyrocatechin and Hydro- 
quinone, obtained by fusing certain resins with a caustic alkali, but best 
prepared by fusing Potassium Benzol-disulphonate with caustic Potassa, 
the salt being decomposed into Potassium Sulphite and Resorcin. It 
crystallizes in colorless, rhombic prisms or plates of neutral reaction, 
odorless, and of sweetish, acrid taste, very soluble in water, also in alco- 
hol, ether, etc. Dose, gr. v-xv; — as an antipyretic gss-j, not repeated 
for several hours, or gr. v every 2 hours. 

Physiological Action. 
Resorcin is closely allied to Carbolic Acid, but possesses an advantage 
over the latter in that it is odorless, more soluble and almost non-irritant. 
It is equally powerful as an antiseptic and antiferment, arresting decom- 
position and destroying low organisms. Injected beneath the integument 
in solution it produces very little irritation, and never causes inflammation 
or abscess. Vesication results from its application to the mucous mem- 
brane. Internally a 30- to 60-grain dose causes a sense of heat, discom- 
fort and oppression, followed by profuse perspiration and languor ; if fever 
be present the temperature of the body is lowered several degrees, but 
rises again after a rigor in from 2 to 4 hours. Larger doses (150 
grains) have produced deafness, dizziness, salivation, confused vision, 
vertigo, unconsciousness, general clonic convulsions, and tetanic rigidity 
of the muscles of the neck, with no decline of temperature in feverless 
subjects. Toxic doses (gr. xv to each 35 ozs. of weight) cause in animals 
trembling succeeded by epileptiform convulsions, which increase in se- 
verity and then decline ; the respiration is quickened and enfeebled, the 
heart's action becomes rapid, weak, and irregular, and death results from 
paralysis of respiration, the drug paralyzing the motor tracts in the spinal 
cord, but not affecting the general sensibility. It is eliminated chiefly 



356 RESORCINUM. 

by the urine, which it colors a bluish-violet hue, and with great rapidity, 
about one hour serving for its excretion. The best test of its presence is 
the solution of the Perchloride of Iron, which produces with it a dark- 
violet, almost black color. 

Antagonists. 

Atropine and other cardiac and respiratory stimulants, cerebral excitants and agents 
which raise the arterial tension, are physiologically antagonistic. 

Therapeutics. 

Resorcin is employed as an antipyretic and antiseptic, being preferred 
to carbolic acid for internal and subcutaneous use. A 3 per cent, solu- 
tion gives good results in stomach complaints, as gastralgia, gastric catarrh, 
gastritis, gastric ulcer and cancer, fermentative indigestion, etc. In ulcer 
of the stomach its analgesic property is so marked that the stomach is 
enabled to tolerate food. It has given very great satisfaction in the 
treatment of diarrhoea of children ; and is highly recommended by some 
observers in intermittent fevers and malarial diseases generally, while 
others have been much disappointed with its action therein. As an anti- 
pyretic it has been used in erysipelas, puerperal fever, septicaemia, and 
diphtheria, and in the latter disease it has been locally employed in crys- 
tals with decided benefit. As a local application to tuberculous and 
other ulcerations of the larynx, in diphtheria, tonsillitis, pharyngitis, 
chronic rhinitis, etc., strong, even supersaturated solutions are employed 
with increasing satisfaction, being highly efficient and quite painless. 
Applied to the peri-laryngeal mucous membrane, it has proved very use- 
ful in the treatment and prophylaxis of pertussis. A 2 per cent, solution 
has given great satisfaction as a local antiseptic application to wounds, 
parasitic skin diseases, cystitis, gonorrhoea, anthrax, and syphilitic sores 
of unhealthy character. As spray a similar solution is well applied to 
catarrhal or ulcerative affections of the respiratory passages. As a caustic 
it may be applied in undiluted form to chancres, papillomata, carbuncles, 
etc. A saturated ethereal solution is a good application where the caustic 
action of the drug is required. 

A paste of equal parts of Resorcin and Zinc Oxide has been lately 
applied to the face to promote peeling of the skin in the treatment of 
acne rosacea. In three or four days the skin becomes like parchment, 
when the application must be stopped, in order to avoid the cracking of 
the skin, which begins at that stage. A dressing of gelatin, glycerin, 
zinc oxide and hot water is then applied, covered with cotton wool. In 
a few more days the dressing comes off, bringing the epidermis with it. 
Some few dangerous and unfavorable results have followed this method, 
, but a number of very satisfactory cases are reported. Freckles and other 
superficial spots on the skin may be removed by the same treatment. 
(Unna.) 



RHAMNUS PURSHIANA — RHEUM. 357 

RHAMNUS PURSHIANA, Cascara Sagrada (Chittem Bark, 
Sacred Bark), — is the bark of Rhamnus Purshiana, the California Buck- 
thorn, a small tree of the nat. ord. Rhamneae, growing on the Pacific coast 
of the United States. It contains a Volatile Oil, a neutral crystalline sub- 
stance, several Resins, with tannic, malic and oxalic acids. It has been 
found very serviceable in the treatment of chronic constipation, given in 
gradually diminished doses. It produces large, soft and painless evacua- 
tions, and the bowels are said to act naturally and regularly after its disuse. 

Another species of the same order, Rhamnus Frangula, is official under 
the title Frangula, which see. 

Preparations. 

Extractum Rhamni Purshianae Fluidum, Fluid Extract of Cascara Sagrada, — 
is made with diluted alcohol. Dose, ^ss-jss, two or three times a day.' 

Cascara Cordial is a trade preparation, intended as a remedy for constipation, dys- 
pepsia and hemorrhoids, and as a pleasant excipient for nauseous and bitter drugs. A 
similar preparation may be made by combining the fluid extract with the official Elixir 
Aromaticum in the proportion of 3J to^ij, of which teaspoonful doses or more may be 
administered. 



RHEUM, Rhubarb, — is the root of Rheum officinale, a perennial 
plant of the nat. ord. Polygonacese, a native of Thibet. There are many 
other undetermined species of Rheum, several of which are cultivated in 
Europe and America, their leaf-stalks being used as a fruit. The com- 
monly accepted medicinal Rhubarb is the Chinese variety, and is imported 
from Shanghai and Canton. It occurs in cylindrical or conical segments, 
sometimes flattened and bored with a hole, of a dirty-brown-yellow color 
externally, internally marbled with fine waving lines, of peculiar odor, 
gritty between the teeth, and of a bitter, astringent taste. It imparts its 
virtues to water and alcohol, and contains several substances of greater 
or less activity, the least important being Phozoretin, C 32 H 32 O u , the rhu- 
barb-resin, — Erythroretin, C 38 H 36 O u , and Chrysophan, H 27 O 30 C 14 , the latter 
of which is split by acids into sugar and Chrysophanic Acid. (See 
Chrysarobinum.) It also contains Rheo-tannic Acid, C 52 H 52 28 , Rheumic 
Acid, Q H 32 O 18 , and probably a principle which is identical with Cathar- 
tic Acid (see Senna), on which its purgative activity may depend. Dose 
of Rhubarb as a stomachic, gr. j-v ; as a purgative, gr. x-xxx. 

Preparations. 

Extractum Rhei, Extract of Rhubarb. — Dose, gr. j-x. 

Extractum Rhei Fluidum, Fluid Extract of Rhubarb. — Dose,n\x-gj. 

Pilulae Rhei, Pills of Rhubarb, — are composed of Rhubarb 60, Soap 6, Water to 
100 ; each pill containing about 3 grains of powdered Rhubarb. Dose, j-v pills. 

Pilulae Rhei Compositae, Compound Pills of Rhubarb, — each pill contains of Rhu- 
barb about 2 grains, Aloes \ l / 2 , Myrrh I, Oil of Peppermint ^ grain. Dose, ij-v pills. 
A safe and efficient laxative. 



358 RHEUM. 

Tinctura Rhei, Tincture of Rhubarb, — has of Rhubarb io, Cardamom 2, Glycerin 
10, Alcohol and Water to 100. Dose, gj-iv. 

Tinctura Rhei Aromatica, Aromatic Tincture of Rhubarb, — has of Rhubarb 20, 
Cinnamon 4, Cloves 4, Nutmeg 2, Glycerin 10, Alcohol, Water and Diluted Alcohol to 
100. Dose, £j-iv. 

Tinctura Rhei Dulcis, Sweet Tincture of Rhubarb, — has of Rhubarb 10, Glycyr- 
rhiza 4, Anise 4, Cardamom I, Glycerin 10, Alcohol, Water and Diluted Water to 100. 
Dose, ^ss-ij. 

Syrupus Rhei, Syrup of Rhubarb, — has of the Fluid Extract 10, Spirit of Cinnamon 
0.4, Potassium Carbonate 1, Glycerin 5, Water 5, Syrup to 100. Dose, for an infant, ^j ; 
for older children ^ij-iv. 

Syrupus Rhei Aromaticus, Aromatic Syrup of Rhubarb, — has of the Aromatic 
Tincture 15, Syrup 85. Dose, as the Syrup. 

Pulvis Rhei Compositus, Compound Powder of Rhubarb, — has of Rhubarb 25, 
Magnesia 65, Ginger 10. Dose, a teaspoonful. 

Mistura Rhei et Sodse, Mixture of Rhubarb and Soda, — has of Sodium Bicarb. 
2,%,, Fluid Extract of Rhubarb 1%, Fluid Extract of Ipecac y£, Glycerin 35, Spirit of 
Peppermint 3^, Water to 100. Dose, ^ij-^ij. 

Physiological Action and Therapeutics. 

Rhubarb is classed among the tonic-astringent and resin-bearing pur- 
gatives, which increase the circulation of the glandular appendages of the 
intestinal canal, and stimulate the muscular layer of the bowel. In small 
doses (gr. j-v) its action is that of a stomachic and intestinal astringent, 
the influence of the bitter principle and the rheo-tannic acid probably 
predominating. In larger doses (gr. xxx-lx), its cathartic action prevails, 
producing in 6 to 8 hours copious yellow, pultaceous stools, with some 
griping and considerable hepatic stimulation. After the cathartic prin- 
ciple is expelled, the astringent quality of its tannin asserts itself and 
constipation is likely to result. The yellow color of the stools is partly 
due to the rhubarb pigment and partly to excess of bile, the drug having 
marked cholagogue properties, in all probability due to its resin, Phaeore- 
tin. Its pigment stains the milk, urine and sweat, the milk acquiring a 
bitter taste and purgative properties. The cathartic action of Rhubarb 
may be obtained from its application locally to ulcers, by being rubbed 
into the moist skin, or applied to the abdomen as a poultice. 

Rhubarb is highly esteemed as a cathartic for children, from the mild- 
ness of its action, as, though occasionally producing quite severe griping, 
it never inflames the gastro-enteric mucous membrane. The tonic and 
astringent action following its catharsis makes it a valuable agent in 
diarrhoeas due to the presence of irritating matter in the bowel, and to 
correct atonic indigestion accompanied by diarrhoea. For hemorrhoids 
with constipation its gentle action makes it peculiarly suitable, its astrin- 
gent after-effect being entirely overcome by 2 to 4 drachm doses of olive 
oil nightly. It may be combined with a mercurial or with Sodium Bicar- 
bonate, the latter being supposed to overcome its astringent action and to 
disguise its taste in some degree. In small doses the tincture is a very 
efficient stomachic tonic, improving appetite, increasing the flow of the 
gastric juice, assisting digestion, and promoting the action of the liver 



RHINACANTHUS RHUS. 359 

without producing any cathartic results. The preparations most in use 
for children are the Aromatic Syrup and the Mistura Rhei et Sodae. 



RHINACANTHUS (Unofficial), — the leaves and root of Rhinacanthus co7nmunis, 
a shrub of the nat. ord. Acanthaceae, indigenous to India and China. The root contains 
a quinone-like body named Rhinacanthin, C 14 H 18 4 , which forms with alkalies intensely 
red compounds which are decomposed by benzin. It is known in China as Hong-Pang- 
Chong, and is employed as a local remedy for ringworm and parasitic skin diseases, the 
leaves being bruised and mixed with lime-juice. Used internally a tincture of the root 
has some reputation as a feeble tonic and antiperiodic. The same preparation is applied 
locally in chronic eczema, tinea and psoriasis. 



RHUS AROMATICA, Sweet Sumach (Unofficial),— is an indigenous shrub of 
the nat. ord. Terebinthaceae, growing about 5 feet high, and having yellow flowers in 
spikes. The root-bark contains a volatile oil, several resins, fat, tannin, etc. A fluid 
extract is prepared from the bark of the root according to the general pharmacopceial 
rule, and may be given in doses of rTLx-xxx, every 2 or 3 hours. 

Rhus Aromatica has astringent properties, and seems to possess a selective action upon 
the urinary tract. Its action is not yet clearly made out. Therapeutically it has been 
used with advantage in cystitis, night-sweats, hematuria, menorrhagia, diabetes insipidus, 
diarrhoea and dysentery. As a remedy for incontinence of urine in children it has 
attracted considerable attention, having been extremely efficient in doses of TT\,xv of a 
good fluid extract four times daily, administered in glycerin and water, or any other suit- 
able excipient. It is reported to be equally effective in hysterical enuresis of adults, but 
larger doses (TTlxx-xxx several times a day) are required. Diabetes insipidus is remark- 
ably benefited by its continued use, and even in diabetes mellitus its employment has 
occasionally seemed to have been followed by curative results. 



RHUS GLABRA, Smooth Sumach,— is the fruit of Rhus 
glabra, an indigenous shrub of the nat. ord. Anacardiece, growing in 
rocky and barren soil to a height of 8 to 12 feet. The berries are about 
}£ inch in diameter, subglobular, densely hairy, of crimson color and 
acidulous taste, but inodorous. The leaves and bark have an astringent 
and bitter taste, and are also used medicinally. It contains tannin, 
coloring matter, potassium and calcium malates. 

Extractum Rhoi's Glabrae Fluidum, Fluid Extract of Rhus Glabra. — Dose, gj-ij. 

Sumach-berries form a useful acidulous and astringent drink or gargle 
in catarrhal pharyngitis, stomatitis, aphthae, etc. An infusion (gj to the 
pint) or the official fluid extract may be used as a wash and dressing for 
ulcers and wounds. Internally they are useful remedies for mild catarrhal 
affections of the stomach and bowels. 



RHUS TOXICODENDRON, Poison Ivy— is the fresh leaves 
of Rhus radicans, a plant of the nat. ord. Anacardiece, indigenous to 
Canada and the greater part of the eastern United States. This climbing 



360 RHUS TOXICODENDRON. 

plant is not by itself a distinct species, but a variety of the erect shrub, 
Rhus Toxicodendron, the Poison Oak, formerly official as a source of the 
drug ; both of which when wounded exuding a poisonous, acrid, milky 
juice which turns dark on exposure. The leaves are trifoliate, on peti- 
oles 4 or 5 inches long, the lateral leaflets sessile, entire and glabrous in 
R. radicans (or variously notched, toothed or lobed, downy beneath, in 
R. Tox.), inodorous, astringent and acrid. They may be confounded 
with the leaves of the hop-tree, Ptelea trifoliaia, which are quite similar 
in appearance, but all its leaflets are sessile. The poisonous principle of 
the plant is Toxicodendric Acid, which is volatile, and also exists in Rhus 
venenata or Swamp sumach, Rhus pumila, and Rhus dive?'siloba, the 
former of which is probably the most poisonous of the four. The dose 
of the leaves is generally placed at gr. j-iv, but if old and dry they will 
generally prove to be inert. - There are no official preparations. 

Preparations. 
Tinctura Rho'fs Toxicodendri, Tinctitreof Rhus Toxicodendron (Unofficial), — may 
be prepared according to the formula of the Pharmacopoeia for Tincturse Herbarum 
Recentium (Tinctures of Fresh Herbs), one part of the fresh leaves to two of Alcohol. 

Dose, ULtV^J- 

ExtractumRho'isToxicodendri, Extract of Rhus Toxicodendron, — has been used in 
France in large doses. It is probably inert. 

Physiological Action. 

The effects of Rhus Toxicodendron upon the skin are familiar to all 
who have suffered from contact with poison-oak or ivy. Some persons 
are so susceptible to the poison that the exhalations from the plant will 
produce on them its characteristic action. Others are apparently insus- 
ceptible to its influence, and can with impunity rub the juice into their 
skin, or even chew its leaves. 

The action of the plant when locally applied is that of a cutaneous 
irritant, causing redness and swelling of the affected parts, with a vesicu- 
lar eruption and intolerable itching, which may spread rapidly over the 
surface of the body and extend to the mucous membranes, producing 
conjunctivitis, redness and tumefaction of the mouth and throat, thirst, 
cough, nausea and vomiting, vertigo, stupefaction, etc. Colicky pains 
are experienced in the abdomen, are worse at night and are aggravated 
by food or drink. Diarrhoea may occur, with tenesmus and bloody 
stools, also diuresis, bloody urine, or even complete retention. Fever 
with delirium is frequently present, and may be typhoid in character, or 
intermittent with profuse perspiration. Pains of rheumatoid type are ex- 
perienced throughout the body, but particularly in the joints and lumbar 
region, apparently intensified by rest and heat. The fibrous structures 
are evidently the seat of its selective action, and a sensation of numb- 
ness in the lower extremities is frequently experienced. Similar phe- 
nomena attend its internal administration, but fatal results have not 



RICINI OLEUM. 361 

followed in any case of poisoning recorded. The effects of the poison 
usually last from ten to fifteen days, and are then followed by desquama- 
tion of the epidermis. 

Antidotes. 

Cocaine Hydrochlorate, in 4 to 8 per cent, solution, is the best lotion to relieve the in- 
tolerable itching and burning. Grindelia Robusta makes one of the best local applica- 
tions, and a solution of Mercuric Chloride is also a very serviceable lotion, and Lime- 
water with Linseed-oil, solution of Plumbum Acetate, solution of Chlorinated Soda, and 
Alum-curd are all very useful. Rest, low diet and laxatives are appropriate, and Opium 
or strong black coffee to relieve the irritability of the nervous system. 

Therapeutics. 
Rhus Toxicodendron was used medicinally by Dufresnoy in France and 
by Alderson in England about the close of the eighteenth century. The 
attention of the former was attracted to it by the accidental poisoning of 
a student who was afflicted with chronic eczema, which disappeared on 
the subsidence of the Rhus symptoms. It is a favorite remedy with the 
so-called homceopathists, who ascribe to it extraordinary virtues in acute 
cutaneous affections of vesicular type, subacute and chronic rheumatism, 
vesicular erysipelas and typhoid fever. Among regular authorities it meets 
with very little favor as a remedial agent, but Dr. Phillips recommends 
it strongly in rheumatic affections of the fibrous tissues, erythema and ery- 
sipelas, eczema, herpes zoster and pemphigus. Dr. Piffard corroborates 
these opinions of its therapeutical value, and states that when rheumatic 
pain is " worse at night " prompt relief may be expected from Rhus. It 
was used by Dufresnoy in paralyses with a certain degree of success, and 
Eberle reports a case of paralysis in which it proved curative. It is ad- 
mitted by many observers to be a useful remedy in paralytic affections of 
the lower extremities depending on a rheumatic diathesis, or resulting 
from exposure to cold and wet. As an external application it is effica- 
cious in sprains and other affections of ligaments and tendons, also to 
extensive but superficial burns, stings of insects, and chilblains. For these 
affections a lotion of about 3SS of the tincture to a pint of water is usually 
employed. 



RICINI OLEUM, Castor Oil,— is a fixed oil expressed from the 
seeds of Ricinus communis, a tree of the nat. ord. Euphorbiaceae, indigen- 
ous to India, but extensively cultivated in the United States, where it is 
an annual plant about 5 or 6 feet high, bearing ovate seeds, smooth and 
shiny, of gray color marbled with brownish spots and stripes, three con- 
tained in a pod. The oil is an almost colorless, transparent, viscid liquid, 
of faint odor, bland or slightly acrid taste, neutral reaction, sp. gr. 0.950 
to 0.970, soluble in an equal weight of alcohol, and congealing at about 
— 0.4 F. It consists mainly of Ricinoleic Acid, C 18 H 34 3 , combined with 



362 RICINI OLEUM. 

glycerin, but palmitin, stearin, cholesterin, and probably a resin and an 
alkaloid also occur in small quantities. It is contained in Collodium 
Flexile (3 per cent.) and in Linimentum Sinapis Co. (15 per cent.). 
Dose, sj-Ij. 

Physiological Action. 
Used externally pure Castor Oil is perfectly bland. Internally admin- 
istered it is non-irritant until it reaches the duodenum, where it is decom- 
posed by the pancreatic juice, setting free the Ricinoleic Acid, which 
produces purgation by a mildly irritant action on the bowel, stimulating 
the intestinal glands and muscular coat, but not the liver. It is a simple 
purgative, acting in four to six hours, producing one or more liquid stools 
without pain or tenesmus, and followed by a sedative effect on the intes- 
tines. The leaves are believed to possess galactagogue properties when 
locally applied as a poultice to the breasts. Ricinoleic Acid enters the 
blood and the tissues, and is excreted with the various secretions of the 
body, imparting its purgative qualities to the milk of the nursing mother. 

Therapeutics. 

Castor Oil is the best of simple purgatives, and is used where a free 
evacuation of the bowels is alone indicated, or when only a laxative action 
is desired, as in the constipation of typhoid fever, in pregnancy and post- 
partum conditions, diarrhoea from the presence of irritating matter in the 
bowels, and after operations on the abdominal or pelvic organs. It is 
often used as a purgative for children, also for the aged and infirm. In- 
fants bear a larger relative dose than adults, probably from their ability to 
digest a larger quantity of what is taken. It is employed with great benefit 
as a laxative in irritation or inflammation of the bowels, in hemorrhoids, 
inflammatory or spasmodic affections of the genito-urinary organs, ne- 
phritis or cystitis, gonorrhoea, calculi, and stricture of the urethra and 
rectum. In cases of dysentery 10 to 20 drops of Laudanum may be added 
to each dose to counteract the pain, tenesmus and exhaustion resulting 
from the frequency of the passages. If much depression exists, as shown 
by lowered arterial tension and a dry, glazed tongue, 5 drops of Oil of 
Turpentine should also be added. 

Castor Oil is much used in the puerperal state and greatly abused. 
There is considerable evidence in support of the charge that it induces 
hemorrhoids by congesting the rectal vessels. Its purgative action is 
milder in proportion to the purity of the sample employed. Externally, 
the pure oil is employed as a local sedative and protective, as in neutral- 
izing the effects of lime upon the conjunctiva. 

The leaves of the castor-oil plant are used to promote the secretion of 
milk. They may be applied to the breast in poultice, and a decoction or 
fluid extract given internally at the same time. 



ROSA. 363 

Administration. 

The nauseous smell is best concealed by the Essential Oil of Bitter Almonds. Emul- 
sions are not a success. Capsules containing the requisite dose are easily obtained. In 
the absence of these the best way to administer a dose of oil is to smear the sides of a 
clean wineglass with very thick cream, then to pour in the oil, covering it with a little 
more cream. A teaspoonful of cream being then taken into the patient's mouth, he is 
directed to bolt the dose at one gulp. Some prefer it floated on orange-juice, strong 
coffee, gruel or wine. One of the best vehicles for it is foaming beer. Glycerin increases 
its purgative power, when given conjointly. 



ROSA, Rose, — is represented in pharmacy by the petals of two 
species and the volatile oil from a third. 

Rosa Centifolia, Pale Rose, — is the petals of Rosa centifolia, the 
Cabbage Rose, a well-known and cultivated shrub of the nat. ord. Rosa- 
ceae. They are of pink color, fragrant odor, a sweetish taste, changing 
to slightly bitter and faintly astringent. The odor is due to a minute 
quantity of a volatile oil, besides which the petals contain tannin, fat, 
resin, sugar, etc. If it is desired to keep Pale Rose fresh for any length 
of time, it should be mixed with one-half its weight of Sodium Chloride 
and pressed into a jar, which should be kept in a cool place, well closed. 

Rosa Damascena, Damask Rose, — is the source of the official Oil 
of Rose, which is distilled from the fresh flowers. This variety of the 
nat. ord. Rosaceae is largely cultivated in Roumelia, on the southern 
slope of the Balkan mountains, from which section comes nearly all of 
the oil supplied to commerce. 

Rosa Gallica, Red Rose, — is the petals of Rosa gallica, collected 
before expanding. They occur usually in small cones of deep purple 
color, having a roseate odor, and a bitterish, slightly acidulous and dis- 
tinctly astringent taste. They contain an aromatic oil, tannic and gallic 
acids, quercitrin, coloring matter, salts, etc. 

Preparations of Rosa Damascena. 

Oleum Rosae, Oil of Rose {Attar of Rose), — is a volatile oil distilled from the fresh 
flowers of Rosa damascena. It is a pale-yellowish, transparent liquid, having a strong 
odor of rose, a sweetish taste and a slightly acid reaction, but slightly soluble in alcohol, 
of sp. gr. about 0.870. It consists of an aromatic oxygenated elaeopten and an odorless 
solid stearopten (rose-camphor). Being very expensive it is much adulterated with other 
volatile oils. It is used chiefly for perfuming cosmetic preparations, ointments and lotions, 
and as the basis of the following : 

Aqua Rosae Fortior, Stronger Rose Water {Triple Rose Water), — is water satur- 
ated with the volatile oil of Rose petals, obtained as a by-product in the distillation 
of Oil of Rose. An agreeable excipient and flavoring agent. Dose, ^ss-j. 

Aqua Rosae, Rose Water, — consists of equal volumes of the preceding and distilled 
water, mixed together immediately before use. It is an ingredient of Mistura Ferri Com- 
posita. Dose, gj-ij. 

Unguentum Aquae Rosae, Ointment of Rose Water {Cold Cream), — has of Stronger 
Rose Water 19, Expressed Oil of Almond 60, Spermaceti 12^, White Wax 12, and 
Sodium Borate l^. For local use. 



364 ROSMARINUS RUBIDIUM. 

Preparations of Rosa Gallica. 

Extractum Rosae Fluidum, Fluid Extract of Rose, — prepared with glycerin and 
diluted alcohol. Dose, rr^v-gj. 

Confectio Rosae, Confection of Rose, — has of Red Rose 8, Sugar 64, Honey 12, 
Stronger Rose Water 16, beaten together into a mass, which is used as a basis for pills. 
Dose, gr. x-gj. 

Mel Rosas, Honey of Rose, — has of the Fluid Extract 12, and Clarified Honey to 
100. Dose, ^j-ij. 

Syrupus Rosae, Syrup of Rose, — has of the Fluid Extract 12)4, with Syrup 87^. 
Dose, £j-ij, for flavoring. 

Red Rose is an ingredient of Pil. Aloes et Mastiches. 

Pale Rose petals are only used for odoriferous purposes. Rose Water 
has no strictly medicinal properties, but is an agreeable excipient for 
lotions, collyria and urethral injections. The ointment, commonly 
termed "cold cream," is a pleasant emollient and protective, generally 
used for chapped hands and other superficial skin affections. Red Rose 
is classed among the astringents, as it contains an appreciable amount of 
tannic and gallic acids. A Compound Infusion, containing sugar and 
dilute sulphuric acid, was formerly official, and is used as an agreeable 
gargle for the throat and mouth in inflamed and ulcerated conditions. 
The chief uses of the rose preparations, however, are as vehicles for other 
agents, or to impart flavor and odor to extemporaneous prescriptions. 



ROSMARINUS, Rosemary, — the source of the official Oil of Rosemary, is the 
leaves of Rosmarinus officinalis, a shrub of the nat. ord. Labiatae, cultivated in gardens 
for the sake of its large, pale-blue flowers. They are pungently aromatic and somewhat 
camphoraceous, and contain the volatile oil, a little tannin, some resin and a bitter 
principle. 

Oleum Rosmarini, Oil of Rosemary, — is the volatile oil distilled from Rosemary, a 
colorless or yellowish liquid, of sp. gr. about 0.900, having the characteristic odor of the 
plant, a camphoraceous taste, and is readily soluble in alcohol. It consists of a terpene, 
isomeric with Turpentine, C 10 H 16 , and a body allied to camphor. It is an ingredient of 
Linitn. Saponis, Spiritus Odoratus and Tinct. Lavandulae Comp. Dose, TTLJ-v. 

Rosemary was formerly considered emmenagogue, galactagogue and diuretic, but is 
now never employed in substance. Its Oil is somewhat stimulant and carminative, and in 
excessive quantity has caused death. It is chiefly employed as an external stimulant in 
liniments and lotions, especially to the scalp in alopecia, where it is supposed to increase 
the blood-supply to the hair bulbs, and is usually combined with cantharides. Inhaled 
it reduces the body temperature and gives the urine a violaceous odor. 



RUBIDIUM, Rubidium, Rb, (Unofficial), — is one of the rarer metals, belonging to 
the group of alkaline metals of which potassium and sodium are typical. It has a molec- 
ular weight of 85, that of Potassium being 39, and that of Sodium 23. Its salts are 
supposed to act more promptly and efficiently than those of the latter, upon the theory 
that the physiological action of salts is as much a periodic function of the atomic weights 
of their elements as are their physical and chemical characters. The principal salt of 
Rubidium is — 

Rubidii Iodidum, Rubidium Iodide, Rb I, (Unofficial), — occurs in white, non-efflor- 
escent crystals, odorless, of milder taste and greater solubility in water tfyan Potassium 
Iodide. Dose, gr. v-xxx or more. 



RUBUS RUBUS ID.EUS — RUMEX. 365 

Rubidium Iodide has generally the same physiological and therapeutical action as 
Potassium Iodide, but has a far less toxic action upon the cardiac muscle. It is well borne 
by the stomach, does not disturb the appetite nor give rise to digestive derangements, and 
does not affect the circulation. It rarely produces iodism, and even when the iododerma 
and catarrh were present as a result of the administration of potassium iodide, the change 
to the rubidium salt has resulted in decrease of these symptoms. It has been employed 
in lieu of the potassium salt, with greater efficiency and less disturbance, in most of the 
affections for which the iodides are indicated. In eye affections requiring an absorptive 
treatment it is employed internally and externally as a 5 per cent, vaselin ointment or in 
the form of 5 per cent, drops, (3J in ^ijss). 



RUBUS, Blackberry-Bark, — is the bark of the root of Rubus vittosus, the common 

Blackberry, Rubus canadensis, the Dewberry, and Rubus trivialis, the Bush Blackberry 
of the Southern States, all of the nat. ord. Rosacea?. It occurs in thin, tough, flexible 
bands, blackish-gray externally, pale-brown internally, inodorous, strongly astringent and 
of somewhat bitter taste. It contains over 10 per cent, of Tannin. Dose, gr. xv-xxx. 

Extractum Rubi Fluidum, Fluid Extract of Rubus. — Dose, rrpc-^j. 

Syrupus Rubi, Syrup of Rubus, — has of the Fluid Extract 25, Syrup 75. Dose, 

3J-:fj. 

Syrupus Rubi Aromaticus, Aromatic Syrup of Rubus (Unofficial), — contains Rubus, 
Cinnamon, Cloves and Mace. Each fl Hj has 30 grains of the drug. Dose, gj-^j. 

Blackberry-bark derives its virtues from its tannin. It is strongly astringent, and may 
be used in decoction, wine or the above-named preparations. It is highly esteemed in 
summer and infantile diarrhoeas. 



RUBUS ID^US, Raspberry,— is the fruit of Rubus idceus, the Raspberry bush, 
nat. ord. Rosacea?. It contains sugar, malic and citric acids, proteids, pectin, etc., also a 
Volatile Oil consisting of compound ethers, to which the odor is due. Its sole use in 
medicine is to prepare a pleasantly flavored syrup. The closely allied, light-red fruit of 
Rubus slrigostts, the wild Red Raspberry, and the purplish-black fruit of Rubus Occident- 
alis, the Thimble-berry, may be employed in place of the above. 

Syrupus Rubi Idaei, Raspberry Syrup, — has of Raspberries and Sugar any convenient 
quantity, boiled (but not in tinned vessels) and strained. Dose, ad libitum. It has a bright- 
red color, a fruity, agreeable odor, a pleasant, acidulous taste and an acid reaction. It 
has no special medicinal virtues, but forms an agreeable flavoring for mixtures, and mixed 
with water a pleasant drink in febrile conditions. 

The leaves of the wild Red Raspberry {Rubtis strigosus) are considerably astringent, 
and in infusion, 3j j to the pint, are a popular domestic remedy for diarrhoeas. 



RUMEX, Yellow Dock, — is the root of Rumex crzspus, and of 
some other species of Rumex, plants of the nat. ord. Polygonacese, grow- 
ing as common weeds along roadsides. Several species of Rumex have 
sour leaves, and are popularly called Sorrel to distinguish them from the 
others which are called Dock. The official root is 8 to 12 inches long, 
Yz inch thick, somewhat fusiform and fleshy, annulate above, deeply 
wrinkled below, externally rusty-brown, internally whitish, with fine 
medullary rays; fracture short, odor slight, taste bitter and astringent. 
It contains tannin, mucilage, starch, calcium oxalate, and two principles 



366 RUTA. 

named Rumicin and Lapalhin, which are shown to be identical with 

Chrysophanic Acid. Its constituents are nearly identical with those of 

Rhubarb. Dose, gr. xv-£j. 

Preparations. 

Extractum Rumicis Fluidum, Fluid Extract of Rumex. — Dose, H\xv-gj. 
Decoctum Rumicis, Decoction of Rumex (Unofficial), — ^ij of the fresh root, or 
^j of the dry root to Oj of water. Dose, ^j-ij. 

Rumex is astringent, tonic and laxative. It has also been considered 
alterative and anti-scorbutic. It has been employed chiefly in chronic 
cutaneous disorders, glandular swellings, and other symptoms of the stru- 
mous diathesis. It seems to possess a selective action on the mucous 
membrane of the larynx, and in many cases of laryngeal irritation with 
catarrhal symptoms, dry, violent cough, and a sense of soreness behind 
the sternum, it will give prompt relief. The Rumex Acetosa has a popu- 
lar reputation as a local application for cancer. 



RUTA, Rue (Unofficial) — is the source of Oil of Rue, which is dis- 
tilled from the leaves of Ruta graveolens, an herbaceous perennial of the 
nat. ord. Rutaceae, growing wild throughout Southern Europe, and fre- 
quently cultivated in gardens for its yellowish flowers. The fresh leaves 
only should be used, and as drying impairs their qualities the oil is gen- 
erally employed. 

Oleum Rutae, Oil of Rue (Unofficial), — the volatile oil distilled from Ruta graveo- 
lens; a colorless, or greenish-yellow liquid, of disagreeable but aromatic odor, pungent 
acrid taste and neutral reaction, sp. gr. about o.88o, soluble in an equal weight of alcohol. 
Dose, TT\j-v, in mucilage. 

Physiological Action and Therapeutics. 

Rue is an active irritant, locally a rubefacient, the oil producing heat, 
inflammation and vesication. In the ordinary dose it causes a sensation 
of heat in the stomach and skin, increases the action of the heart, and 
stimulates the bronchial, cutaneous and renal secretions, the odor of the 
oil being distinctly perceptible in the breath, sweat and urine. After 
toxic doses of the oil violent gastro-enteritis results, with extreme pros- 
tration, convulsions, strangury and suppression of the urine. Abortion 
may be produced by large doses, but with great danger to life. Rue is an 
efficient emmenagogue, and in men aphrodisiac ; it is also considered 
antispasmodic and carminative. 

The Oil of Rue is employed internally in amenorrhoea, menorrhagia 
and metrorrhagia, hysteria, convulsions and flatulence. As an emmena- 
gogue it is very efficient when the condition is one of functional inactivity 
of the uterus and ovaries. In small doses it has been well used in metror- 



SABINA. 367 

rhagia from debility and after abortion. A decoction of the fresh leaves 
is often employed by injection against ascarides, and internally to remove 
lumbricoid worms. Externally the same preparation has been applied to 
the chest in chronic bronchitis, also in various scaly eruptions and 
glandular enlargements. Used as an abortifacient it has frequently caused 
death, preceded by symptoms of narcotic and irritant poisoning. Even 
in poisonous doses its abortifacient action is very uncertain, so that only 
the most ignorant criminals employ it with such purpose. It was formerly 
official, but has been dismissed from the last edition of the pharmacopoeia. 



SABINA, Savine, — the tops of Juniperus Sabina, a small evergreen 
shrub of the nat. ord. Coniferae, growing in Northern Europe, Asia and 
America. It closely resembles Red Cedar {Jimiperus virginiana), but is 
distinguished from the latter by its smaller size and by its larger fruit. 
It occurs in short, thin branchlets, having oveo-lanceolate leaves in four 
rows; of peculiar, terebinthinate odor, and nauseous, bitter, resinous 
taste. It contains a Volatile Oil (which is official), also tannin, resin, 
extractive matters, chlorophyll, etc. Dose, gr. v-x. 

Preparations. 

Extractum Sabinse Fluidum, Fluid Extract of Savine. — Dose, TTLv-xv. 

Ceratum Sabinae, Savine Cerate (Unofficial), — may be prepared by incorporating the 
Fluid Extract 25 in Resin Cerate 90, melted and cooled. Formerly official, but dismissed 
from the last edition of the pharmacopoeia. 

Oleum Sabinae, Oil of Savine, — a volatile oil distilled from Savine existing in the 
fresh tops in the proportion of 2^ per cent., and in the berries 10 per cent. It is a 
colorless, or yellowish liquid, isomeric with oil of turpentine, C 10 H 16 , having a peculiar, 
terebinthinate odor, a pungent camphoraceous taste, and neutral reaction, of sp. gr. about 
0.910 to 0.940 and soluble in an equal volume of alcohol. Dose, tt\J-v. 

Physiological Action and Therapeutics. 

Externally the action of Savine resembles that of Turpentine, except 
that it is more irritant, the oil producing vesication if applied sufficiently 
long. Internally a full medicinal dose causes heat sensations, nauseous 
eructations, flatulence, increased cardiac action, stimulation of the cuta- 
neous, bronchial and renal secretions, irritation of the kidneys, hyperae- 
mia of the ovaries and uterus and increased menstrual activity. In large 
doses it produces hematuria, dysuria, and intense gastro-enteritis, with 
violent vomiting and purging. It may originate uterine contractions in 
the pregnant female, but its abortifacient effect can only be produced by 
a quantity sufficient to endanger life. The oil diffuses into the blood and 
is excreted by the various excretory channels. 

As an emmenagogue Savine is highly esteemed by many authorities, 
Dr. Phillips considering it " one of the most certain and powerful " agents 
of this class, " with the additional advantage that it can be given with 



368 SACCHARINUM — SACCHARUM. 

perfect freedom from risk of doing harm." So irritant an agent, however, 
requires the exercise of great caution in its use. It has been found 
extremely efficient in dysmenorrhea when not due to mechanical causes ; 
also, in menorrhagia and hemorrhage after abortion. In chronic gout 
and the joint affections of chronic rheumatism, it was formerly much em- 
ployed. Externally the Cerate is used to prolong the discharge from 
blisters, setons or issues, and to stimulate the healing of indolent ulcers. 
For these purposes it is considered safer than Cantharides, as its prolonged 
employment does not bring on strangury or vesical irritation. As a 
caustic it is efficient for the destruction of warts and other excrescences, 
and the moistened powder is used as a paste on venereal condylomata, in 
combination with burnt alum or cupric subacetate. The Oil is the most 
efficient preparation for internal administration. 



SACCHARINUM, Saccharin (Unofficial),— is a recently discovered derivative of 
a coal-tar product, Toluene, from which it is prepared by a complicated process. It has 
the chemical title Benzoyl-sulphonic-imide, and the formula C 6 H 4 (CO)(S0 2 )NH. It 
occurs as a white, amorphous powder, with a very sweet taste, and a faint flavor of bitter 
almonds, is soluble in alcohol and in ether [Sugar is not soluble in ether], sparingly in 
cold water, more so in hot water. 

Saccharin is 220 times sweeter than sugar to the taste, and is also an efficient antiseptic. 
It is not a food, like sugar; and has no injurious action on man. It is useful as a substi- 
tute for sugar in cases of diabetes, but it has no curative action upon that disease. 



SACCHARUM, Sugar (Cane-sugar), C 12 H 22 O n , — is the refined sugar 
obtained from Saccharum officinarum, the Sugar-cane, a perennial plant 
of the nat. ord. Gramineae, indigenous to India and adjoining countries, 
but cultivated in tropical regions throughout the world. It is also obtained 
from various species or varieties of Sorghum (nat. ord. Graminese), and 
from one or more varieties of Beta vulgaris, the Sugar-beet (nat. ord. 
Chenopodiacese). It is present in several other grasses, as Zea Mays, 
Maize ; in the juice of various trees (maple, birch, palm, etc.); and in 
many roots. 

Cane-sugar occurs in white, dry, hard crystalline granules, permanent in the air, odor- 
less, of purely sweet taste and neutral reaction, soluble in 0.5 of water and in 175 of 
alcohol at 59 F., in 0.2 of boiling water and in 28 of boiling alcohol, insoluble in ether. 
The aqueous solution, saturated at 59 F., has the sp. gr. 1. 345, and is miscible with alco- 
hol in all proportions. Its freedom from Grape-sugar (glucose) and from more than a 
slight quantity of Inverted Sugar (glucose plus levulose) is ascertained by dissolving I 
gram in 10 Cc. of boiling water, then mixing with the solution 4 or 5 drops of test- 
solution of Silver Nitrate and about 2 Cc. of Aqua Ammonia, and quickly heating to 
boiling, when not more than a slight coloration, but no black precipitate should appear 
after standing at rest for 5 minutes. 

Other Sugars. 

Saccharum Lactis, Sugar of Milk, Lactose, C 12 H 22 O n -j- H 2 0, — see next page. 

Glucose, Dextrose, Grape-szigar, Starch-sugar, C 6 H 12 6 , or hydrated C 6 H 12 6 -f- H 2 
(Unofficial), also known as liver-sugar, diabetic sugar, — forms yellowish nodules or crys- 
tals, very soluble in water and in alcohol, has a sweet taste, less marked than that of cane- 



SACCHARUM LACTIS. 369 

sugar, may be obtained artificially from cane-sugar or from starch, by boiling with a dilute 
mineral acid, or by the action of Diastase, a vegetable ferment formed during the germi- 
nation of grain. Boiling solutions of the alkalies convert it into a brown substance 
(melassic acid). 

Levulose, Fruit-sugar, C 6 H 12 6 (Unofficial), — frequently found with grape-sugar in 
fruits, also in honey. See also Diabetin, below. 

Inosit, Phaseo mannit, C 6 H 12 6 -f- 2H 2 (Unofficial), — exists in the juice of some 
meats, in asparagus, etc. Is very sweet, but does not undergo alcoholic fermentation. 

Allied Substances. 

Theriaca, Treacle, Sugar-house Molasses (Unofficial), — is the uncrystallizable residue 
of the process for refining sugar, — a thick, brown, fermentable syrup, very sweet and of 
sp. gr. about 1.40. It is official in the B. P., and is used in making up some of the official 
pills of that pharmacopoeia. 

Amylum, Starch, C 6 H 10 O 5 , — when boiled with dilute mineral acids or when subjected 
to the action of diastase, ptyalin or pancreatin, starch is converted into glucose. (See 
ante, article Amylum.) 

Cellulose, C 6 H 10 O 5 (Unofficial), — forms the basis of all vegetable fibre, and is isomeric 
with starch. It exists almost pure in cotton and in Swedish filter paper. Pyroxylin, 
Gun-cotton, is dinitro-cellulose. 

Glycogen (Unofficial), — closely resembles starch in its properties, being converted into 
glucose by the same agents which so act on starch. It exists in the liver of all animals. 

Dextrin (Unofficial), — is produced by the action of dilute acids on starch, and is an 
intermediate product in the conversion of starch into glucose. It is a transparent, brittle 
solid, looking like gum, soluble in water and dilute alcohol, is not fermentable, nor is it 
colored by Iodine. 

Preparations. 

Sugar is an ingredient of Pil. Ferri Carbonatis, Pil. Ferri Iodidi, Ferri Carbonas Saccha- 
ratus, Mistura Ferri Composita, Pulvis Cretae Compositus, Pulvis Glycyrrhizae Compositus, 
and the Troches, Syrups, Compound Syrups, etc. 

Physiological Action and Therapeutics. 
Sugar is employed in pharmacy and therapeutics chiefly as a vehicle, a 
corrigent, a preservative and an antiseptic. Syrups protect the active 
ingredients against putrefaction, but not always against fermentation. 
They also protect certain ferruginous preparations against oxidation. As 
an ingredient in troches, powders and extemporaneous mixtures sugar is 
used to cover the taste or to make insoluble substances more easily mis- 
cible with water. It increases the solubility of Lime in water. As a food 
it possesses well-known properties, being a nutrient to adipose tissue and 
a respiratory fuel, and is decidedly diuretic in its action upon healthy 
kidneys. Sugar and sugar-forming food constitute more than one-half 
of the nourishment needed by a healthy person, and when withheld, as 
in diabetes, the patient is actually starved, and undergoes progressive and 
rapid emaciation. Levulose is found to be more easily consumed in the 
system than is cane-sugar, and in the treatment of diabetic patients may 
be used with benefit for some time. Heretofore its cost has been very 
great, but it is now being manufactured in large quantities, and sold at 
a reasonable price, under the trade-name "Diabetin." 



SACCHARUM LACTIS, Sugar of Milk {Lactose),— C 12 H 22 O n + H 2 0,— is one 
of the constituents of the milk of mammals, and is officially described as a peculiar, 
crystalline sugar obtained from the whey of cow's milk by evaporation and purified by 
24 



370 SALIC1NUM. 

re-crystallization. Occurs in white, hard, crystalline masses, yielding a gritty, white 
powder, odorless, permanent in the air, of faintly sweet taste and neutral reaction, soluble 
in about 6 of water at 59 F. and in 1 of boiling water, insoluble in alcohol, ether or 
chloroform. On adding to a solution of sugar of milk in an equal weight of boiling 
water some solution of soda, the liquid turns brownish, and on further addition of test- 
solution of Cupric Sulphate a brick-red precipitate separates. 

Sugar of Milk is the least soluble of all sugars in water and is insoluble in alcohol. It 
enters into alcoholic fermentation with difficulty. In the presence of decomposing albu- 
minous matter and under certain other influences, it undergoes the lactic fermentation, 
which results in the formation of Lactic Acid, Carbon Dioxide and Alcohol. It readily 
reacts with the reduction tests. 

Lactose has been shown to act as a powerful diuretic, especially in cardiac dropsy, in 
which Dr. See considers it " the best and most ceitain diuretic we possess, the excretion 
of urine caused by it being greater than that due to any other drug." He found that it 
acts similarly to, though more powerfully than, Caffeine, while possessing none of the 
disadvantages of the latter. Its diuretic action is but very little in cases where extensive 
renal disease exists, and it has no power over dyspnoea. 

Sugar of Milk is used in the Triturations, also in Dover's Powder, Deodorized Opium, 
etc., as a diluent. Being much harder than cane-sugar it is considered a valuable exci- 
pient for powders requiring fine trituration and the minute subdivision of their medicinal 
constituent. It is less sweet than cane-sugar, and being less apt to ferment in the stomach 
and bowels is better than the latter for use with infants' food. 



SALICINUM, Salicin, C 13 H 18 7 , — is a neutral principle obtained 
from several species of Salix, Willow, and Populus, Poplar, trees of the 
nat. ord. Salicacese. It is found also in Gaultheria procumbens, Winter- 
green (nat. ord. Ericaceae), and in Betula lenta, the Sweet Birch (nat. 
ord. Betulacese), the volatile oils of which, distilled from the leaves of the 
former and from the bark of the latter, consist almost entirely of methyl 
salicylate. (See below.) Salicin occurs in colorless or white and silky, 
shining crystalline needles, or a crystalline powder, odorless, of very 
bitter taste, permanent in the air, of neutral reaction ; soluble in 28 of 
water and in 30 of alcohol, in 0.7 of boiling water and in 2 of boiling 
alcohol ; almost insoluble in ether or chloroform. Dose, gr. x-gj. 

Acidum Salicylicum, Salicylic Acid, HC 7 H 5 3 , — is an organic acid, 
existing naturally in combination in various plants, but most largely pre- 
pared synthetically from carbolic acid. It occurs in light, fine, white, 
prismatic needles, or a crystalline powder, odorless, of sweetish, after- 
wards acrid taste and acid reaction, permanent in the air ; soluble in 
about 450 of water and in 2.4 of alcohol, in 14 of boiling water, 2 of 
absolute alcohol, 2 of ether, 80 of chloroform, very soluble in boiling 
alcohol. 100 parts may be dissolved in 100 of water by the aid of 8 of 
Borax. Dose, gr. v-£j. 

Salicylic Acid is a derivative of Salicin, probably by double oxidation ; but may also be 
considered as a substitution-derivative of Benzene, formed by replacing 2 atoms of its 
hydrogen, the one by hydroxyl, and the other by carboxyl. (See page 195, ante.) It is 
obtained, therefore, either synthetically by combining the elements of Carbolic Acid with 
those of Carbonic Acid, and subsequent purification, — or from natural Salicylates as the 
Oils of Wintergreen and Sweet-Birch, — or from Salicin, by heating with caustic potash 



SALICINUM. 37I 

and treating the mass with hydrochloric acid. The acid prepared from natural sources is 
purer and more efficient than that prepared artificially, and will often be tolerated by a 
patient who cannot bear the latter. 

Official Preparations. 

Salol, Salol (Phenyl Salicylate), C 6 H 5 C 7 H 5 3 , — is the salicylic ether of phenol, now 
obtained from salicylic acid by heating up from 320 to 464 F., excluding the air ; by 
which process the acid is converted into Salol, Water and C0 2 . It is a white, crystalline 
powder, odorless and almost tasteless, nearly insoluble in water, soluble in 10 of alcohol, 
and very soluble in ether, chloroform and oils. On being warmed with an alkali it splits 
up into Salicylic Acid 60, and Carbolic Acid 40. Dose, gr. v-xv, frequently repeated, in 
compressed tablets or in cachets, or suspended by mucilage of acacia or of tragacanth. 

Lithii Salicylas, Lithium Salicylate, LiC 7 H 5 3 , — a white, or grayish- white powder, 
odorless, sweetish, deliquescent, very soluble in water and in alcohol. Dose, gr. v-^j. 

Sodii Salicylas, Sodium Salicylate, NaC 7 H 5 3 , — a white, amorphous powder, odor- 
less, sweetish, permanent; soluble in ^ of water and in 6 of alcohol, also in glycerin. 
Dose, gr. v-^j. 

Physostigminae Salicylas, Physostigmine {or Eserine) Salicylate, — is described 
under Physostigma. Dose, gr. T ^o~¥U"- 

Methyl Salicylas, Methyl Salicylate, Artificial (Synthetic) Oil of Wintergreen, CH g - 
C 7 H 5 3 , — is a colorless liquid, having the characteristic odor and taste of Oil of Gaultheria, 
with the essential constituent of which it is identical. It is wholly identical with Oleum 
Betulse Volatile, and is soluble in all proportions in alcohol, carbon disulphide, or glacial 
acetic acid. Dose, 1T\, v-xv, suspended in water or in sugared water. 

Oleum Betulse Volatile, Volatile Oil of Betula (Oil of Sweet Birch), — is a volatile 
oil distilled from the bark of Betula lenta, the Sweet Birch. It is identical with Methyl 
Salicylate (see above), and nearly identical with Oil of Gaultheria. Russia leather 
derives its odor from this oil. Dose, TT\, v-xv. 

Oleum Gaultheriae, Oil of Gaultheria (Oil of Wintergreen), — consists almost en- 
tirely of Methyl Salicylate, and is nearly identical with the preceding. It is described 
under the title Gaultheria. 

Unofficial Preparations. 

Salophen, Para-amidophenol Salicylate, — contains the equivalent of nearly 51 per 
cent, of Salicylic Acid, and occurs as minute, white, crystalline scales, odorless and taste- 
less, insoluble in water, soluble in alcohol; decomposed by alkalies into Salicylic Acid 
and Acetyl-para-amidophenol ; also by the organism as demonstrated in the urine. Dose, 
gr. v-xv, up to 3 j or jss in the 24 hours. 

Salipyrin, Antipyrin Salicylate, C 18 rI 18 N 2 4 , — is produced by the combination of 
Salicylic Acid 57.7, and Antipyrin 42.3 parts. It is a white, crystalline, odorless powder, 
very soluble in alcohol, insoluble in water. Its claims to preference are based upon its 
comparative harmlessness ( 3 ijss having been taken within 3 or 4 hours without the slight- 
est ill effect) ; also its freedom from unpleasant after-results. Dose, gr. x-xxx every hour 
or 2 hours until 3 i j have been taken. It is best administered in wafers as a powder, or 
in mixture, rubbed up with glycerin and flavored with raspberry syrup. It is not obtain- 
able in this country, owing to a conflict between the patentees thereof and those of antipy- 
rin. It is a very loose combination at best, and there is no reason whatever why as good 
results would not be obtained from the administration of its constituents in conjunction, 
in proper doses for each individual case. (Squibb.) 

Physiological Action. 
Willow-bark is highly astringent and antiperiodic and feebly tonic, 
but is never employed medicinally, owing to its bulk. Salicin is a bitter 
tonic, also antiferment, antiseptic, and highly destructive to low organ- 
isms. It has slight antiperiodic power and is feebly antipyretic. It pre- 
vents the reaction between Amygdalin and Emulsin (see page 74), and 
also that of Ptyalin, etc., on Starch (see page 114). It seems to be devoid 
of toxic power on man, and is mainly excreted as Salicylic, Salicyluric 
and Salicylous acids, being first changed in the bowel into Saligenin and 
Glucose. Salicin is well borne by the stomach. 



372 SALICINUM. 

Salicylic Acid has properties similar to the above, but is much more 
energetic in its action, being a powerful antipyretic and antiseptic. It is 
also anhydrotic, checking local perspiration when locally applied. Inhaled 
it causes irritation of the respiratory passages, producing sneezing and 
cough. In small doses it stimulates the stomach, heart and respiration, 
but moderate quantities derange the stomach, causing nausea and vomit- 
ing, while large doses depress the heart's action and the respiration after 
a primary excitation of both, lower the arterial tension, relax the vessels, 
produce free perspiration, and reduce the temperature in fever. It causes 
vertigo, dilated pupils, tinnitus aurium, a sensation of tension in the 
frontal cerebrum, delirium, and may produce bed-sores from depression 
of the circulation, but does not affect the peripheral nerves as to either 
motion or sensation. In the blood it is first changed to Sodium Salicylate, 
but a portion is again set free and uniting with glycocoll forms Salicyluric 
Acid (HC 9 H 8 N0 4 ), coloring the urine green. It is slowly excreted with 
the secretions generally, especially in the urine, sweat, saliva and bile. 
It stimulates the kidneys, at the same time disinfecting them and increas- 
ing the acidity of the urine, but may so irritate the kidneys as to produce 
albuminuria and hematuria. 

Salicylic Acid is destructive to the torula, prevents alcoholic fermenta- 
tion, also that caused by the organic ferments (pepsin, ptyalin, etc.). In 
solutions containing bacteria, it will prevent their development, if in the 
proportion of i per cent. ; and in that of i in 60 it will destroy them when 
in full activity. 

Sodium Salicylate is remarkably antipyretic in doses of gr. xv, given 
4 or 5 times in 24 hours. It is a powerful diaphoretic, and an efficient 
cholagogue, and it is supposed to possess the curious property of increas- 
ing the fluidity of the bile, at the same time that it promotes its secre- 
tion, — other cholagogues increasing the proportion of solids therein. 
(Brunton.) It has no antiseptic power unless in association with a strong 
mineral acid, which will liberate the salicylic acid. 

Salol is antiseptic, antipyretic, and germicide, in a higher degree than 
either of its constituents. As an antipyretic in fever it stands next after 
Antipyrin, and it acts with such force as to frequently depress the tem- 
perature a degree or two below normal. It is sedative to the cerebro- 
spinal system, and somewhat analgesic. It causes profuse sweating, and 
in a few cases considerable depression has accompanied its antipyretic 
employment; but it is not toxic, and may be used freely in its proper 
dosage, which ranges from 5 to 60 grains, up to 2 or 3 drachms in the 24 
hours. 

Therapeutics. 
Salicin and its derivatives are chiefly used in acute rheumatism, to 
lower temperature, relieve pain, and reduce articular swelling. They 



SALICINUM. 373 

are most suitable to strong, vigorous patients, and if not promptly effi- 
cient they should be abandoned. The acid is much used as an antipy- 
retic in fevers, especially those of septicemic character. It is a useful 
local application in gangrenous wounds, eczema of the hands or feet, 
cancer, burns, and in fetid perspirations, in the last affection being 
used in solution with borax. 

Sodium Salicylate is more soluble than the acid and less irritant to 
the stomach, while in doses about 50 per cent, larger it is equally effi- 
cient. It is employed in 3- to 5-grain doses internally after meals, to 
arrest gastric fermentation, and to prevent acidity and flatulence. It is 
used instead of the acid in acute and chronic rheumatism, to relieve 
headaches, and for phlegmasia alba, in which it is considered very effi- 
cient, — also in cases where there is a tendency to the formation of 
gall-stones. It is considered a very efficient remedy to cut short an 
attack of tonsillitis, a "bad cold," and also other acute affections of 
the respiratory mucous membrane. 

Lithium Salicylate is also non-irritant and is supposed to act towards 
uric acid in the same manner as the other salts of this metal. It is expected 
to be of especial value in acute rheumatism and rheumatic gout. 

Salol is one of the most efficient remedies for duodenal catarrh, 
catarrh of the bile-ducts and catarrhal jaundice ; also in the bilious form 
of sick-headache, and in some forms of neuralgia. Its therapeutic value 
depends chiefly upon its property of splitting up in the alkaline fluids of 
the intestine into Salicylic Acid and Phenol compounds, whereby it 
effects the thorough antisepsis of the intestinal tract and performs the 
work of its constituent elements upon the organism. In all affections 
associated with micro-organisms in the intestines, as acute diarrhoea, 
cholera, dysentery, etc., it has done most excellent service; even in 
Asiatic Cholera. It is highly praised in epidemic influenza (grippe), 
having proven itself remarkably efficient in the treatment of recent 
epidemics of that affection. 

Salol is a remedy of very great value in typhoid fever ; disinfecting the 
ulcerated intestines, it promotes the healing process therein, and hinders 
reinfection. It is highly recommended in dysentery, in cholera, and in 
infantile diarrhoea. Given in the latter affection, a dark staining of the 
child's diapers is often noticed, which is due to the development of car- 
bolic acid from the remedy. Its greatest power is manifested over acute 
rheumatism, in which disease many clinicians maintain that it has no 
superior, if given in 15- to 30-grain doses, up to 2 drachms in the 24 
hours, and continued for some time after the acute symptoms have sub- 
sided. In large doses, however, it is liable to induce symptoms of car- 
bolic acid poisoning, which may be met by administering sodium sulphate 
or any other sulphate. It proves to be an efficient disinfectant in catarrh 



374 SALVIA. 

of the bladder, its constituents being excreted with the urine, and coming 
in contact with the vesical mucous membrane for a considerable length 
of time. It is much quicker in its actionup on the urine than ammonium 
benzoate, as in a day or two, ordinarily, the urine loses its foul odor and 
alkalinity and becomes clear. Dissolved in Retinol, it is considered ' 
especially useful in subacute cystitis, having conquered cases in which 
other remedies had proven ineffectual. 

Externally, it is employed as an antiseptic and deodorant powder, 
against impetigo, eczema, sycosis and other skin diseases ; and has done 
good service as an insufflation in the treatment of ozaena. In spirituous 
solutions (5 per cent.) it is used with various flavoring agents in the 
preparation of mouth-washes, and dentifrices; and it also enters into the 
composition of soaps, face powders, and other toilet articles. A mixture 
of equal parts of Camphor and Salol, heated together, has given good 
results in the treatment of suppurations of the middle ear ; giving no 
pain and setting up no inflammation of the parts. 

Salix Nigra, the Pussy Willow, grows along streams in the Southern 
States. A fluid extract is on the market, and may be used in doses of 3SS 
thrice daily, as a sexual sedative. 

Salophen is considered non-toxic in action upon the organism, while affording all the 
medicinal qualities of Salol. It has been employed with success, in dosage of % j to g jss 
daily, in the treatment of acute rheumatism, acute rheumatic arthritis, typhoid fever, 
cholera and allied conditions; also in neuralgia and sciatica, gastro- enteritis, pyelitis, and 
cystitis. In intestinal dyspepsia, with flatulence, and in gastrectasis it has been used with 
decided benefit, in the latter affection chiefly for the relief of the fermentive disturbances 
to which the dilated stomach is so liable. 

Salipyrin has been employed with excellent results in acute and chronic rheumatism, 
rheumatic sciatica, neuralgia, and influenza. In rheumatic fever I5grain doses are given 
at short intervals (^ hour to I hour), until about gij have been taken, continuing with 
smaller doses for a long time after convalescence, to prevent relapses. A dose of 8 grains 
is often sufficient against neuralgia. It was extensively used during the epidemic of in- 
fluenza in 1 89 1, and highly extolled for efficiency therein, as well as for its freedom from 
cardiac action. As it is not obtainable in this country, by reason of a legal conflict be- 
tween its patentees and those of Antipyrin, and as it is a very loose combination at best, 
Dr. Squibb suggests that there is no good reason whatever why as good results should 
not be obtained from the administration of its constituents in conjunction, in proper doses 
to suit each individual case, and in the proportion of about 3 of Salicylic Acid to 2 of 
Antipyrin. 



SALVIA, Sage, — the leaves of Salvia officinalis, the common garden Sage, a peren- 
nial plant of the nat. ord. Labiatae, native in Southern Europe, but cultivated in our gardens 
for its strong, fragrant odor. The leaves are about 2 inches long, finely crenulate, grayish- 
green, thick and wrinkled ; soft, hairy and glandular beneath, of aromatic odor and 
bitterish, astringent taste. They contain tannin, resin, etc., and a volatile oil which 
consists of Salviol (C 10 H 16 O), camphor and terpenes. There are no official preparations. 
Dose of the powdered leaves, gr. xx-xxx, in infusion. 

Sage is aromatic, stimulant, tonic, astringent, and a vulnerary. It was highly esteemed 
in ancient times, and even yet is popular as a domestic cure-all with many people. In an 
infusion it may be used as a beverage in febrile conditions and to check sweating, also for 
the night-sweats of phthisis. Like other members of the same class it has a slight influence 
over enteralgia and flatulence. It makes a good astringent and stimulating gargle. 



SAMBUCUS — SANGUINARIA. 375 

SAMBUCUS, Elder, — the flowers of Sambucus canadensis, the common Elder, a 
shrub of the nat. ord. Caprifoliacese, from 6 to io feet high, having small white flowers dis- 
posed in loose cymes of five divisions, the cream-colored corolla being whorl-shaped with, 
five stamens on the tube. The berries are small, globular, and when ripe of a deep purple 
color. The plant contains a small quantity of a volatile oil, also a resin and valerianic 
acid. The common Elder of Europe (S. nigra) is more of a tree, and is official in the 
B. P. There are no official preparations. Dose, gr. xxx- 3 j, in hot infusion. 

Elder-flowers are stimulant and diaphoretic, also perhaps diuretic in some degree. The 
berries are diaphoretic and laxative, while the inner bark is a hydragogue cathartic and in 
large doses emetic. Formerly the inspissated juice of the berries was employed as an 
alterative in rheumatism and syphilis, but at present the flowers are used only for flavoring 
purposes. Elder-flower Water (Aqua Sambuci, B. P.) is a nice vehicle for collyria and 
lotions. 



SANGUINARIA, Blood-root,— is the rhizome, collected in 
autumn, of Sanguinaria canadensis, a perennial plant of the nat. ord. 
Papaveracese, which grows abundantly throughout the U. S., being one of 
the earliest and most beautiful of the spring flowers. It has a single white 
flower on an erect stalk, the petals often tinged with rose or purple. Leaf 
reniform, smooth, deeply lobed, yellow-greenish above, paler beneath, and 
strongly marked with orange-colored veins. The rhizome is about 2 
inches long and x /z inch thick, cylindrical, horizontal, wrinkled, reddish- 
brown, fracture short, waxy, with numerous small red resin-cells, bark 
thin, odor slight, taste very bitter and acrid. It contains 3 alkaloids, — 
Sanguinarine, C 17 H 15 N0 4 , which is probably identical with Chelerythrine 
(see Chelidonium), Porphyroxine, and Puccine, combined with Cheli- 
donic and Sanguinarinic acids, — also resin, gum, albumen, sugar, etc. 
The salts of its alkaloids are of brilliant red and orange colors and are 
all soluble in water. Dose of the powdered root as an expectorant, gr. 
j-v ; as an emetic, gr. x-xx ; best given in pill. 

Preparations. 

Extractum Sanguinariae Fluidum, Fluid Extract of Sanguinaria. — Dose, mj-v 
as expectorant and stimulant; Tn^x-lx as emetic, cautiously. 

Tinctura Sanguinariae, Tincture of Sanguinaria, — strength 15 per cent. Dose, 
as expectorant, TTLv-sjj, as emetic ^j-iij. 

Sanguinarina, Sanguinarine, C 17 H ]5 N0 4 (Unofficial), — is the chief alkaloid and prob- 
ably the active principle of the plant. Dose, as an expectorant, gr. y 1 ^— \ ; as an emetic, 
gr. % repeated in 10 minutes will produce vomiting after the second or third dose. 

Physiological Action. 
Sanguinaria is sternutatory, sialagogue, expectorant and emmenagogue, 
a systemic emetic, a cardiac paralyzer, a violent irritant, an acro-narcotic 
poison and an alterative. Its taste is bitter and acrid. It causes violent 
sneezing when inhaled, increases secretion by irritating the secretory 
organs as it is eliminated, and in full doses produces salivation, catharsis 
and vomiting with great depression. Overdoses are violently irritant, 
the heart's action being at first increased, together with the arterial ten- 
sion, then markedly depressed, and finally paralyzed by stimulation of 



376 SANTALUM ALBUM. 

its inhibition. The reflexes are lowered by paralysis of the spinal centres, 
muscular contractility impaired, the pupils dilated, temperature lowered, 
cold sweats, great thirst and collapse supervene, and death occurs by 
paralysis of the cardiac and respiratory centres, often preceded by con- 
vulsions. Locally used, Sanguinaria is a feeble escharotic. 

» Antagonists and Incompatibles. 

Opium, Amyl Nitrite, Atropine, etc., to antagonize the depression of the circulation and 
the local irritant action. Incompatibles are alkalies, Tannin, and most of the metallic 
salts. 

Therapeutics. 

As a tonic to the stomach and a stimulant to the liver Sanguinaria or 
its active principle is well employed in small doses (gtt. iij of the tinc- 
ture or gr. yL- of the alkaloid) for atonic dyspepsia, duodenal catarrh and 
catarrh of the biliary ducts with jaundice. Respiratory affections are 
often remarkably amenable to its influence, particularly chronic nasal 
catarrh, asthma and acute bronchitis. In these affections expectorant 
doses are the best, namely, gtt. x of the tincture, and in the former the 
powder locally as a sternutatory. A decoction is a very efficient gargle 
in the sore-throat of scarlet fever. Sanguinaria is a very serviceable 
remedy in chronic bronchitis and in amenorrhoea of functional charac- 
ter, also in functional impotence from irritability of the organs, with 
daily losses and relaxation of the genitalia. By many practitioners it is 
considered a specific emetic in croup, but others look upon it with dis- 
favor as too uncertain and harsh in its action. It has been thought to 
have alterative properties, and hence is frequently used with Stillingiaand 
other plants in the treatment of strumous and syphilitic affections. In 
pneumonia of typhoid type and in pleuro-pneumonia it has undoubtedly 
been of great service in many cases. 

Locally, the powdered root is well employed as an application to foul 
ulcers and fungous granulations, and by insufflation to nasal polypi, and 
for chronic hypertrophy of the nasal mucous membrane. 

Sanguinarine has been used with good results in pneumonia, bronchitis 
and atonic dyspepsia. Doses of gr. y L to \ are expectorant without irri- 
tating the stomach ; and still smaller doses (gr. -^ to y 1 ^) are stimulating 
to the gastric and intestinal secretions. 



SANTALUM ALBUM, White Sandalwood,— is the source 
of the official Oil of Santal (see below), but is not itself official. It is a 
tree of the nat. ord. Santalacese, having its habitat in India but now nearly 
exterminated there ; — Santalum ciirinum, the yellow Sandalwood, from the 
Sandwich and Feejee Islands, is more commonly met with in commerce. 



SANTALUM RUBRUM — SANTONICA. %'J'J 

Preparations. 

Oleum Santali, Oil of Santal {Oil of Sandalwood), — a volatile oil distilled from the 
wood of Santalum album ; a pale-yellow liquid, of sp. gr. about 0.975, soluble in al- 
cohol, of peculiar and aromatic odor, pungent taste and acid reaction. Dose, tr^x-ocxx, 
in emulsion or capsule. 

Extractum Santali Fluidum, Fluid Extract of Santal (Unofficial), — made with 
alcohol as a menstruum. Dose, ^j-iij. 

Physiological Action and Therapeutics. 

Sandalwood is a very agreeable perfume. The Oil is astringent to 
mucous membranes, producing dryness of the fauces, thirst, colic, and a 
sense of fulness in the renal regions. In concentrated form it is a local 
irritant, but the effects of large doses have not been studied. It is exten- 
sively used in chronic bronchitis and in gonorrhoea, forming the contents 
of proprietary capsules which are sold for the cure of the latter disease in 
all drug stores. As found in the shops it is extensively adulterated with 
Oil of Cedar, and hence is a very unreliable remedy. 

SANTALUM RUBRUM, Red Saunders,— is the wood of Pterocarpus santalinus, 
a tree of the nat. ord. Leguminosae, native in India. It comes as a dark reddish-brown, 
heavy, coarse wood, in chips or as a coarse powder, nearly inodorous and tasteless, not 
imparting any red color to water when macerated in it, but coloring alcohol, ether and 
alkaline solutions a bright red. The wood has no medicinal properties and is employed 
solely for the purpose of coloring alcoholic preparations. It is a constituent of Tinctura 
Lavandulae Compositus. 



SANTONICA, Levant Wormseed, — the unexpanded flower- 
heads of Artemisia pauciflora, a small, perennial plant of the nat. ord. 
Compositae, which grows in Asia Minor, Turkestan, etc., and contains a 
volatile oil and the peculiar, crystalline principle, Santonin (see below). 
Flower heads about -^ inch long, pale-greenish brown, smooth, resem- 
bling seeds in appearance, but consisting of imbricated involucral scales 
with a green midrib, enclosing 4 or 5 tubular florets ; odor strong and 
peculiar, somewhat camphoraceous, taste aromatic and bitter. Dose, gr. 
x-lx. 

Santoninum, Santonin, C 15 H 18 3 , — the neutral principle obtained 
from Santonica. Occurs in colorless, prismatic crystals, turning yellow 
on exposure to light, odorless, of bitter after-taste, and neutral reaction, 
nearly insoluble in cold water, but soluble in 250 of boiling water, in 40 
of alcohol, 3 of boiling alcohol, 140 of ether, 4 of chloroform, also in 
solutions of the caustic alkalies. Dose, gr. %-] for a child, gr. j-v for 
an adult, not repeated too soon, as the action of the drug is slow. 

Preparation. 

Trochisci Santonini, Troches of Santonin, — each troche contains about l / 2 grain of 
Santonin, with Sugar, Tragacanth, and Stronger Orange Flower Water. Dose, j-v, as 
per age.' 

Santonin and its preparations are sensitive to light and should be kept in amber-colored 
bottles tightly corked. 



378 sapo. 

Physiological Action and Therapeutics. 

Santonin is anthelmintic to the round worm (Ascaris lumbricoides), 
also but in less degree to the thread-worm (Oxyuris vermicularis). It is 
taken into the blood as Sodium Santoninate, and affects the cerebral 
faculties and the vision, objects appearing at first blue, green or red, then 
yellow (chromatopsia), often succeeded by blindness for a week or more. 
Large doses disturb the consciousness of the patient, produce a sort of 
intoxication, tremors, weakness, with enfeebled respiration and slowing 
of the pulse, coldness of the surface, vomiting, sweating, mydriasis, con- 
vulsions and death from failure of respiration. A dose of 2 grains is said 
to have proved fatal to a feeble child of five years old. It is excreted by 
the kidneys, coloring the urine if acid a greenish-yellow, if alkaline a 
reddish-purple, and produces considerable enuresis. 

As an anthelmintic Santonin is the most certain agent against the round- 
worm, and is best administered in powder with Calomel at bedtime after 
a day of fasting, a Senna-draught or a dose of Castor Oil being used the 
following morning. It also acts fairly well in suppository against the 
thread-worm, but is inoperative against tape-worm. Some observers con- 
sider it more promptly efficient when given in Castor Oil, and that the 
oil lessens the risk of evil after-effects. It has also been prescribed with 
great benefit for nocturnal incontinence of urine, and for certain eye 
affections, particularly amaurosis from atrophic or inflammatory changes 
in the retina and optic nerve. It should never be given to children during 
a fever, nor when the bowels are constipated, for fear of toxic results. 



SAPO, Soap, White Castile Soap, — is Soap prepared from soda and 
olive oil ; a whitish solid, hard, yet easily cut when fresh, of faint, peculiar 
odor free from rancidity, a disagreeable, alkaline taste, and alkaline 
reaction ; readily soluble in water and in alcohol. Is an ingredient of 
several of the official pills. 

Sapo Mollis, Soft Soap (Green Soap), — is Soap prepared from potassa 
and linseed oil ; a soft, unctuous mass, of a yellowish-brown color, soluble 
in about 5 of hot water and in 2 of hot alcohol. The name Green Soap 
is a misnomer. 

Insoluble Soaps are combinations of the oily acids with earths and 
metallic oxides. Two of them are official, viz., — the Soap of the Mon- 
oxide of Lead (Emplastrum Plumbi) and the Soap of Lime (Linimentum 
Calcis). 

Saponification is a process of double decomposition between a fat (stearate, palmitate 
or oleate of glyceryl) and an alkali, in which glycerin and the metallic salt of the fatty 
acid are formed. The glycerin, not being saponifiable, is set free, but the fatty acid 
(stearic, palmitic or oleic) unites with the salifiable base to form soaps, which are there- 
fore mixed stearates, oleates and palmitates of various bases. Nearly all soaps are oleates 



SARSAPARILLA. 379 

or palmitates (or both) of sodium or potassium (or both). Hard soaps are soda soaps, 
soft soaps are potassium soaps. [Compare the articles Oleum Olivae, Adeps, Acidum 
Oleicum, Glycerinum, etc.] 

Unofficial Soaps. 

Sapo Animalis, Curd Soap, — official in the Br. Phar., — is made with Soda and a 
purified animal fat, consisting chiefly of Stearin. Used in pills and suppositories. 

Sapo Medicatus, — official in the Fr. Codex, — is a Soda soap prepared from expressed 
Almond Oil. 

Preparations. 

Emplastrum Saponis, Soap Plaster, — has of Soap 10, Lead Plaster 90, Water q. s. 

Linimentum Saponis, Soap Liniment, — has of Soap 7, Camphor 4^, Oil of Rose- 
mary I, Alcohol 75, Water to 100. Opodeldoc is a similar preparation. Soap Liniment 
is an ingredient of Chloroform Liniment. 

Linimentum Saponis Mollis, Liniment of Soft Soap {Tincture of Green Soap), — 
has of Soft Soap 65, Oil of Lavender 2, Alcohol 30, Water to 100. 

Physiological Action and Therapeutics. 

Soap is a laxative, antacid and antilithic ; externally it is a stimulating 
discutient, and is used for cleansing the skin, removing fatty substances 
and softening the epidermis, but if too long applied it may prove de- 
cidedly irritant. It is a good antidote in poisoning by acids, and should 
be administered freely in such cases until more energetic alkalies can be 
obtained. In aqueous solution it makes a useful enema for constipation, 
or a plug of soap may be inserted into the rectum. 

Soft Soap is a powerful detergent stimulant and is much employed 
in skin diseases, especially eczema rubrum, in which the tincture is well 
rubbed on, the diseased skin well washed and then covered with a bland 
ointment. The tincture is the most elegant form for use, and may be 
diluted with three parts of alcohol for shampooing the scalp. 

The Liniment is used with friction in sprains, bruises and stiff joints, 
being a little more stimulating than camphor-liniment. It makes a good 
basis for extemporaneous liniment prescriptions. 



SARSAPARILLA, — is the root of Smilax officinalis, Smilax medica, 
and of other undetermined species of Smilax, plants of the nat. ord. 
Liliacese, growing in Mexico, Central America, Brazil, etc. There are six 
commercial varieties on the market, which are generally put up in differ- 
ently formed bundles. The roots are about as thick as a goose-quill, red- 
dish-brown, several feet in length, covered with rootlets and folded in 
bundles about 18 inches long, taste mucilaginous, bitter and acrid. It 
contains starch, resin, calcium oxalate, an essential oil, and an acrid 
neutral principle named Parillin or Smilacin, which when acted on by 
dilute sulphuric acid affords another principle, Parigenin. 

Preparations. 

Extractum Sarsaparillse Fluidum, Fluid Extract of Sarsaparilla. — Dose, gss-j. 

Extractum Sarsaparillae Fluidum Compositum, Compound Fluid Extract oj 
Sarsaparilla, — has of Sarsaparilla 75, Glycyrrhiza 12, Sassafras 10, Mezereum 3, Glycerin 
10, Water and Alcohol to 100. Dose, ^ss-j. 



380 SASSAFRAS. 

Syrupus Sarsaparillae Compositus, Compound Syrup of Sarsaparilla, — has of the 
Fluid Extract 20, Fl. Ext. of Glycyrrhiza 1^, Fl. Ext. of Senna 1]4, Sugar 65, Oils of 
Sassafras, Anise and Gaultheria, each 0.01, Water to 100. Dose, 3J-^j. A good 
vehicle for Potassium Iodide. 

Decoctum Sarsaparillae Compositum, Compound Decoction of Sarsaparilla, — has 
of Sarsaparilla 10, Sassafras 2, Guaiacum Wood 2, Glycyrrhiza 2, Mezereum 1, Water to 
100. Dose, §j-iv. 

Syrup of Sarsaparilla (Unofficial), — so much used in flavoring soda-water, is a mix- 
ture of the oils of sassafras and gaultheria in syrup. 

Physiological Action and Therapeutics. 
Those who believe that Sarsaparilla has any action ascribe to it prop- 
erties as a diuretic, diaphoretic, tonic and alterative. So far careful 
physiological experiments with the drug and its principle have given 
negative results. It has been used as a so-called "blood-purifier" in 
scrofula, chronic abscesses, necrosis, old ulcers, many cutaneous diseases, 
etc., but is generally combined with other agents of undoubted activity. 
The compound decoction is considered a good agent in tertiary syphilis, 
especially in debilitated subjects ; while the other preparations are com- 
monly employed as vehicles for Potassium Iodide and Mercuric Chloride 
in syphilis of any form. Whenever used, the compound decoction will 
give the best results, the hot water and its other constituents having 
medicinal value, if the principal ingredient has none. 



SASSAFRAS, — is the root-bark of. Sassafras variifolium, a tree of the nat. ord. 
Laurinese, growing throughout the U. S., and occurs in irregular fragments of a bright, 
rust-brown color, strongly fragrant, taste sweetish, aromatic and somewhat astringent. 
The volatile oil is official, and contains, as its principal constituent, Safrol, also obtained 
from Camphor oil, and used largely to disguise the odor of the fatty bases in soap manu- 
facturing. 

Sassafras Medulla, Sassafras Pith, — is the pith of the tree described above. Occurs 
in slender cylindrical pieces, often curved or coiled, light, spongy, white, inodorous, 
insipid. Macerated in water it forms a mucilaginous liquid which is not precipitated on 
the addition of alcohol. 

Mucilago Sassafras Medullar, Mucilage of Sassafras Pith, — has of the pith 2, in 
water 100. Dose, indefinite. 

Oleum Sassafras, Oil of Sassafras, — a volatile oil distilled from Sassafras, — a colorless 
or yellowish liquid, having the odor of Sassafras, a warm, aromatic taste and a neutral 
reaction, readily soluble in alcohol. Sp. gr. about 1.080. Treated with cold nitric acid 
it becomes of a dark red color, and is finally converted into a red resin. Dose, fflj-iv. 

Infusum Sassafras, Infusion of Sassafras (Unofficial), — is a popular "tea" which 
may be taken ad libitum. 

Sassafras is a constituent of the three compound Sarsaparilla preparations. 

Sassafras is a stimulant diaphoretic when used in quantity of the hot infusion. It enjoys 
a popular reputation as a " blood-purifier," and has a destructive influence on infusoria. 
It is employed chiefly in combination with Sarsaparilla and Guaiacum in cutaneous disor- 
ders and rheumatic and syphilitic affections. The mucilage of the pith is an excellent 
demulcent drink in acute gastritis or enteritis, or in poisoning by irritant or corrosive agents. 
It may also be used in extemporaneous prescriptions to hold insoluble substances in sus- 
pension and for flavoring purposes. The oil is chiefly used for flavoring in mixtures and 
confectionery. The syrup popularly known as " Sarsaparilla" is composed of Oil of 
Sassafras and Oil of Gaultheria, in syrup. 



SCAMMONIUM — SCILLA. 38 I 

SCAMMONIUM, Scammony, — is a resinous exudation from the 
root of Convolvulus Sca7?imonia, a plant of the nat. ord. Convolvulacese,' 
growing chiefly in Syria and Asia Minor. It occurs in irregular, angular 
pieces or circular cakes, of a greenish-gray or blackish color, a peculiar, 
cheese-like odor, and a slightly acrid taste ; easily triturated into a dirty- 
gray powder, and with water yields a smooth, greenish emulsion. It 
contains about 80 per cent, of Resin, with gum, sugar, starch, etc. The 
active principle, Jalapin, is probably identical with the Convolvulin of 
Jalap, and is contained in the root, the resin, etc. Dose, gr. v-x. 

Preparations. 
Resina Scammonii, Resin of Scammony, — is wholly soluble in ether. Dose, gr. 

iij-viij. 

Extractum Colocynthidis Compositum, — (see ante, page 206) contains 14 per 
cent, of Resin of Scammony, and is an ingredient of the Compound Cathartic Pill. 

Physiological Action and Therapeutics. 

Scammony is an active cathartic, stimulating the liver and the intesti- 
nal glands, and causing free purgation in a few hours, with considerable 
griping. Its solution in the bile is necessary to its action, and it combines 
with the soda in that secretion. Though quite drastic in action it is 
somewhat uncertain as a purgative and is generally employed in combina- 
tion with similarly acting agents. It is anthelmintic against the tapeworm, 
and in overdoses produces a high degree of irritation. 

It is used as a drastic purgative for children with Calomel or Potassium 
Sulphate, when an active cathartic is indicated. In the same way it is 
the appropriate agent on the principle of derivation in dropsies and 
cerebral affections, also in torpid states of the intestines with much slimy 
intestinal mucus; but it is contraindicated in cases attended by irritability 
of the stomach and bowels. 



SCILLA, Squill, — is the sliced bulb of Urglnea maritima, a peren- 
nial plant of the nat. ord. Liliacese, growing on the shores of the 
Mediterranean. It comes in narrow segments about two inches long, of 
yellowish-white or reddish color, slightly translucent, inodorous, mucil- 
aginous, bitter and acrid to the taste. Its active principle has not yet 
been definitely isolated, but it is probably the acrid, bitter glucoside 
Scillitoxin. Other principles have been obtained and named Scillipicrin, 
Scillitin and Scillin, also Sinistrin, a peculiar carbo-hydrate or mucilage, 
and the usual constituents of plants. Dose, in powder, gr. j-iij. 

Preparations. 

Extractum Scillse Fluidum, Fluid Extract of Squill. — Dose, rt\J-v. 
Tinctura Scillae, Tincture of Squill, — 15 per cent. Dose, nXv-xxx. 
Acetum Scillae, Vinegar of Squill,— 10 per cent. Dose, HVx-gj. 



382 SCOPARIUS. 

Syrupus Scillae, Syrup of Squill, — has of the Acetum 45 parts, with Sugar 80, and 
Water to 100. Dose, ^ss-ij. 

Syrupus Scillae Compositus, Compound Syrup of Squill, — has of the fluid extracts 
of Squill and Senega, each 8, Tartar Emetic 0.2, Calcium Phosphate I, Sugar 75, Water 
to 100. Is known popularly as Coxe's Hive Mixture, and contains a little less than one 
grain of Tartar Emetic to the fluid ounce (15 grains in 17 fl. ozs.). Dose, for children 
Tr i v- 3J> tne l atter being an emetic dose; for adults, as an expectorant rr^xx-xxx. 

Physiological Action and Therapeutics. 

In small doses Squill is expectorant, in larger doses emetic and diuretic, 
and in overdoses it is a violent irritant poison, producing nausea, vomiting, 
purging, gastro-enteritis, strangury, bloody urine, perhaps suppression of 
urine, paralysis and convulsions, with death by paralysis of the heart in 
systole. Medicinal doses slow the heart, making the pulse stronger and 
slower, raising the arterial tension, and increasing the flow of urine (like 
Digitalis). Its active constituents diffuse into the blood, and its systemic 
effects follow on its application to the skin and seem to be exerted upon 
the mucous membrane of the secretory organs, especially affecting the 
bronchial, gastro-intestinal and genito-urinary. 

Squill is employed in medicine for its expectorant and diuretic effects. 
It is especially applicable in cardiac dropsy, combined with Digitalis or 
the saline diuretics, and in chronic bronchitis, in which it may be associ- 
ated with Ipecac or Ammonia, Asafcetida, Benzoin, etc. It is also used 
in croup, but is usually combined in this affection with some other emetic, 
as Tartar Emetic in the Compound Syrup, a mixture which may produce 
very depressing effects and should be used with caution. In whooping- 
cough and other irritant coughs with tickling sensations in the throat the 
Syrup or Vinegar of Squill is often of great service. 

The action and uses of Squill should be studied in connection with 
those of Digitalis and Ipecacuanha. 



SCOPARIUS, Broom, — the tops oi.Cytisus Scoparius, the Broom- 
plant, a common garden shrub of the nat. ord. Leguminosae, having 
small, downy leaves and numerous large golden-yellow flowers. It occurs 
in thin, flexible twigs, usually free from leaves, nearly smooth, tough, of 
a peculiar odor when bruised and a disagreeably bitter taste. It contains 
Scoparin, C 2 iH 2 2O 10 , a neutral, crystallizable principle; and Sparteine, 
C 15 H 26 N 2 , a volatile, liquid alkaloid, having no oxygen, but possessing 
very decided basic qualities and being highly poisonous. 

Preparations. 

Extractum Scoparii Fluidum, Fluid Extract of Scoparius, — made with diluted 
alcohol. Dose, 3 ss-i j . 

Decoctum Scoparii, Decoction of Broom-tops (Unofficial), — ^j to the pint. Dose, 
^j every three hours until a diuretic effect is produced. 



SCOPARIUS. 383 

Sparteinae Sulphas, Sparteine Sulphate, — white, prismatic crystals, or a granular 
powder, of slightly saline and bitter taste, very soluble in water and alcohol. Dose, gr. 
^-A, hypodermically ; — gr. ^-ij per oreni. Small doses, gr. ^-\, every five hours, for 
cardiac action; — larger, gr. j-ij, for diuresis. (Clarke.) Larger doses are necessary, say 
gr. iss-iij, ter die. (Prior.) 



Physiological Action. 

Broom-tops are diuretic and laxative, also emetic and cathartic in large 
doses. In the form of decoction they have long been a favorite diuretic 
and vehicle for other diuretics, in the treatment of dropsies, both cardiac 
and renal, but are considered most reliable in the dropsy of renal origin. 

Sparteine has been thought to resemble Coniine in its action, paraly- 
zing the end-organs of the motor nerves and vagi, lowering the reflex 
excitability of the cord, and causing death by paralyzing the respiratory 
centre in the medulla. Recent observations, however, place it in the 
Digitalis group, and in the front rank among the members thereof. 

In small doses Sparteine slows and strengthens the heart-beats, and 
raises arterial tension, at the same time increasing the cutaneous and renal 
circulation, so that the surface becomes flushed and moist, and in some 
cases marked diuresis and diaphoresis occur. The respiration, at first 
quickened, is soon slowed and deepened, — the patient having a sense of 
increased warmth and well-being, and if suffering from irregular cardiac 
action, prascordial distress and dyspnoea, these symptoms are promptly 
relieved. If the pulse has been abnormally slow Sparteine will quicken 
it, though its general action is to slow the cardiac rate. An overdose 
brings on marked palpitation, a small and rapid pulse of very high tension, 
praecordial pain and a sense of " tightness " about the chest, with anxiety, 
and a feeling of intense debility, perhaps. even muscular tremor. Death 
occurs by asphyxia from depression of both the centre and the muscles 
of respiration. 

The action of Sparteine upon the circulation is manifested quickly as 
compared with that of other similarly-acting drugs. In y 2 hour after its 
ingestion the pulse is markedly slower, — in another y 2 hour the arterial 
tension rises, and both effects last from 5 to 6 hours. When taken regu- 
larly for several days or weeks its influence remains for nearly a week after 
its discontinuance. There is, however, no danger of cumulative action, 
and though the dosage employed has varied from gr. -^ every 4 hours, to 
gr. xij in 24 hours, no toxic action was observed, nor was there any evi- 
dence of accumulation, even when given continuously for 3 to 4 months. 
(Clarke.) Only from a dose of gr. xxxj were evil effects observed. (Prior.) 

Its diuretic power on healthy persons is denied by some observers and 
affirmed by others, though all acknowledge it in disease. It is accompa- 
nied by increased excretion of urea, — is due to the increase of blood- 



( 



( 



384 SCUTELLARIA. 

pressure both behind and in front of the renal circulation, — and is 
produced only by large doses, gr. ^-gr. ij. 

Sparteine acts directly on the cardiac muscle, as well as upon the inhib- 
itory apparatus, thus giving greater force to the cardiac contractions, and 
regulating (generally slowing) the pulse-rate. It also stimulates the vaso- 
motor centre to contract the vessels throughout the splanchnic area, thus 
increasing the circulation in the skin and kidneys, and raising arterial 
tension generally. 

Therapeutics. 

Broom-tops are a favorite remedy for dropsies of cardiac origin, and 
for the general anasarca of chronic kidney disease, but are inadmissible 
in acute renal affections or where there is pulmonary congestion or in- 
flammation. 

Sparteine has been employed with very great benefit in cardiac affec- 
tions requiring stimulation of the heart's action with the smallest possible 
increase of arterial tension, relief of dyspnoea, prsecordial pain, palpita- 
tion and oedema. In such cases small doses, gr. -^ to J, are best, and 
as the influence of the drug is remarkably sustained, they need not be re- 
peated oftener than once in 5 or 6 hours. It has given the most marked 
satisfaction in mitral regurgitation, in which it relieves all the symptoms; 
also in mitral stenosis, when the pulse is small, weak and irregular. In 
aortic regurgitation, it quiets excited action of the heart, without unduly 
prolonging the systole, and is of great value. Used in chronic Bright's 
disease, with hypertrophy and high arterial tension, it stimulates the heart 
without increasing the tension.. In exophthalmos, it gives remarkable 
relief to all the symptoms. For cardiac palpitation and arrhythmia, small 
doses are of great service. In asthma it is of signal benefit, cutting short 
the paroxysms, and rendering their recurrence much less frequent. In 
the opium-habit it is used at periods of depression during the treatment, 
to overcome the "plateau" shown in the sphygmograph trace, by stimu- 
lating the cardiac action. (Jennings.) For this purpose, doses of gr. iss-iij 
three or four times daily are necessary. (Prior.) 



SCUTELLARIA, Skull-cap, — is the plant Scutellaria lateriflora, an indigenous, 
perennial herb of the nat. ord. Labiatse, growing in moist places and along ditches ; hav- 
ing small, pale-blue flowers disposed in long, leafy racemes, of slight odor and bitterish 
taste. It contains a little volatile oil, traces of a bitter principle, besides fat, tannin, sugar. 

Extractum Scutellariae Fluidum, Fhtid Extract of Scutellaria. — Dose, gss-ij. 

Scutellaria produces no very obvious effects when taken internally. By some practi- 
tioners it is said to have tonic, nervine and antispasmodic powers, and it has been used in 
domestic practice to calm the nervous system in diseases characterized by restlessness, 
tremors, spasms, twitching of the muscles, hyperesthesia, etc., as chorea, delirium tremens, 
nervous exhaustion from fatigue or over-excitement, hydrophobia, hysteria and epilepsy. 
The Scutellarin of the eclectics is not a proximate principle, but an extract precipitated 
by alum from a concentrated aqueous tincture. It is given in dose of gr. j-iv. 



SENEGA SENNA. 385 

SENEGA, — is the root of Polygala Senega, an indigenous, perennial 
plant of the nat. ord. Polygaleae, having small, white flowers in a close 
spike at the summit of the stem. The root is about 4 inches long, with a 
knotty crown and tortuous, spreading branches, thick bark inclosing a 
porous, yellowish wood ; odor slight but unpleasant, taste at first sweetish, 
afterwards acrid. Its principal constituent is the glucoside Senegin, 
C 32 H 51 18 , which is identical with Saponin, and closely allied to Digitonin. 
It is a white, amorphous powder, readily soluble in alcohol and hot water, 
forming a soapy emulsion when mixed with boiling water, and decom- 
posed by HC1 into sugar and Safogenin, C 14 H 22 2 . 

Preparations. 

Extractum Senega? Fluidum, Fluid Extract of Senega. — Dose, TTlx-xx. 

Syrupus Senegae, Syrup of Senega, — has of the fluid extract 20, Aqua Ammoniae %, 
Sugar 70, Water to 100. Dose, gj-ij. 

Syrupus Scilla? Compositus, Compound Syrup of Squill, — contains 8 per cent, of 
Senega. (See page 382.) Dose for children, TT^v- gj ; for adults as an expectorant, 
Tl\xx-3ss. 

Physiological Action and Therapeutics. 

Senega is a stimulating expectorant, a diuretic and a diaphoretic. It 
causes irritation of the throat, with some salivation and gastro-intestinal 
irritation, an inclination to cough, increased bronchial secretion, and 
perhaps some diuresis and diaphoresis. Inhaled as a snuff it is very irri- 
tant to the mucous membrane of the nose, causing cough, sneezing and 
nasal catarrh. Senegin is violently irritant and a powerful depressant to 
the heart, vessels, nervous and muscular systems. It is excreted by the 
bronchial mucous membrane, the kidneys and the skin, all of which it 
stimulates and in large quantity irritates. 

The use of Senega is chiefly that of a stimulating expectorant in chronic 
bronchitis, the second stage of acute bronchitis, typhoid pneumonia, 
asthma, croup, and as a diuretic in dropsy due to renal disease. It re- 
moves the tightness and oppression experienced in the subacute chest affec- 
tions, relieves the cough and rapidly promotes expectoration. When the 
mucous is tough and scanty this remedy is of no value. It has been used 
with benefit in amenorrhcea, given in saturated decoction for two weeks 
before the expected period. In chronic rheumatism and in rheumatic 
paralysis its stimulating and diaphoretic powers have been of great value. 
Senegin has been successfully used in 2-grain doses as a remedy for uterine 
hemorrhage. 



SENNA, — the leaflets of Cassia acutifolia (Alexandria Senna)> and of 

Cassia angustifolia (India Senna), shrubs of the nat. ord. Leguminosae, 

growing in Egypt and India. The leaflets are from 1 to 2 inches long, 

lanceolate, brittle, dull green, of peculiar odor, and nauseous, bitter taste.. 

25 



386 SENNA. 

They contain an amorphous glucoside, Cathartic Acid, C 180 H I92 N 2 SO 82 , 
which forms salts with bases and may be decomposed into glucose and 
Cathartogenic Acid. Other constituents are Sennapicrin and Sennacrol, 
both glucosides; — Catharto-mannite, a peculiar unfermentable sugar; also 
a coloring matter allied to Chrysarobin and various vegetable salts. 

Preparations. 

Extractum Sennse Fluidum, Fluid Extract of Senna, — an excellent preparation. 
Dose, gss-jss. 

Syrupus Sennse, Syrup of Senna, — has of Alexandria Senna 25, Oil of Coriander 
y 2 , Alcohol 15, Sugar 70, Water to 100. Dose, .^ss-ij. 

Confectio Sennas, Confection of Senna, — has of Senna 10, Cassia Fistula 16, Tama- 
rind 10, Prune 7, Fig 12, Sugar 55^, Oil of Coriander ]/ 2 , Water to 100. Is sold under 
the trade names " Tamar-Indien" " Tropical Fruit Laxative" etc. Dose, ^j-ij. 

Infusum Sennae Compositum, Compound Infusion of Senna [Black Dratighf), — 
has of Senna 6, Manna 12, Magnesium Sulphate 12, Fennel 2, Boiling Water 80, Cold 
Water to 100. Dose, ,f j-iij. 

Pulvis Glycyrrhizae Compositus, Compound Liquorice Powder (See under Gly- 
cyrrhiza), — contains 18 per cent, of Senna. Dose, gss-^jss. 

Syrupus Sarsaparillae Compositus, Compound Syrup of Sarsaparilla (See under 
Sarsaparilla), — contains 1^ per cent, of the fluid extract of Senna. Dose, 3J-^j. 

Physiological Action and Therapeutics. 

Senna is a very efficient and safe cathartic, producing, when taken in- 
ternally, copious yellow stools in about 4 hours, with considerable griping 
and flatulence, which may, however, be lessened by combining it with 
carminatives. Its action is chiefly expended on the small intestine, and 
it increases both peristalsis and secretion. It has no irritant quality in 
ordinary medicinal doses, and does not produce hypercatharsis, nor leave 
constipation as an after-result. Its infusion injected into the veins causes 
both vomiting and purging; and in large doses per or em it produces nau- 
sea, vomiting, flatulence, excited pulse, and drastic purgation with severe 
tenesmus, but its effects are never poisonous. It may cause hemorrhoids 
and increase the menstrual flow in women. Given to a nursing mother 
her milk will acquire purgative powers. In some very susceptible per- 
sons the odor of the leaves or of the infusion will cause an evacuation of 
the bowels. Its odor and taste are particularly disagreeable, especially 
when administered in infusion. 

Senna would probably take rank as our best and safest cathartic but for 
the nauseousness of its smell and taste. It is a favorite laxative in Eng- 
land for children, and is used with great benefit in habitual constipation 
or where prompt evacuation of the bowels is required. In hemorrhoids 
and anal fissures it is employed to produce soft and easy motions ; but if 
a tendency to hemorrhoids exists, the use of this drug in cathartic doses 
will cause irritation of the part and induce an acute attack. For the 
same reason it is contraindicated in any such conditions as hemorrhage 
or inflammation of the intestinal mucous membrane, hemorrhoids, menor- 
rhagia, abortion, etc. The least disagreeable of its preparations are the 
Confection of Senna and the Compound Liquorice Powder. 



SERPENTARIA SESAMI OLEUM. 387 

SERPENTARIA, Virginia Snake-Root,— is the rhizome and 
roots of Aristolochia Serpentaria and of Aristolochia reticulata, indige- 
nous herbaceous plants of the nat. ord. Aristolochiaceae, growing in rich, 
shady woods, with purple flowers arising from joints near the root. The 
rhizome is about an inch long, thin and bent, having on the upper side 
short stem-remnants, on the lower side numerous thin, branching roots ; 
odor and taste are aromatic and camphoraceous. It contains a volatile 
oil, a camphor-resin and a bitter principle named Aristolochine, which is 
soluble in both alcohol and water. All its preparations should be made 
from the fresh root, as it deteriorates by keeping. 

Preparations. 

Extractum Serpentarise Fluidum, Fluid Extract of Serpentaria. — Dose, tt\x-xxx. 
Tinctura Serpentarise, Tincture of Serpentaria, — 10 per cent. Dose, 5 ss-ij. 
Tinctura Cinchonas Composita, Compound Tincture of Cinchona, — has two parts 
of Serpentaria in 100. (See ante, under Cinchona.) Dose, gj-ij. 

Physiological Action and Therapeutics. 

Serpentaria is a stimulant expectorant and tonic, also a cardiac stimu- 
lant, a diaphoretic, diuretic, emmenagogue, aphrodisiac, and somewhat 
of an antiperiodic. Its taste is warm and pungent, its odor characteris- 
tic. Small doses promote appetite and digestion, increase the bronchial 
and intestinal secretions, the action of the heart, the cutaneous circula- 
tion and the surface temperature, and produce considerable mental exhila- 
ration. Large doses are irritant, causing nausea and vomiting, vertigo 
and headache, colic, borborygmi, rectal tenesmus, flatulent distention and 
frequent but not watery stools. The irritant action seems to produce gas 
rather than fluid. Pruritus ani and hemorrhoids are occasionally caused 
by its use. 

Serpentaria is chiefly employed as a vehicle for other stimulant drugs, 
but has many uses of its own. In bronchial affections it is extremely 
valuable as a stimulating expectorant. In typhoid pneumonia it is a good 
vehicle for ammonium carbonate, and in the exanthemata is extremely 
useful when much depression exists. It is indicated in typhoid condi- 
tions generally, and in the amenorrhcea of anaemia and chlorosis it is an 
efficient emmenagogue in many cases. It will often restore the waning 
sexual power in functional impotence, while in bilious vomiting it fre- 
quently checks the nausea and settles the stomach. It is used as a vehicle 
for cinchona in remittent fever. In diphtheria, scarlatina, etc., an infu- 
sion forms an excellent gargle. Its diaphoretic and diuretic properties, 
though slight, are sometimes of avail in chronic rheumatism. 



SESAMI OLEUM, Oil of Sesamum (Teei Oil, Benn'e Oil),— is a fixed oil ex- 
pressed from the seeds of Sesamum indicum, or Benne plant (nat. ord. Pedaliaceae), which 
is a native of India, but is cultivated in the southern portion of the U. S. It is a yellow- 
ish or yellow, oily liquid, inodorous or nearly so, having a bland, nut-like taste and a 



388 SEVUM SILICATES SINAPIS. 

neutral reaction. It is a bland fixed oil, very similar in its properties to olive oil, and 
may be used for the same purposes. It is rich in Olein (76 per cent.) and keeps better 
than olive oil. It is chiefly employed as a hair-oil. 



SEVUM, Suet {Mutton Suet), — is the internal fat of the abdomen of Ovis Aries 
(the Sheep), purified by melting and straining. It should be kept in well-closed vessels 
and not used after it has become rancid, as it will on exposure to air. It is a white, 
smooth, solid fat, of bland taste and neutral reaction, insoluble in water or cold alcohol, 
soluble in 44 of boiling alcohol, 60 of ether, and slowly in 2 of benzin. It consists 
chiefly of Stearin, but also has Palmitin and Olein, and is a constituent of Unguentum 
Hydrargyri. It is a harder fat than lard and more liable to turn rancid. It is used in 
ointments and liniments to give them greater consistency, but may be applied alone as a 
dressing to ulcers. In physiological action and therapeutics it follows the other oils and 
fats. (See under Morrhu^e Oleum and Oliv,e Oleum, ante.) 



SILICATES of Sodium (Na 2 Si0 3 ), of Potassium (K 2 Si0 3 ), and of 
Magnesium (2Mg03Si0 2 ) are used in medicine and surgery, a solution of 
the Sodium Silicate being official. 

Liquor Sodii Silicatis, Solution of Sodium Silicate {Soluble Glass 
Solution), — is a semi-transparent, colorless or yellowish, viscid liquid, 
odorless, of sharp saline and alkaline taste and alkaline reaction, of sp. 
gr. 1.300 to 1.400. A small quantity should not produce any caustic 
effect when applied to the skin. It usually contains about 20 per cent, 
of Silica and 10 per cent, of Soda, and is used on bandages to make 
immovable dressings, being lighter than plaster-of- Paris and stronger than 
starch. 

Liquor Potassii Silicatis, Solution of Potassium Silicate (Unofficial), — also known 
as Soluble Glass Solution, — is used for immovable dressings in the same manner as the 
preceding. A mixture of 2 parts of this solution with one of the soda salt solution is 
said to set more quickly and firmly than either solution separately. Diluted (1 to 4) the 
solution of Potassium Silicate has been applied locally in erysipelas, gonorrhoea, cystitis, 
vaginitis, etc., as an antiseptic, and with good results. 

Magnesii Silicas Hydratus, Hydrated Magnesium Silicate {Meerschaum), 2MgO, 
3Si0 2 -|- 2H 2 (Unofficial), — : a mineral used for the manufacture of smoking-pipes, and 
employed in France as a substitute for Bismuth Subnitrate in obstinate choleraic diarrhoea, 
to protect the intestinal mucous membrane or as an absorbent. It is given in fine powder 
and in doses of 5jj-iv per diem. 



SINAPIS, Mustard, — is official under the two following titles, but 
the pharmacopceial preparations are directed to be made from Black Mus- 
tard only : — 

Sinapis Alba, White Mustard, — the seed of Brassica alba, an annual 
plant of the nat. ord. Cruciferas, cultivated in our gardens. It has yellow 
flowers in racemes, and ribbed pods with a long, ensiform beak. The 
seeds are about -^ inch in diameter, yellowish, hard, almost globular with 
a circular hilum ; embryo oily, with a curved radicle and two cotyledons, 
one folded over the other; inodorous, taste pungent and acrid. 



SINAPIS. 389 

White Mustard contains Myrosin, a ferment, and Sinalbin, a crystalline substance, 
which reacting on each other in the presence of water produce Sulpho-cyanate of Acrinyl, 
a rubefacient principle allied to the volatile-oil of black mustard. It also contains Sin- 
apine, an alkaloid, Erucic or Brassic Acid, and a bland, fixed oil, all three contained also 
in Black Mustard. 

Sinapis Nigra, Black Mustard, — is the seed of Brassica nigra, an 
annual plant of the nat. ord. Cruciferae, native of Europe, but naturalized 
in the U. S. • It has small, yellow flowers standing closely together on 
peduncles at the end of the branches, also smooth, erect pods with a 
short beak. The seeds are about one-half the size of those from white 
mustard, black and hard, almost globular with a circular hilum ; embryo 
as in Sinapis Alba ; inodorous when dry, but when moist of a pungent, 
irritating odor; taste pungent and acrid. 

Black Mustard contains Myrosin, a ferment, and Sinigrin (Potassium Myronate), 
which reacting on each other in the presence of water produce the Sulpho- cyanide of 
Ally I, or Volatile Oil of Mustard. It also contains Sinapine, an alkaloid, Erucic or 
Brassic Acid, and a bland, fixed oil ; all three of which are contained also in White 
Mustard. 

Commercial Flour of Mustard (Unofficial), — is a mixture of white 
and black mustard seeds ground to a fine powder. It may be employed 
in lieu of either variety. Dose, as emetic, 31J— iv. 

Preparations. 

Oleum Sinapis Volatile, Volatile Oil of Mustard {Sulpho- cyanide of Allyl), C 4 H 5 - 
NS, — a colorless or pale yellow liquid, of very pungent and acrid odor and taste and 
neutral reaction, sp. gr. 1. 018 to 1.029, almost insoluble in water but freely soluble in 
alcohol and ether. Dose, tt^ %-%. 

Charta Sinapis, Mustard Paper, — consists of Black Mustard, the fixed oil removed 
by percolation with Benzin, mixed with Solution of Gutta-Percha and spread on paper. 
Each square inch should contain about gr. vj of Mustard. For local use. 

Linimentum Sinapis Compositum, Compound Liniment of Mustard, — has of the 
Volatile Oil 3, Fl. Ext. of Mezereum 20, Camphor 6, Castor Oil 15, Alcohol to 10c. For 
local use. 

Physiological Action and Therapeutics. 

Locally used, Mustard is rubefacient, counter-irritant, and a nervous 
stimulant, causing heat, redness and severe burning pain. Its prolonged 
application produces vesication by inducing local inflammation. Inter- 
nally it is a local emetic in full doses, in smaller a condiment and carmi- 
native. Its irritant effect on the gastric mucous membrane is much less 
powerful than on the skin. 

Mustard is commonly used as a local application to relieve local pain, 
to stimulate the viscera, and to produce counter-irritation. These objects 
find their application in muscular rheumatism, neuralgia, colic, gastralgia, 
inflammation of the throat, larynx, bronchi, lungs, pleurae and peri- 
cardium, also as a derivative in headache, cerebral congestion, and sup- 
pressed menstruation. It may also be used as a stimulant to the heart, 
vascular system and respiratory apparatus. When action of a mild char- 
acter is desired it may be diluted with flaxseed or flour. 



390 SODIUM. 

Internally it may be employed as an emetic in indigestion or narcotic 
poisoning. Its use as a condiment, is familiar, acting by stimulation of 
the gastric mucous membrane. In overdoses it may excite severe gastritis. 
White Mustard seed, unground, has been used as a laxative, as it produces 
no irritation. 

The Oil is one of the most irritant of the volatile oils, producing severe 
gastro-enteritis. It is used chiefly as an ingredient of stimulating lini- 
ments, but may be employed internally in small doses. 



SODIUM, Natrium, Na. — This metal is represented by a number 
of official salts, which are generally colorless or white, and with very few 
exceptions are readily soluble in water. Some of them are found native, 
as the Chloride (in sea- water, salt lakes, salt mines), — the Nitrate (in 
Peruvian deserts, etc.) and the Borate (in lakes of Persia, California, 
etc). The Carbonate is found in the ashes of marine plants. From the 
Chloride is prepared the Sulphate, from this the Carbonate, and from the 
latter, most of the other salts are prepared. All sodium salts impart a 
yellow color to flame, which should not appear more than transiently red 
when observed through a blue glass, which cuts off the yellow rays but 
allows the violet ones of Potassium to be seen. 

Sodium Compounds and their Preparations. 

Soda, Sodium Hydrate, Caustic Soda, NaOH, — a white, hard, opaque solid, deliques- 
cent in moist air, efflorescent in dry air, odorless, of intensely acrid and caustic taste and 
strongly alkaline reaction, soluble in 1.7 of water at 59 F., and in 0.8 of boiling water, 
very soluble in alcohol. Is a powerful caustic, but milder than Potassa, and should be 
kept in well-stoppered bottles made of hard glass. 

Liquor Sodae, Solution of Soda, — contains about 5 percent, of the hydrate, and is pre- 
pared by dissolving Sodium Carbonate 170, in 400 of boiling Distilled Water, also 50 of 
Lime in the same quantity of Distilled Water, boiling, mixing the solutions gradually, 
again boiling and when cold adding water up to 1000 parts, straining, settling, and then 
removing the clear solution. Or, by dissolving 56 of Soda in 944 of Distilled Water. It 
is a clear, colorless liquid, odorless, of acrid and caustic taste and strongly alkaline. Dose, 
Y(\y— ^ss, well diluted with water. 

Sodii Acetas, Sodium Acetate, NaC 2 H 3 2 -f- 3H 2 0, — large, transparent prisms, efflo- 
rescent in dry air, odorless, of saline, bitter taste and a neutral or faintly alkaline reaction, 
soluble in 1.4 of water and in 30 of alcohol at 59 F., in y 2 of boiling water and in 2 of 
boiling alcohol. Dose, gr. xx-gj. 

Sodii Carbonas, Sodium Carbonate, Na 2 C0 3 -f- loH 2 0, — large, colorless crystals, 
rapidly efflorescent, with a harsh alkaline taste and strongly alkaline reaction; very solu- 
ble in water, insoluble in alcohol. By heat it undergoes aqueous fusion and then dries 
up, losing 63 per cent, of its weight. Of it 20 grains will neutralize 9.7 grains of Citric 
Acid, or 10^ grains of Tartaric Acid. Dose, gr. v-xxx. 

Sodii Carbonas Exsiccatus, Dried Sodium Carbonate, — is the Carbonate 200 parts 
dried at a heat of 113 F., until it is converted into a white powder weighing 100 parts. 
Is chiefly used for pharmaceutical purposes. 

Sodii Bicarbonas, Sodium Bicarbonate, NaHC0 3 , — an opaque, white powder, per- 
manent in the air, odorless, of cooling, saline taste, and a slightly alkaline reaction; soluble 
in 1 1.3 of water at 59 F., insoluble in alcohol, decomposed by hot water and con- 
verted into normal Carbonate. It is distinguished from the Carbonate by its solution in 
cold water giving a white and not a colored precipitate with solution of perchloride of 
mercury. Of it 20 grains neutralize 16.7 grains of Citric Acid, or 17.8 grains of Tartaric 



SODIUM. 



391 



Acid. It is a constituent of Mistura Rhei et Sodse and of Pulvis Effervescens Compositus. 
Dose, gr. x-gj. 

Trochisci Sodii Bicarbonatis, Troches of Sodium Bicarbonate, each troche contains 
of the Bicarbonate about 3 grains, with Sugar, Nutmeg and Mucilage of Tragacanth. 
Dose, as of the Bicarbonate. 

Sodii Chloras, Sodium Chlorate, NaC10 3 , — colorless, transparent tetrahedrons of the 
regular system, permanent in dry air, odorless ; of cooling, saline taste and neutral reaction, 
soluble in 1. 1 of water and in about 100 of alcohol at 59 F., also in 0.5 of boiling water 
and in about 40 of boiling alcohol. When heated it melts and then gives off a portion of 
its oxygen, leaving a residue of sodium chloride. Should be kept in well-stoppered bot- 
tles, and should not be mixed or heated or triturated with readily oxidizable or combustible 
substances. Dose, gr. v-xx. 

Sodii Chloridum, Sodium Chloride, Common Salt, NaCl, — white, hard, cubical 
crystals or a crystalline powder, permanent in the air, odorless, of a purely saline taste 
and neutral reaction ; soluble in 2.8 of water at 59 ° F., and in 2.5 of boiling water. Al- 
most insoluble in alcohol. Dose, gr. x-gj. 

Sodii Nitras, Sodium Nitrate {Cubic Nitre, Chili Nitre, Chili Saltpetre), NaN0 3 , — 
colorless, transparent crystals, slightly deliquescent, odorless, of cooling, saline and bitter 
taste, and neutral reaction; soluble in 1.3 of water at 59 F., in 0.6 of boiling water, 
scarcely soluble in cold alcohol. Dose, ^j-ij. 

Sodii Sulphas, Sodium Sulphate {Glauber's Salt), Na 2 S0 4 -f- ioH 2 0, — large, col- 
orless, transparent, monoclinic prisms, rapidly efflorescent in air ; of cooling, saline taste and 
neutral reaction; soluble in 2.8 of water at 59 F., in 0.25 of water at 93. 2° F., and in 
0.47 of boiling water, insoluble in alcohol. Dose, gr. v— xx; as a purgative 25 ss-j or a 
third of a teaspoonful in a large glass of water. 

Sodii Ethylas, Sodium Ethylate {Caustic Alcohol), C 2 H 5 NaO (Unofficial), — is a 
white powder, often having a brownish tinge, dissolving in water with a hissing sound. 
Upon contact with the smallest quantity of water or moist living tissue it splits into alco- 
hol and caustic soda. An alcoholic solution is made by dissolving sodium in absolute 
alcohol, and is used as a caustic. Chloroform decomposes it at once into ether and sodium 
chloride. It should be kept in a cool place as it is liable to explode. 

The Arsenate is described under Arsenic; — the Benzoate under Benzoin ; — the 
Borate under Ac. Boricum; — the Bromide under Bromum; — the Solution of Chlo- 
rinated Soda under Chlorum; — the Iodide under Iodum; — the Hypophosphite, 
Phosphate and Pyrophosphate under Phosphorus; — the Nitrite under Amyl Ni- 
tris ; — the Salicylate under Salicin; — the Sulphite, Bisulphite and Hyposulphite 
under Acidum Sulphurosum; — and the Sulpho-carbolate under Acidum Carboei- 
cum. 

Physiological Action. 
The action of the Sodium salts is similar to that of the Potassium salts, 
except that the former are feebler as alkalies, are not so depressant, and 
are not so poisonous to the cardiac muscle or the nerves. They are dif- 
fused more slowly, are neither absorbed nor excreted so readily, and have 
not so marked a diuretic action. Locally applied in large doses to mus- 
cular and nervous tissue they are paralyzant, but not so powerfully as 
potassium salts. Sodium Urate is not soluble like the urates of lithium 
and potassium, is therefore much less readily excreted, forming the masses 
called " chalk-stones " in gouty subjects. Soda is a less active escharotic 
than potash, having less affinity for water. Liquor Sod^e renders the 
blood and secretions more alkaline, but does not alter nutrition to the 
extent that liquor potassse does. The Acetate is converted into the 
Carbonate in the blood, and is a less active diuretic than the correspond- 
ing potassium salts. The Carbonate is chiefly used in the preparation 
of the other salts. The Bicarbonate is slightly irritant, stimulates the 
secretion of gastric juice, acts as an antacid and will increase the alka- 



392 SODIUM. 

linity of the blood. The Chloride is a most important food. It exists 
normally in the blood, where it keeps the fibrin and albumen in solution, 
and plays an important part in tissue change. In inflammation, being 
thus needed, it accumulates at the seat of the morbid action, disappearing 
from the urine ; its reappearance therein being a sign of improvement. 
A solution of 0.65 parts to 100 of water does not destroy animal tissue 
like water alone, and may be mixed with blood without destroying the 
corpuscles, though strong solutions are intensely irritating. Internally 
used in quantity it is emetic and hemostatic. As an enema it is destruc- 
tive to ascarides. 

Sodium Nitrate is a mild cathartic, and in solution is a solvent of 
false membranes. The Sulphate is generally cathartic in action, though 
in small doses and with little water it may be passed off by the kidneys. 
It is mixed with the Bicarbonate to imitate the salts obtained by evapora- 
tion of Carlsbad water. The Ethylate is antiseptic, and a powerful but 
almost painless caustic. 

The action of the other Sodium salts is described under the titles of 
the respective constituents to which their effects are mainly referable. 

Antagonists and Incompatibles. 

Poisoning by caustic alkalies is treated by the dilute Vegetable acids, as vinegar, cider, 
lemon-juice ; then demulcent drinks and oils to protect the mucous membrane, and the 
usual vital supporters. The alkalies and their carbonates are incompatible with the acids 
and also with metallic salts, and the caustic alkalies decompose most alkaloids. 

Therapeutics. 
The Sodium salts treated of in this article are not much used internally, 
the corresponding Potassium salts being preferred, especially when it is 
desired to alkalinize the urine or to promote oxidation. In the alkaline 
treatment of stomach affections the Sodium salts are the most efficient, 
especially the Bicarbonate, in small doses before meals or on an empty 
stomach to increase the secretion of the gastric juice. This same salt is 
used in diabetes to lessen the amount of sugar, in frontal headache with 
constipation, the pain being seated at the junction of the forehead with 
the hairy scalp, — also as a wash (gr. ij ad ^j) in itching skin affections and 
as a lotion in burns and eczema. The Chloride is used internally as an 
antidote in poisoning by Silver Nitrate and as an emetic, and will often 
relieve hemoptysis and migraine. In bilious diarrhoea it is employed in 
doses of gr. x-^j, thrice daily. Locally in baths it is a good stimulant to 
the skin, and in solution (^ to 1 per cent.) to wash wounds in place of 
water, to cleanse the nasal cavities, or to destroy ascarides, in which case 
it is given by enema of the strength of two tablespoonfuls to the pint. 
The Carbonate may be used in dilute solution locally to prevent itch- 
ing, but is chiefly employed in the preparation of the other salts. The 
Sulphate is a good purgative, either alone or with the Bicarbonate in 



SOMNAL. 393 

imitation of Carlsbad Salts, for bilious disorders, gouty affections, chronic 
constipation, obesity and diabetes mellitus. The Chlorate has similar 
uses to those of Potassium Chlorate, and being more soluble can be used 
in stronger solutions, but this is of doubtful benefit for internal use, as it 
has all of the irritating power on the kidneys and destructive action on 
the blood possessed by the other salt. The Nitrate is employed as a 
mild cathartic, and in solution by atomization to destroy the false mem- 
brane in croup. The Ethylate has been of service as a caustic in cancer, 
lupus and nsevus, for the latter affection being painted over the growth 
with a glass rod. Caustic Soda is a better escharotic than caustic 
potassa, as it has less affinity for water, and hence does not destroy the 
tissues so deeply, nor has it the same tendency to run over adjacent 
parts. 

The therapeutics of the other sodium salts are described as noted on 
the preceding page. 



SOMNAL (Unofficial), — is the suggestive name given to a liquid 
preparation formed by the union of Chloral, Alcohol and Urethan, de- 
scribed as Ethylirtes Chloral-urethan, represented by the formula C 7 H 12 C1 3 - 
3 N, and claimed to be a complex body, not a simple mixture of its con- 
stituents. It occurs as a colorless liquid, resembling chloroform in its 
behavior with cold water, with which it forms globules and refuses to mix 
or dissolve. It is soluble in hot water, in alcoholic solutions, and in 
alcohol, 3 parts in i. The advantage claimed for Somnal is that when 
administered in 20-grain doses it induces within half an hour a quiet 
sleep lasting from six to eight hours without any inconvenient after- or 
by-effects. 

Doses of 45 and even 60 minims produced no depression of the circulation or respira- 
tion. In doses of gss its action is usually very prompt, the dose is well borne always, 
easily taken (in a little syrup of tolu or whiskey), and entirely without deleterious effect. 
The effects are much more striking and certain than those of Urethan, and far less de- 
pressing than those of Chloral; and there is no vertigo or depression, as may follow the 
use of Sulphonal. In drachm-doses, this drug is not powerful enough to decidedly con- 
trol delirium tremens, maniacal delirium or severe pain. (Dr. Gilman Thompson.) 

The sedative and somniferent action of Somnal is strikingly manifested 
in the insomnia of convalescence from acute disease, but where an 
adynamic condition exists it must be used with caution. In whooping- 
cough, spasmodic laryngitis, asthma, the so-called "nervous cough " and 
in chorea, it shows decided sedative properties. A great element of 
safety in its use is that its action is never out of proportion to the 
quantity ingested, nor does it act in a cumulative or other unexpected 
manner. It seems to have little or no influence over insomnia due to 
acute inflammation. (Dr. O. M. Myers.) It is injurious in acute mania 



394 SPIGELIA — STAPHISAGRIA. 

and general paralysis, but is of great value in cases of melancholia, in 
which it promotes sleep and produces a soothing effect on the mental 
condition by removing depression and gloomy forebodings. It is contra- 
indicated when the digestion is out of order. (Dr. de Montyel.) 



SPIGELIA, Pink-root, — is the rhizome and roots of Spigelia ma~ 
rilandica, the Carolina Pink, an herbaceous perennial of the nat. ord. 
Loganiacese, native of the southern states ; having large, showy flowers, 
scarlet or crimson externally, yellow within. The rhizome is 2 inches 
long, y& inch thick, horizontal, bent and branched ; having cup-shaped 
scars above and numerous thin rootlets below. It contains a bitter prin- 
ciple and a volatile oil, also tannin, wax, resin, lignin and salts. Dose, 
3J-ij for an adult, gr. x-xx for a child of 3 years. 

Preparations. 

Extractum Spigelian Fluidum, Fluid Extract of Spigelia. — Dose for an adult, 
gj-ij ; for a child of 3 years, TTLx-xx. 

Infusum Spigeliae Compositum, Compound Infusion of Spigelia, Worm Tea (Un- 
official), — has of Spigelia 15, Senna 10, Fennel 10, Manna 30, Water 500. Dose, §iss-v. 

Spigelia is anthelmintic against the round worm (Ascaris lumbricoides), 
and is in popular use as a vermifuge, administered usually with Senna. In 
large doses it is an uncertain cathartic, and may produce quite serious 
symptoms, as vertigo, dimness of vision, dilated pupils, spasms and even 
convulsions. These effects are most apt to occur when the drug fails to 
produce purgation, hence it is usually administered with an active ca- 
thartic. 

Spigelia Anthelmia, Demarara Pink-root or Worm-grass, produces 
vomiting, dilated pupils, dyspnoea, convulsions, and death. If eaten by 
cattle they perish in great agony. It has been used with real benefit in 
cardiac affections of rheumatic origin, also in rheumatic fever, and in 
cardiac palpitation with dyspnoea, due to mitral and aortic disease. A 
tincture (1 to 8) may be used in doses of r^v-xx. 



STAPHISAGRIA, Stavesacre, — is the seed of Delphinium Staphisagria, an annual 
or biennial plant of the nat. ord. Ranunculacese, a native of Europe, having bluish or 
purple flowers, in terminal racemes ; and seeds in straight, oblong capsules. The seeds 
contain an alkaloid Delphinine, probably 3 other alkaloids, a bitter principle, a volatile 
oil and a fixed oil, etc. There are no official preparations. 

Unofficial Preparations. 

Unguentum Staphisagriae, Ointment of Staphisagria, — contains of the powdered 
seeds 1 part with 2 each of olive oil and lard. 

Delphinina, Delphinine, C 22 H 35 N0 6 , — is the active alkaloid, and exists in the fatty oil 
which is extracted by ether. Dose, gr. j. 2 ~l. 



STILLINGIA. 



395 



Stavesacre is a violent emetic and cathartic, also parasiticide. The alkaloid is irritant 
to the skin if locally used, producing tingling, burning and inflammation. Internally, it 
lowers the activity of the heart and respiration and produces a most profound adynamia, 
and may prove fatal from paralysis of the spinal cord and asphyxia. In many respects 
its alkaloid resembles Aconitine and Veratrine. 

The ointment is often employed as a parasiticide against pediculi and the acarus 
scabiei. The fixed oil is probably equally effective. Delphinine has been used internally 
in asthma, rheumatism and neuralgia, and in the latter affection is well employed as an 
ointment (gr. xx to § j), applied over the course of painful superficial nerves. It has been 
suggested as an antipyretic and for dropsy. A tincture or fluid extract is a very efficient 
application against pediculi. 



STILLINGIA, Queen's Root, — is the root of Stillingia sylvatica, 

or Queen's Delight, an indigenous, perennial plant of the nat. ord. 

Euphorbiaceae, with yellow flowers on a spike, and a large, thick and 

woody root, of peculiar and unpleasant odor, and an acrid, pungent, 

bitter taste. It contains a resin and a volatile oil, but its active principle 

has not yet been isolated. The fresh root should be used in making the 

preparations, as those from the dried root are almost inactive. Dose of 

the powdered root, gr. x-gj. 

Preparations. 

Extractum Stillingiae Fluidum, Fluid Extract of Stillingia. — Dose,rrLx-3J. 

Tinctura Stillingise, Tincture of Stillingia (Unofficial). — Dose, £ss-ij. 

Decoctum Stillingiae, Decoction of Stillingia (Unofficial). — ^j adOj. Dose, ^ j-ij. 

Syrupus Stillingiae Compositus, Compound Syrup of Stillingia (Unofficial), — 
is composed of Stillingia, Corydalis, Iris, Chimaphila, Coriander, Xanthoxylum, Sambu- 
cus, Sugar, Water and Alcohol. For the formula, see U. S. Disp., 17th edition, page 
1286. 

Physiological Action and Therapeutics. 

Stillingia in large doses is emetic and cathartic, in smaller doses it is 
expectorant, diaphoretic, diuretic, sialagogue and cholagogue, possessing 
the various properties which are considered "alterative." Its taste is 
acrid and pungent, and it increases the action of the heart, skin, kid- 
neys, and bronchial mucous membrane; and the gastric, hepatic, intes- 
tinal and salivary excretions. Full doses often excite epigastric pain, 
nausea and vomiting. 

Stillingia is much employed with Sarsaparilla and similarly acting drugs 
as an alterative in syphilitic affections, particularly in chronic cases of 
the tertiary form, in which the system is greatly reduced by the abuse of 
mercurials and iodides. In these cases it possesses considerable power 
and frequently cures. It is also valuable in strumous affections, in 
ascites due to hepatic changes, portal changes with jaundice following 
malaria, habitual constipation, hemorrhoids from hepatic obstruction, 
and intermittents. In the latter affection the fluid extract with Quinine 
or Arsenic is a very useful combination. A strong decoction is used to 
ward off an impending paroxysm of ague. The compound syrup, not- 
withstanding its reputation as a model of polypharmaceutical skill, is 
largely used in the West and South. 



I 



396 STRAMONIUM. 

STRAMONIUM, Thornapple .— The plant Datura Stramonium, 
Jamestown Weed or Thornapple (nat. ord. Solanacese), is official in two 
forms, the leaves and the seed. It is an annual, of rank and vigorous 
growth, having a green stem with large white flowers, and numerous seeds 
in a large, fleshy, four-celled capsule, open at the summit. It grows wild 
in Southern Russia and the middle United States, and contains an alka- 
loid, Daturine (see below), which is generally considered identical with 
Atropine both physiologically and chemically, — also malic acid, albumen, 
gum, resin, etc. 

Stramonii Folia, Stramonium Leaves, — the leaves of Datura Stra- 
monium, are about 6 inches long, smooth, petiolate, ovate, pointed, un- 
equal at the base, coarsely toothed, of bitter and nauseous taste. Dose, 
gr. ij-xx. 

Stramonii Semen, Stramo?tium Seed, — the seed of Datura Stramo- 
nium, is about *4> inch long, reniform, flattened, pitted and wrinkled, the 
testa blackish and hard, enclosing a curved embryo embedded in whitish, 
oily albumen ; of unpleasant odor when bruised and an oily, bitter taste. 
Dose, gr. j. The official preparations are all made from the seed. 

Preparations. 

Extractum Stramonii Seminis, Extract of Stramonium Seed. — Dose, gr. */£-^. 

Extractum Stramonii Seminis Fluidum, Fluid Extract of Stramonium Seed. — 
Dose, Ttij-v. 

Tinctura Stramonii Seminis, Tincture of Stramonium Seed, — 15 percent. Dose, 
rr\,v-xxx. 

Unguentum Stramonii, Stramonium Ointment, — has of the Extract 10, Diluted 
Alcohol 5, Benzoinated Lard 85. 

Daturina, Daturine, C 17 H 23 N0 3 (Unofficial), — is the alkaloid found in all parts of the 
plant, also in Datura Tatula. It is a Tropate of Tropin, isomeric and identical with Atro- 
pine. Dose, gr. ifa-fa. 

Physiological Action. 

The action of Stramonium is similar to that of Belladonna in almost 
every particular, except that Stramonium is more powerful and chiefly 
influences the .sympathetic nervous system, not affecting the motor or 
sensory nerves. It excites a greater degree of cardiac irregularity and a 
more furious delirium, and seems to have a special affinity for the gen- 
erative apparatus, being decidedly aphrodisiac in full doses. [Compare 
Belladonna, ante, 142.] 

As previously stated the alkaloids, Atropine, Daturine, Hyoscyamine, 
and Duboisine are chemically alike and almost identical physiologically. 
They all produce dilatation of the pupil, increase the cardiac action, the 
pulse and respiration rate, and cause delirium. Poisoning by one of 
them is indistinguishable from that by another. 

Antagonists and Incompatibles. 
These are the same as for Belladonna. Poisoning by Stramonium is not uncommon, as 
children may eat the seeds, which should be evacuated by an emetic. If physiological 
symptoms follow Opium must be exhibited as the antagonist, but cautiously, lest opium- 
narcosis be substituted. 



strontium. 397 

Therapeutics. 
Stramonium is chiefly used as an antispasmodic and to relieve pain. In 
asthma the leaves are smoked with advantage at the commencement of a 
paroxysm, the smoke being drawn into the lungs. In other spasmodic 
affections, as hepatic colic, laryngeal cough, chorea and stammering, it is 
very beneficial. In dysmenorrhcea and neuralgia it is used in combina- 
tion with Opium and Hyoscyamus, and in tic douloureux and sciatica it 
is often very efficient. In nymphomania with great mental depression it 
is frequently effective, and in mania of furious character, particularly the 
puerperal form with suicidal tendency, it is highly serviceable in 10-20 
minim doses of the tincture every 3 or 4 hours. The ointment is much 
used in irritable ulcers, and as an anodyne application in painful hemor- 
rhoids and certain cutaneous diseases. 



STRONTIUM, Sr. — The metal Strontium is represented in the 
pharmacopoeia by three of its salts, viz. — 

Strontii Bromidum, Strontium Bromide, SrBr 2 -f- 6H 2 0, — colorless, transparent, hex- 
agonal crystals, very deliquescent, of bitter, saline taste ; very soluble in water and 
alcohol, insoluble in ether. Dose, gr. v-xxx. 

Strontii Iodidum, Strontium Iodide, Srl 2 -)- 6H 2 0, — hexagonal plates, colorless, 
transparent, of bitter, saline taste ; very soluble in water, also in alcohol and slightly so 
in ether. Dose, gr. v-xxx. 

Strontii Lactas, Strontium Lactate, Sr(C 3 H 5 3 ) 2 -f- 3H 2 0, — a white, granular 
powder, or crystalline nodules, of slightly bitter and saline taste, permanent in the air; 
soluble in 4 of water, in less than y^ part of boiling water, also in alcohol. Dose, gr. 
v-xxx. 

Physiological Action and Therapeutics. 

The Strontium salts are among the- most recent additions to the materia 
medica. Their marked anti-putrescent and antiseptic properties were first 
noticed in 1891 by Germain See, on patients suffering from gastric dila- 
tation. He found that, in such cases, the Bromide prevented the acetic 
and lactic fermentations, and the formation of the gases of decomposition. 
The toxic action, hitherto attributed to the salts of Strontium, has been 
ascertained to be due to Barium, which was present in the impure com- 
mercial products used. When pure, they may be safely employed in the 
same doses, and in the same cases, as the corresponding preparations of 
potassium and sodium ; than which they are much less liable to cause 
eruptions, and are more rapidly and completely eliminated by the 
kidneys. 

The action of Strontium Iodide is analagous to that of potassium 
iodide, intravenous injections producing at first a rapid elevation of 
arterial pressure with, acceleration of the cardiac rate ; followed by slowing 
of the heart, and, later on, lowered blood-pressure with increased heart- 
rate. It has been used, with good results, in the treatment of scrofulous, 



( 



398 STROPHANTHUS. 

rheumatoid and cardiac disorders; especially scrofuloderma, scrofulous 
otorrhcea, and enlarged lymphatic glands; also in lupus vulgaris and 
ozsena. 

The Lactate has been successfully employed in diabetes, and in albu- 
minuria. It diminishes the amount of albumen excreted in Bright' s 
disease, in the parenchymatous nephritis of rheumatic and scrofulous 
subjects, and in the albuminuria of pregnancy; for which purpose it 
should be given in full doses, (gr. xxx) thrice daily. It is contraindicated 
when there is scanty urine or symptoms of uraemia. 

The uses of Strontium Bromide are detailed with those of the Bro- 
mides, on page 152, ante. 



STROPHANTHUS,— is the seed, deprived of its long awn, of 
Strophanihus hispidus, an African climbing plant (nat. ord. Apocynaceae), 
from which the natives extract a toxic preparation known as the Kombe 
arrow-poison. It contains a crystalline glucoside, named Strophanthin, 
the active principle, which is bitter, slightly acid, soluble in water 
and in alcohol, but almost insoluble in ether, chloroform, benzin, etc. 
It is very plentiful in the seeds (8 to 10 per cent.), and is an agent of 
great energy, the frog being killed by a solution of 1 in 10,000,000. 
(Denian.) 

Preparations. 

Tinctura Strophanthi, Tincture of Strophanthus, (1 in 20). — Dose, TT^ v-x, or 
TTL^-ij frequently repeated. A stronger tincture (1 in 8) is on the market. 

Strophanthinum, Strophanthin (Unofficial). — Dose, gr. xio - ^ hypodermically : gr. 
-gL has been used, the influence of the one injection upon the circulation lasting at least 
8 days. 

Physiological Action. 

Strophanthus acts primarily upon muscular tissue, by direct contact 
through the blood, and with great energy. It increases the contractile 
power of all striped muscle, and in poisonous quantity it fixes the mus- 
cular contraction into a condition of tetanic permanence, the muscle 
being unable to resume its normal condition of partial flexibility. As 
the heart receives much more blood in a given time than any other mus- 
cle in the body, it is quickly and markedly affected by the strophanthus- 
charged fluid, and by regulating the dosage, the cardiac muscle may 
alone be affected, by a quantity which would not influence the other 
muscles. 

Small doses stimulate the cardiac contractions, increasing the force of 
the ventricular systole, and lowering the rate of the heart-beats. At the 
same time the general blood-pressure is raised, and diuresis produced, 
both being due to the vis a tergo, — the direct stimulation of the circula- 
tion from behind. Large doses paralyze the heart in systole, and leave 



STROPHANTHUS. 399 

the cardiac muscle in a state of contraction resembling cadaveric rigidity. 
It does not act through the nervous system, but paralyzes the muscular 
tissue, striated and non-striated, by direct contact ; — and when contract- 
ility has been once destroyed thereby, no stimulus will re-excite it. It 
does not affect the vascular system directly. 

Compared with Digitalis, then, we have in Strophanthus a powerful 
cardiac stimulant, differing from Digitalis in not producing vaso-motor 
constriction of the arterioles. It reduces the pulse, lowers body-temper- 
ature somewhat, is not cumulative in action, and does not cause any 
gastro-intestinal disturbance. It is diuretic, by direct stimulation of the 
renal circulation; and has power over rigors, by its rapid cardiac action, 
stopping them, and preventing their recurrence. 

Therapeutics. 

Strophanthus is undoubtedly a valuable cardiac stimulant, from the 
rapidity and permanence of its action, as well as its non-interference 
with the calibre of the peripheral vessels. It promptly relieves cardiac 
dyspnoea, often modifies the pulse-rate in less than an hour, while the 
influence of a single dose upon the circulation persists for a long time. 
It may well replace Digitalis in the treatment of chronic Bright's disease 
and valvular lesions of the heart, when it is important that the work of 
the heart should not be increased by any additional resistance in the 
arterial system. 

Strophanthus has been reported as exceedingly useful in the treatment 
of Bright's disease, for the dyspnoea, orthopncea, dropsy and uraemia; 
also in mitral insufficiency, with great anasarca and dyspnoea; in pal- 
pitation, exaggerated cardiac action, and in weak heart, and for exoph- 
thalmos, with tumultuous action of the heart ; also in pulmonary oedema, 
due to valvular lesions, or to pneumonia. It is useful in endocarditis, also 
in atheroma of the arteries; in reflex palpitation of neurasthenia, hysteria 
and chlorosis, and for rigors due to catheterization, or operations on the 
urethra. These high claims, made by enthusiastic therapeutists, have not 
been maintained by the experience of the general profession, so that this 
drug is gradually falling into disuse, although but recently added to the 
official pharmacopoeia. 

Ouabain, C 30 H 46 O 12 (Unofficial), — is a glucoside obtained from the root and wood of 
Acocanthera Oua&aio, an apocynaceous tree of the Somali coast; also from the seeds of 
Strophanthus glabrus, a climbing plant from Gaboon. The former furnishes an arrow 
poison, much used by the African natives. Ouabain occurs in white, odorless crystals, of 
feebly bitter taste; soluble in hot water and in spirit, slightly in cold water, insoluble in 
absolute alcohol, chloroform and anhydrous ether. Dose, gr. joVo evei 7 three hours, to 
children. 

Ouabain is an extremely active poison, paralyzing the cardiac muscle by direct action. 
It is a powerful emetic, especially when given hypodermically ; and a potent local anaes- 
thetic, being considered by many observers as superior to Cocaine in this respect. In thera- 
peutic doses it does not seem to affect the body temperature, but increases urination, either 






400 STYRAX SUCCINUM SULPHONAL. 

by stimulating the blood pressure or by paralyzing the sphincter vesicae. It also promotes 
defecation, probably by stimulating peristalsis. Very small doses give some evidence of a 
possible action similar to that of Digitalis. It has been employed with striking benefit in 
all stages of pertussis ; and has been used to some extent as a local anaesthetic for the 
eye. 



STYRAX, Storax, — is a balsam prepared from the inner bark of Liquidambar 
orientalis, the Oriental Sweet-gum, a tree of the nat. ord. Hamamelaceae, growing in 
Asia Minor. It is semi-liquid, sticky, opaque and gray-colored, of agreeable odor and 
balsamic taste, completely soluble (except accidental impurities) in an equal weight of 
warm alcohol. It consists of a volatile oil named Styrol, C 8 H 8 , — a crystalline solid Sty- 
racin, which is a cinnamate of cinnamic ether, — two peculiar resins, one hard, the other 
soft, — and Cinnamic Acid, C 9 H 9 2 , a colorless, odorless, crystalline body, closely allied 
to Benzoic Acid, excreted in the urine partly as Hippuric Acid, and occurs also in the 
Balsams of Peru and Tolu. , Dose of Storax, gr. v-xx. 

Tinctura Benzoini Composita, Compound Tincture of Benzoin, Friar's Balsam, 
— contains 8 per cent, of Storax. Dose, gss-ij. 

Storax is a stimulant expectorant, an antiseptic and a disinfectant, acting both locally 
and remotely, like Benzoin and the Balsams of Tolu and Peru. It is used with benefit 
in chronic bronchitis and other affections of the respiratory organs, also in chronic 
catarrhs of the genito-urinary passages, in gonorrhoea and in amenorrhoea. Externally it 
is employed in ointment as a detergent for foul ulcers, and as a parasiticide for scabies 
and phthiriasis. 



SUCCINUM, Amber (Unofficial), — the source of Oil of Amber, is a fossil resin, 
occurring in alluvial deposits, chiefly in Prussia, Bohemia, and Courland. It is usually 
associated with lignite, sometimes encloses insects and parts of vegetables, and consists of 
a volatile oil, a yellow resin, another resin, succinic acid and a bituminous principle. Its 
source is thought to be an extinct coniferous tree, the Pittites succinifer, of which amber 
represents the exudation. 

Oleum Succini, Oil of Amber (Unofficial), — is a volatile oil obtained by the destruc- 
tive distillation of Amber, and purified by subsequent rectification ; — a colorless or pale 
yellow, thin liquid, of sp. gr. about 0.920, of empyreumatic and balsamic odor, a warm, 
acrid taste, and a neutral or faintly acrid reaction, and readily soluble in alcohol. Dose, 
gtt. v-x. 

Oil of Amber is stimulant, antispasmodic and diuretic, when used internally. Exter- 
nally it is irritant and rubefacient. It has been employed with benefit in epilepsy, hysteria, 
convulsions, amenorrhoea, whooping-cough, etc. As a liniment it is often used in chronic 
rheumatism, and has been applied along the spine in infantile convulsions, mixed with an 
equal part of laudanum and diluted with olive oil or brandy. 



SULPHONAL, Sulphonal, Diethylsulphon - dimethyl- methane, 
C 7 H 16 S 2 4 (Unofficial), — is a synthetical hypnotic which has recently 
been admitted to an official place in the pharmacopoeias of several 
countries, though unofficial as yet in the United States. It is produced 
by the interaction of anhydrous Mercaptan (Ethyl Hydrosulphide) and 
anhydrous Acetone, in the presence of a stream of dry HC1. The re- 
sulting Mercaptol is separated, washed and oxidized by potassium per- 
manganate; yielding Sulphonal in colorless, prismatic crystals, soluble in 



SULPHONAL. 4OI 

15 of boiling water, in about 450 of cold water, and in about 50 of cold 
alcohol ; very soluble in boiling alcohol and in ether. Sulphonal is a 
very stable body, being unaffected by concentrated acids, alkalies, or 
oxidizing agents, cold or warm. Dose, gr. xv-xl. 

Physiological Action and Therapeutics. 

Sulphonal was introduced about five years ago as a harmless hypnotic, 
producing sound and quiet sleep without unpleasant after effects, without 
intoxicant or narcotic action, and having no unfavorable effects on the 
heart or circulation, even in full doses. It rapidly came into general use 
as a hypnotic in mental diseases, in nervous insomnia, and in sleeplessness 
from various causes. Recently a number of competent observers have 
recorded instances of toxic action following its use, and opinions are now 
greatly divided as to its therapeutical value. If it were not for the very 
evident advantage of the drug when used with care, and under medical 
supervision, it would stand a very fair chance of being either excluded 
from practice or restricted by legislative authority. (Squibb.) In many 
cases of serious poisoning thereby death has followed ; and its prolonged 
use may give rise to such minor toxic effects as noises in the ears, head- 
ache, vertigo, weakness and incapacity for mental or physical exertion. 
The patient may next pass into a condition of drowsiness or stupor, or 
he may suffer from difficulty of speech ; and ptosis, oedema of the eyelids 
and cyanosis may be experienced. The stopping of the drug in subjects 
of sulphonism is followed by vertigo, motor disturbances, general weak- 
ness, digestive troubles, etc., a condition resembling that in morphinism 
when the morphine is suddenly cut off. (Lepine.) In one reported case- 
a dose of 20 grains nightly for 15 months was accompanied by complete 
cessation of menstruation. It has produced persistent skin eruptions in 
some cases, and severe functional disturbances in others. The chief 
characteristics of chronic poisoning by this drug are as follows : — dis- 
turbances of digestion, shown by vomiting and diarrhoea or constipation ; 
disturbances of the nervous system, as ataxy and feebleness of the limbs, 
ptosis and ascending paralysis; also ischuria and oliguria, sometimes 
albuminuria, or the presence of hsematoporphyrin. (Karst.) Recovery 
rapidly follows if the entire alimentary tract be thoroughly purged ; and 
as long as this is kept-free, and the kidneys act efficiently and normally, 
the drug may be considered harmless. (Fuerst.) In order to secure 
elimination and to guard against cumulative action and consequent 
toxicity, its administration should be interrupted from time to time. 
Anorexia, vomiting, or pains in the stomach may be regarded as indica- 
tions for immediate discontinuance. (Kast.) 

As a hypnotic Sulphonal acts admirably in many instances, if admin- 
istered in hot fluids and about two hours before its action is required ; but 
26 



4<D2 SULPHUR. 

its efficacy decreases with use, and it is of no value whatever against 
insomnia due to pain. The average hypnotic dose is about 20 grains for a 
woman and 30 grains for a man. The dose is to be administered only once 
daily, and should be discontinued at the first sign of toxic action. In no 
case should its administration be continued over any great length of time. 
In cases of insomnia due to neuralgia and nervous excitement, the dose 
of Sulphonal may be advantageously combined with a small dose of 
Morphine, in proportion to suit individual cases, the mixture forming a 
safe and efficient hypnotic. (Gonzales.) 

Trional, Dielhyhulphon-methyl-ethyl-methane, — differs from Sulphonal only in the 
substitution of an ethyl for a methyl group. It occurs in lustrous, bitter, tabular crystals, 
soluble in 320 of cold water, readily soluble in alcohol and in ether. It is an efficient 
hypnotic, less liable to produce ill effects than Sulphonal, but must be given in doses fully 
as large, gr. xv— xl. It is said to be peculiarly valuable in cases of slight psychical excite- 
ment accompanied by obstinate insomnia, and to act promptly and usefully in many forms 
of delirium. When pain is present it may be administered in conjunction with Phenacetin 
or Acetanilid. A potent objection to its use is the fact that it is patented! in this country, 
which is also true of the following agent. 

Tetronal, Diethyhulphon-diethyl-methane, — contains 4 ethyl groups, to 3 in Trional, 
and but 2 in Sulphonal. Dr. Lauder Brunton holds of the physiological action of the 
disulphones, to which group these three substances belong, that only those containing 
ethyl groups are active, and that the hypnotic activity is increased with the number of 
such groups. This, if substantiated in practice, would make Tetronal the most powerful 
hypnotic of the three. Trional is found to be, generally, more active, however, in this 
respect, and to be freer from unpleasant by-effects, Tetronal producing vomiting and 
other digestive disturbances in many cases. Neither of them has any value against 
insomnia due to pain. Dose, gr. xx-xxx, twice or thrice daily. 



SULPHUR, and SULPHIDES.— The non-metallic element Sul- 
phur, S, is a brittle solid of a pale yellow color, permanent in the air, of 
crystalline texture and susceptible of several allotropic states, which are 
for the most part induced by heat. It is obtained native in several vol- 
canic districts, or from the native Sulphides of Iron and Copper (iron 
and copper pyrites) by roasting, as it sublimes at about 238 F. It is 
official in three forms/ viz. : — 

Sulphur Sublimatum, Sublimed Sulphur, S, — is prepared from crude 
Sulphur by sublimation and condensation. It is a fine citron-yellow 
powder, of faintly acid taste and acid reaction, insoluble in water or 
alcohol. Ignited it burns with a blue flame, forming sulphurous acid gas, 
and leaving no residue or only a trace. Dose, gr. x-xx-lx. 

Sulphur Lotum, Washed Sulphur, S, — prepared by digesting sub- 
limed Sulphur with dilute Water of Ammonia, thoroughly washing with 
water and passing through a No. 30 sieve. In this process the Ammonia 
dissolves out any Sulphide of Arsenic which may be present and neutral- 
izes any Sulphurous or Sulphuric Acid. [For solubility and dose see S. 
Pr^ecipitatum, below.] 

Sulphur Prsecipitatum, Precipitated Sulphur {Lac Sulphtiris, Milk 



SULPHUR. 4O3 

of Sulphur), S, — is prepared by boiling sublimed Sulphur with slaked lime 
and water, thus forming the Sulphide and Hyposulphite of Calcium. 
These are then decomposed by HO, and Sulphur is precipitated as a very 
fine powder which is next washed until the washings are tasteless, and it 
is dried with a gentle heat. The result is a very fine, yellowish-white, 
amorphous powder, odorless and almost tasteless, insoluble in water or 
alcohol, but completely soluble in carbon disulphide or a boiling solution 
of soda. By heat it is completely volatilized. Dose, gr.x-^j. 

Preparations of Sulphur. 

Unguentum Suiphuris, Sulphur Ointment, — has of Sublimed Sulphur 30, Benzoin- 
ated Lard 70, rubbed together until thoroughly mixed. 

Pulvis Glycyrrhizae Compositus, Compound Liqziorice Powder (see under Gly- 
CYRRHIZa), — contains 8 per cent, of Washed Sulphur. 

Sulphurous Acid and the Sulphites are described under Acidum Sulphurosum ; 
the Sulphates under the titles of their respective bases. For Sulphuric Acid see 
Acidum Sulphuricum. 

Sulphur Iodide and Sulphides. 

Suiphuris Iodidum, Sulphur Iodide, {Iodine Disulphide), T 2 S 2 , — is prepared by fusing 
together Washed Sulphur I part, and Iodine 4. It is a grayish black crystalline solid, 
having the odor of iodine, an acrid taste and a faintly acid reaction, insoluble in water, 
but very soluble in disulphide of carbon and in about 60 of glycerin. Alcohol and ether 
dissolve out the iodine, leaving the sulphur. Only used as ointment, gr. xxx to the Sj . 

Calx Sulphurata, Sulphurated Lime, {Crude Calcium Sulphide), — is a mixture of 
Calcium Monosulphide, CaS, Calcium Sulphate, CaS0 4 , and Carbon, in varying propor- 
tions, containing at least 60 per cent, of the former. A pale, gray powder, of offensive 
taste and smell, and alkaline reaction, insoluble in alcohol, very slightly soluble in water. 
Dose, gr. T y-f . 

Calcii Sulphidum, Calcium Sulphide, CaS (Unofficial), — a constituent of the preced- 
ing, is named Hepar Suiphuris , Liver of Sulphur, by the homceopathists, who prepare it 
by mixing equal parts of powdered oyster-shell and sublimed sulphur, and heating at a 
white heat in a crucible hermetically sealed. Dose, gr. -y§-\. 

Potassa Sulphurata, Sulphurated Potassa, [Liver of Sulphur), — is a mixture of 
Potassium Trisulphide with small quantities of Potassium Hyposulphite and Potassium 
Sulphate; prepared by heating together Sublimed Sulphur 1, Potassium Carbonate 2, in 
a covered crucible until melted. Occurs in irregular pieces, of liver-brown color, gradu- 
ally changing with age to a greenish- or brownish-yellow, of disagreeable odor, alkaline 
reaction, and alkaline, repulsive taste. Soluble in 2 of water, except a small residue. 
Alcohol dissolves only the potassium sulphide, leaving the other constituents undissolved. 
Dose, gr. ij-x, in pill or solution. 

Hydrogenii Sulphidum, Hydrogen Sulphide, Sulphuretted Hydrogen, H 2 S, — is used 
only for test purposes ; a saturated, aqueous solution being one of the official reagents. It 
is a colorless gas, having the smell of rotten eggs ; and is prepared by the action of dilute 
sulphuric acid on iron sulphide, the resulting gas being passed into water, a solution is 
obtained. It precipitates most of the metals from acid solutions as sulphides; that with 
Arsenic being yellow, — with Antimony, orange, — with Cadmium, yellow, — with Copper, 
Lead, Mercury and Silver, black, — with Bismuth, brown, — with Gold and Platinum, 
brownish- black. 

Carbon Disulphide is described under Carbo ; Antimony Sulphide and Sulphu- 
rated Antimony under Antimonium. 

Unofficial Allied Compounds. 

Ichthyolum, Ichthyol, Ammonium Sulpho-ichthyolate, C 28 II 36 S 3 6 (NH 4 ) 2 — is pre- 
pared from the product of the distillation of bituminous rocks from the Tyrol, which 
contain fossil fishes. It occurs as a viscous, reddish brown mass, of tarry odor and ap- 
pearance, and feebly alkaline reaction ; soluble in water and in a mixture of alcohol and 
ether ; mixes in all proportions with glycerin, fats and oils. It contains a large proportion 



4O4 SULPHUR. 

of Sulphur, about io per cent. Dose, internally, gr. v-xxx. Sulpho-ichthyolates of 
Lithium, Sodium and Zinc are also prepared, and are on the market. 

Thiolum, Thiol, — is prepared by the sulphuration of certain nonsaturated hydrocar- 
bons, and is a product very similar to Ichthyol. It occurs in both dry and liquid form, the 
former, Thiolum siccum, as dark-brown lamelise or powder, of bituminous odor, and bitter, 
astringent taste ; soluble in water and in chloroform, sparingly in alcohol, insoluble in ether 
and in benzin. The liquid form, Thiolum liquidum, is a dark-colored, syrupy fluid, 
miscible in all proportions with water. Dose, internally, gr. v-xxx. 

Tumenolum, Tumenol, — is obtained by treating the unsaturated hydrocarbons of 
mineral oils with concentrated sulphuric acid. It occurs in several forms, solid and fluid, 
that known as Commercial Tumenol being considered the most generally useful. It is a 
dark-brown fluid, which can be employed in ointment and in tincture, externally. 

Physiological Action. 

Sulphur is a mild laxative and a diaphoretic. In contact with living 
protoplasm it enters into combination and produces either sulphuretted 
hydrogen or sulphurous acid ; taken into the intestinal canal a large por- 
tion passes out unchanged, some of it being converted by the alkaline bile 
into sulphuretted hydrogen and sulphides. The former is excreted by 
the lungs, giving to the breath the smell of rotten eggs, and by the skin, 
discoloring silver articles carried about the person by forming a sulphide 
of silver. The Sulphides are partly absorbed into the blood, and are 
excreted in the urine, chiefly as sulphates, and in the faeces, which they 
blacken and render soft. Given in full doses they are irritant to the 
stomach and intestines, extremely nauseous to the taste and smell, increase 
the secretions of the intestinal glands, also peristaltic action, and if used 
for any length of time they impair the blood, causing anaemia, emacia- 
tion, tremor and great debility. 

Sulphuretted Hydrogen is very destructive to plant life, and in ani- 
mals it destroys the tissue functions, decomposing the blood and para- 
lyzing the nervous and muscular systems. The symptoms of poisoning 
are those of asphyxia; muscular tremors occur and are followed by con- 
vulsions and death. This gas is often found in cesspools in large quantities, 
but in one case poisoning occurred from its excessive formation in the 
intestines and subsequent absorption into the blood. 

Calx Sulphurata and Potassa Sulphurata act like the sulphides as 
local irritants and in large doses as irritant poisons, producing narcotic 
symptoms and convulsions. In small doses they act like sulphur and are 
supposed by many observers to have a peculiar influence on suppuration, 
to limit or prevent it if given in small doses frequently repeated. 

The Iodide is believed to possess some of the properties of both its 
elements. It is doubtful whether it is a distinct chemical compound or 
merely a physical mixture. As a parasiticide it is very efficient, and has 
been found remarkably alterative in many local affections of chronic char- 
acter, but may prove very irritant to the skin if improperly prepared. 

The action of Sulphuric Acid, Sulphurous Acid and the Sulphites are 
respectively described on pages 72 and 80, ante. 



SULPHUR. 405 

Antagonists and Incompatibles. 
Solutions of the Sulphides are decomposed by the mineral acids and by solutions of 
metallic salts. Antidotes are Chlorine-water, Chlorides of Sodium and Potassium, Sulphate 
of Iron, etc. Poisoning by Sulphuretted Hydrogen is best treated by artificial respiration. 

Therapeutics. 

Sulphur is chiefly used as a laxative when pultaceous rather than liquid 
stools are required, as in hemorrhoids and anal fissure, also in constipation. 
Scabies has long been treated by its local and internal use, but sulphur 
alone does not kill the itch insect. The older sulphur ointments were 
made with sublimed sulphur, and probably contained a considerable 
amount of sulphurous acid on which their parasiticide property depended. 
The recent ointments, made with purified sulphur, all contain an alkaline 
ingredient and develop sulphides which are powerful insect poisons. 
Sulphur fumigations are practically applications of volatile sulphurous 
acid, while most of the sulphur baths and mineral waters are solutions of 
sulphuretted hydrogen or of the alkaline sulphides. They are of value in 
lead poisoning to favor the elimination of that metal, in chronic consti- 
pation, chronic rheumatism and sciatica, and many skin diseases, especially 
chronic psoriasis, eczema, pityriasis and prurigo. The Ointment and the 
Alkaline Ointment are both used in scabies. 

The Iodide has been used internally in scrofula, glanders and cutaneous 
disorders, but it is chiefly employed as an ointment in lupus and parasitic 
skin diseases, especially herpes circinatus. 

Calx Sulphurata is extremely efficient as an internal remedy in crops 
of boils, scrofulous sores, glandular enlargements, acne, etc., and will 
prevent or limit suppuration. For these purposes it must be used in small 
doses (gr. ^ ) frequently repeated. Potassa Sulphurata is only used 
externally as baths or ointment in skin diseases and mucous discharges, 
also in chronic rheumatism. 

Ichthyol was introduced about ten years ago, by Dr. Unna, the cele- 
brated dermatologist, as a promptly efficient remedy in certain chronic 
skin diseases, particularly eczema and psoriasis. It mixes with vaselin, 
lard and oils, is soluble in a mixture of ether and alcohol, and is not irri- 
tant locally, even if covered with oiled silk. 

In one case of eczema infantile, an ointment was applied containing 1 
part of Ichthyol to 5 of Vaselin, resulting in the child sinking into a 
stupor which lasted for 12 hours. A fatal case of poisoning thereby is 
reported by Bergerio, of Turin, in a woman whose uterus had been 
curetted the day previous. After the washing out of the uterine cavity 
with a solution of Ichthyol 33 to Glycerin 66, she complained of a putrid 
fish taste in her mouth, her pulse became like that in tachycardia, and 
symptoms of general depression rapidly supervened, ending in death after 
about 12 hours. These instances show that this agent is not devoid of 
danger, and that care must be exercised in its employment. 



406 SUMBUL. 

The particular value of Ichthyol, as a local remedy, is due to its non- 
irritant quality and to the large proportion of sulphur contained therein ; 
which, in any pharmaceutical combination, would excite a dermatitis. 
Its application in medicine depends chiefly upon its reducing property, 
its antiseptic powers, and its contractile action upon the vascular system. 
Most of the affections for which it has been recommended are caused by 
anomalous circulation, and especially capillary dilatation. Used internally, 
it retards the disintegration of albumens and favors their formation and 
accumulation. Upon exudations it has a remarkable effect, given in- 
ternally at the same time as applied externally, promoting their reabsorp- 
tion and promptly alleviating pain. For these purposes it has been 
highly praised in gynecology, and even in pleurisy. For chronic rheu- 
matism a 50 per cent, ointment is used locally and the remedy is also 
given internally. It has done excellent service in erysipelas, and ulcers 
of the leg, locally applied in ointment form with Lanolin, or pure; and 
internally in various affections of the digestive and intestinal tract, also 
in syphilis and leprosy. In gynecology it is combined with Glycerin (1 
in 10) ; is used for rheumatism with Turpentine as a liniment, or with an 
equal weight of a mixture of Lanolin and Olive Oil and 30 per cent, of 
Chloroform; against erysipelas as a to to 20 per cent, collodion, with or 
without Castor Oil. 

Thiol, the German artificial Ichthyol, is largely used in place of Ichthyol, by gyne- 
cologists and dermatologists. It causes no pain, burning, or other irritation, and no 
bleeding from eroded surfaces; promotes rapid absorption of effusions, and has many 
advantages over the natural Ichthyol, among which is the ease with which the stains it 
produces on linen may be removed. The dry form, used as a dusting powder, is of 
especial service in erysipelas, and is employed with benefit in eczema, erythema, inter- 
trigo, impetigo, pemphigus and other cutaneous affections ; especially in acute, moist in- 
flammations of the skin and subjacent tissues, in chilblains, periphlebitis, contusions, 
subcutaneous hemorrhages and syphilitic ulcers. It is also an efficient application in 
pelvic exudations and endometritis. It may be applied as a powder, or collodion, in 
aqueous or glycerin solutions, as ointment, soap, plaster, etc. Internally, it is given in 
wine, or chocolate (1 to 2 per cent.), also in pills containing a grain each. Mixed with 
Talc, in the proportion of 10 to 20 per cent of Thiol, it makes an excellent dusting 
powder for use on babies' skin. 

Tumenol is said to owe its therapeutic action to its powerful reducing property rather 
than to the sulphur in its composition. The tincture has been almost universally success- 
ful in all forms of pruritus. Moist eczema is especially benefited by it, and it generally 
gives good results when employed in erosions, excoriations and superficial ulcerations. It 
is not anti-parasitic in action, and is of no service in erysipelas. 



SUMBUL, — is the root of Ferula Sumbul, a very large plant of the nat. ord. Umbelli- 
ferae, which grows to the height of 8 feet in the mountains of Northern Asia. The root 
occurs in transverse segments of a strong and musk-like odor and a bitter, balsamic 
taste, and contains Angelic Acid, C 5 H 8 2 , Valerianic Acid, C 5 H 10 O 2 , also a volatile oil, 
two balsamic resins, a bitter substance, etc. Dose, gr. xxx-^j or more, in infusion, de- 
coction, etc. 

Tinctura Sumbul, Tincture of Sumbul, — 10 per cent. Dose, 3 j-iv. 

Sumbul is an efficient nerve tonic, having qualities closely resembling musk and vale- 
rian. It is used by the Russian physicians in very many morbid conditions, and seems 



TABACUM. 407 

to be a favorite remedy in that country for almost any disease. It is probably of some 
value in hysteria and other nervous derangements of delicate females, and may be used 
as a substitute for musk in typhoid conditions and fevers, asthma, delirium tremens and 
perhaps in epilepsy. 



TABACUM, Tobacco, — the commercial dried leaves of Nicotiana 
Tabacum, an annual plant of the nat. ord. Solanacese, native of tropical 
America, but cultivated in several parts of the world, especially in Cuba 
and Virginia. The leaves are large, as long as 20 inches, mottled-brown, 
ovate or lanceolate, glandular-hairy ; having a heavy, peculiar odor, and 
a nauseous, bitter and acrid taste. It contains a very powerful and poi- 
sonous fluid alkaloid named Nicotine, C 10 H U N 2 , also a concrete, campho- 
raceous, volatile oil, Nicotianin, besides alkaline salts (nitrates, phos- 
phates),, and other less important substances. Its combustion gives rise 
to several empyreumatic products, of which Pyridine, C 5 H 5 N, and its com- 
pounds are the chief, having somewhat the same action as Nicotine, but of 
less severity. Besides these products, tobacco-smoke contains Creosote, 
Hydrocyanic and Hydrosulphurous acids, etc., but little or no Nicotine. 

Unofficial Preparations. 

Enema Tabaci, Enema of Tobacco, — gr. xx infused in ^ viij Boiling Water, and 
administered as one enema. 

Vinum Tabaci, Wine of Tobacco, — ^j to the pint. Dose, TT\,v-gj. 

Oleum Tabaci, Oil of Tobacco, — is an empyreumatic product, obtained by distilla- 
tion at a temperature above that of boiling water, and a most virulent poison. 

Nicotina, Nicotine, C 10 H 14 N 2 , — the alkaloid and active principle; a colorless, oily 
looking fluid, having the odor of tobacco and an acrid taste; readily soluble in water, 
and forming soluble salts with acids. Dose, rtl ^""To m strychnine- poisoning, up to 
rr\, ij in 2 hours. 

[Other Liquid Alkaloids besides Nicotine are — Coniine, Muscarine, Sparteine, Lobe- 
line, Lupuline, and Pyridine.] 

Physiological Action. 

Tobacco is a very depressant nauseant, an emetic by irritant as well as 
by systemic action, and an antispasmodic ; also sternutatory, diuretic, dia- 
phoretic, cathartic, sedative and narcotic. It paralyzes the motor nerv- 
ous system, its action commencing at the periphery and extending towards 
the spinal cord. It increases the salivary and intestinal secretions, and 
produces diuresis, tremor, clonic spasms and a tetanic stage followed by 
paresis. It contracts the pupils, depresses the heart, lowers arterial 
tension, reduces body-temperature, and causes profuse sweating, cold 
and clammy skin, collapse and death usually by paralysis of respiration, 
sometimes by paralysis of the heart. It does not impair the muscular 
irritability, nor does it act upon the cerebrum directly. Its empyreumatic 
products act similarly but less powerfully. Fatal results have followed on 
the inhalation of its vapor into the lungs. 

Nicotine is almost as rapidly fatal as Hydrocyanic Acid, death having 



408 TAMARINDUS. 

occurred from a toxic dose in three minutes, with no symptoms except a 
wild stare and a deep sigh. 

The continued use of Tobacco in excess by smoking or chewing pro- 
duces granular inflammation of the fauces and pharynx, atrophy of the 
retina, dyspepsia, lowered sexual power, nervous depression, and occa- 
sionally angina pectoris. Used by the young it hinders the development 
of the higher nerve centres, and impairs the body nutrition by interfering 
with the processes of digestion and assimilation. 

Antidotes and Antagonists. 
Strychnine is the true physiological antagonist to Nicotine (or Tobacco) and vice versa. 
Alcohol, Ammonia, Ergot, Digitalis, Belladonna, etc., antagonize its action on the circu- 
lation. In poisoning by Tobacco the means resorted to are evacuation of the stomach, 
Tannin, Iodides, and artificial respiration. A curious synergism has been observed by the 
author between Opium and Tobacco. If a person, habituated to the use of the latter, 
either by smoking or chewing, begins to use Morphine, the smallest quantity of Tobacco 
will make him sick, the symptoms being those experienced by a novice in its use. For 
the depression due to excessive smoking, the best agent is Spiritus yEtheris Compositus 
(Hoffman's Anodyne). 

Therapeutics. 

Tobacco is now but little used in medicine ; the dangers attending its 
employment either internally or externally have caused it to be super- 
seded by less violently acting agents. The principal objects for which it 
is used are to relax spasm of the intestines, and to relieve local pain 
therein. Intestinal affections, like impaction of the caecum, intussuscep- 
tion and strangulated hernia, may be overcome by a tobacco-enema to 
relax spasm, but it is a dangerous expedient. In dropsy, especially the 
renal form, it makes a very efficient diuretic. In tetanus there is no 
more effective remedy than minim doses of the alkaloid every two hours 
by the stomach, or rr^ ij by the rectum, or better still the wine in 10- 
minim doses repeated for effect. Strychnine-poisoning is best met by 
minute doses of Nicotine (gr. -fa) hypodermically, as a physiological 
antagonist. It may be employed with advantage in habitual constipation, 
for the dyspnoea of spasmodic asthma and emphysema, and in nympho- 
mania and chordee. 

The use of Tobacco in moderation, when under excessive exertion, aids 
in supporting the system and lessening the sense of fatigue. Smokers 
rarely suffer from constipation, but generally experience an immediate 
laxative result from their morning cigar. 



TAMARINDUS, Tamarind, — is the preserved pulp of the fruit of Tamarindus 
indica, a large tree of the nat. ord. Leguminosse, native in the East and West Indies. 
It occurs as a reddish-brown, sweet-acid and pulpy mass, containing strong, branching 
fibres and brown, quadrangular seeds, each enclosed in a tough membrane. It contains 
citric, tartaric and malic acids, sugar, gum, potassium bitartrate, etc. 

Confectio Sennae, Confection of Senna, — contains Tamarind to the amount of io per 
cent. Dose, 3J-ij. (See under Senna.) 



TANACETUM TARAXACUM TEREBINTHINA. 409 

Tamarind is a laxative and refrigerant fruit. In infusion it may be used by convales- 
cents as a pleasant acidulous drink, or the pulp may be boiled with milk as a whey for 
the same purpose. As a laxative it is usually prescribed in connection with other agents 
having: the same action. 



TANACETUM, Tansy, — the leaves and tops of Tanacetum vulgare, a perennial, 
herbaceous plant of the nat. ord. Compositse, having yellow flowers in dense terminal 
corymbs, indigenous in Europe, but cultivated in our gardens, and growing wild in roads 
and old fields. It contains a volatile oil, a bitter principle named Tanaceiin, a tannic 
acid, etc. There are no official preparations, but a fluid extract may be prepared accord- 
ing to the general rule and administered in doses of TTLx-^j. The dose of the volatile 
oil (Oleum Tanaceti) is I to 3 drops. An infusion (Tansy Tea) may be made in the pro- 
portion of ^j to the pint, and used in doses of 25 j-ij. 

Tansy is emmenagogue, diuretic and anthelmintic, an aromatic bitter and an irritant 
narcotic. Fatal results have frequently followed upon overdoses of the oil (^ss-j) or 
strong decoctions, preceded by clonic spasms, disturbed respiration and cessation of the 
heart's action. It is a useful remedy in amenorrhcea, but is in popular repute as an 
abortifacient, a virtue which it does not possess except in quantity dangerous to life. 



TARAXACUM, Dandelion, — is the root, gathered in autumn, of Taraxacu?n 
officinale, an herbaceous plant of the nat. ord. Compositae, with a perennial fusiform root, 
long, sinuate-toothed or runcinate leaves, and slender peduncles, each bearing a single 
head of yellow flowers. All parts of the plant contain a bitter, milky juice, exuding 
from any break or wound. Its constituents are a bitter amorphous principle named 
Taraxacin, a crystalline principle Taraxacerin, with potassium and calcium salts, Inulin, 
and resinoid bodies, etc. The French name for the plant is " Pissenlit." 

Extractum Taraxaci, Extract of Taraxacum. — Dose, gr. v-xxx. 

Extractum Taraxaci Fluidum, Fluid Extract of Taraxacum. — Dose, 3J-^j. 

Taraxacum is a bitter tonic, a diuretic and an aperient. It has been supposed to act 
especially on the liver, and is chiefly used in dyspepsia with hepatic torpor. As found in 
the shops it is usually inert. The extract is probably only of value as an excipient for 
pills. 



TEREBINTHINA.— A Turpentine means a vegetable exudation, 
liquid or concrete, consisting of resin combined with a peculiar essential 
oil named Oil of Turpentine (C 10 H 16 ), and generally procured from various 
species of the nat. ord. Coniferae (cone-bearers). Of the many turpen- 
tines two only are official, viz. : — 

Terebinthina, Turpentine, — a concrete oleoresin obtained from Pinus 
palustris, the Yellow Pine, and from other species of Pinus, nat. ord. 
Coniferse. Occurs in tough, yellowish masses, brittle when cold, crummy- 
crystalline interiorly, of terebinthinate odor and taste. Dose, gr. v-xxx 
as a stimulant, antispasmodic or diuretic ; 3'j-iv as an anthelmintic. 

Terebinthina Canadensis, Canada Turpentine {Balsam of Fir), — a 
liquid oleoresin obtained from Abies balsamea, the Silver Fir, or Balm of 
Gilead, a tree of the nat. ord. Coniferse. A yellowish, transparent, viscid 
liquid, of agreeable, terebinthinate odor, and a bitterish and slightly acrid 



4IO TEREBINTHINA. 

taste, slowly drying on exposure, forming a transparent mass ; completely 
soluble in ether, chloroform or benzol. Dose, gr. x-xxx. 
Pitch and its preparations are described under Pix. 

Official Preparations of Turpentine. 

Oleum Terebinthinae, Oil of Turpentine, commonly called " Spirit" or " Spirits of 
Turpentine," — is a volatile oil distilled from Turpentine. A thin, colorless liquid, of 
characteristic odor and taste; sp. gr. 0.855 to 0.870; soluble in 3 times its volume of 
alcohol; mixes with other volatile and fixed oils, and dissolves resins, wax, sulphur, 
phosphorus and iodine. Bromine and powdered Iodine act violently on it, and when 
brought into contact with a mixture of Nitric and Sulphuric Acids it takes fire. It is 
isomeric with a number of volatile oils, has the formula C 10 H 16 — but constantly absorbs 
oxygen from the air when exposed, becoming thicker and less active, from formation of 
resin. It is a mixture of several hydrocarbons, each having the same formula as itself, 
viz.:— C 10 H, 6 . 

Oleum Terebinthinae Rectificatum, Rectified Oil of Turpentine, — prepared by 
shaking Oil of Turpentine with 6 times its volume of Lime Water, distilling three- fourths, 
and separating. This preparation should always be dispensed when Oil of Turpentine is 
required for internal use. Dose, as a stimulant or diuretic, lT^v-xv, in emulsion, 3 to 6 
times daily ; — as a cathartic or anthelmintic ^ ss or more, combined with other cathartics. 
A little glycerin and Oil of Gaultheria will disguise the taste. 

Linimentum Terebinthinae, Turpentine Liniment, — has 35 parts of the oil with 65 
of Resin Cerate. 

Unofficial Turpentines. 

Chian Turpentine, — from the Pistacece Terebi?ithus ; a small larch 
tree growing in the islands of Chio and Cyprus, a thick, tenacious, 
greenish-yellow liquid, concreting on exposure to the air into a translu- t 
cent solid. Dose, gr. iij-v in emulsion. 

Venice Turpentine, — procured in Switzerland from the Larix 
Europcza or European Larch ; — a viscid liquid of the consistence of 
honey, does not concrete on exposure, and is entirely soluble in alcohol. 
The Venice Turpentine of commerce is usually prepared by dissolving 
Resin in Oil of Turpentine. 

Thus Americanum, Common Frankincense (B. P.), — the concrete 
turpentine which is scraped off the trunks of Pinus australis and Pinus 
Tceda, Southern States of N. America. An ingredient of the Emplastrum 

Picis of the B. P. 

Derivatives of Turpentine. 

Resina, Resin {Colophony), — is the residue left after distilling off the volatile oil from 
turpentine; the portion of turpentine which is fixed by oxidation; consisting in greater 
part of Abietic anhydride (C 44 H 62 4 ). See ante, under its own title. 

Terebenum, Terebene, C 10 H 16 , — is a hydrocarbon obtained by the oxidation of Oil of 
Turpentine by strong Sulphuric Acid, and occurs as a colorless, or light yellow liquid, 
with the pleasant odor of newly cut pine wood ; practically insoluble in water, but may 
be emulsified, soluble in an equal volume of alcohol. It consists chiefly of Pinene, and 
should contain not more than very small proportions of Terpinene and Dipentene 
(U. S. P.); [consists of Camphene, Cymene, Borneol and Terpilene (Squibb)]. Dose, 
Tl\,v-xx on sugar, or suspended in ^ ss of water by the aid of gr. xx of light magnesium 
carbonate. 

Terpini Hydras, Terpin Hydrate, C 10 H 18 (OH) 2 .H 2 O, — is the hydrate of the diatomic 
alcohol Terpin (Terebinthene), obtained by distilling oil of Turpentine with an alkali. 
Colorless, lustrous, rhombic prisms, nearly odorless, of slightly aromatic and somewhat 
bitter taste; soluble in 10 of alcohol and in about 250 of water at 59 F., in 32 of boil- 
ing water and in 2 of boiling alcohol. Dose, gr. v-x. 



TEREBINTHINA. 41 I 

Terpinol (Unofficial), — an oily body obtained from the preceding, by the action of an 
acid thereon. Dose, gr. ij-v. 

Sanitas Disinfecting Fluid (Unofficial), — is an aqueous, solution of turpentine 
which has been oxidized by exposure to the air. It contains Hydrogen Dioxide, Thymol, 
Camphor and Camphoric Acid, the latter in such small proportion, however, that its 
action cannot be expected. This proprietary preparation has many combined advantages. 
It is a good oxidizing agent and antiseptic, is not poisonous, and does not stain the linen, 
— qualities which strongly recommend it as an external disinfectant, and for use in 
surgical operations. 

Unofficial Analogues of Turpentine. 

Oleum Succini, Oil of Amber, — a volatile oil obtained by the destructive distillation 
of Amber (Succinum), a fossil resin, occurring in alluvial deposits in Bohemia, etc, and 
thought to be the exudation of Pinites succinifer, an extinct coniferous tree. Dose, gtt. 
v-x. (See ante, under Succinum.) 

Oleum Thujse, Oil of Thuja, — a volatile oil which is given in doses of tt\j-v. A 
saturated tincture may be used in drachm doses. Obtained from Thuja occidentalis, the 
Arbor Vitae, a coniferous tree. (See under Thuja.) 



Physiological Action. 

Turpentines are stimulant, diuretic, anthelmintic, and hemostatic ; 
in large doses laxative and irritant, and externally used are rubefacient 
and antiseptic. Their virtues depend entirely on the volatile oil. 

Oil of Turpentine in small doses causes a sense of heat at the epigas- 
trium, burning in the mouth, and salivation by reflex action. In moderate 
doses it at first stimulates the vaso-motor nervous system, afterwards 
paralyzing these centres, thus causing a rise and then a fall of the arterial 
tension. It lowers the functions of the brain, spinal cord and medulla 
in the order stated, causing diminution of voluntary movement and reflex 
action, dilatation of the vessels, lowered blood-pressure, and slowed re- 
spiration, the latter often becoming spasmodic. The pulse is sometimes 
slowed, sometimes quickened. Large doses produce gastro-enteritis, with 
vomiting and diarrhoea, suppression of urine, pain in the lumbar regions, 
burning in the urethra, hematuria and strangury. The muscular power 
is diminished, coordination impaired and a state of intoxication induced. 
Toxic doses cause complete muscular relaxation, profound insensibility, 
with abolished reflexes, dilated pupils, cyanosed face, labored and ster- 
torous breathing and death by paralysis of respiration. It is excreted by 
the various organs of excretion, all of which are highly irritated, the 
kidneys suffering particularly. Its vapor inhaled produces nasal and 
renal irritation, frontal headache, and frequently strangury and hematuria. 
Locally to the skin it is rubefacient, and even vesicant if applied for any 
length of time or if evaporation be prevented. 

The Oil, when exposed to the air, readily absorbs oxygen in the form 
of ozone, which it retains tenaciously. This Ozonized Oil of Turpentine 
is an antidote to Phosphorus, preventing the formation of phosphoric 
acid, and converting the phosphorus into an insoluble substance resem- 
bling spermaceti. Worn about the neck in an open vial it is believed to 



412 TEREBINTHINA. 

prevent necrosis of the jaw and steatosis of the organs in workmen exposed 
to phosphorus-fumes. It is also supposed to dissolve gall-stones. 

Antagonists. 

In cases of poisoning the stomach should be emptied, anodynes and demulcents admin- 
istered, elimination favored, and special symptoms met as they arise. 

Therapeutics. 

The Oil of Turpentine is employed externally as a rubefacient and 
counter-irritant in many conditions producing pain and inflammation. 
Cloths wrung out of hot water and then sprinkled with the oil (turpen- 
tine stupes), are useful applications in sciatica and other neuralgiae, lum- 
bago, chronic rheumatism, chronic bronchitis, peritonitis with tympanites, 
pleurisy, renal colic, etc. It is one of the most efficient agents in hos- 
pital gangrene, applied in full strength to the part affected. The liniment 
is in constant use for sprains, neuralgia, and other slight local affections. 

Internally it is best employed in ulceration and hemorrhage of the 
intestines and in hemorrhages of a passive character from other organs. 
Active bleeding with a plethoric condition and hematuria are states in 
which it is contraindicated. It is often used with Ether (i to 3) in 
biliary and flatulent colic, as an anodyne and antispasmodic. As a ver- 
mifuge against tape-worm it must be employed in large doses (^ss-ij) 
with Castor oil to promote its rapid passage through the intestinal canal. 
The French acid oil, which is old and contains ozone, is used in phos- 
phorus poisoning. It is well employed as a stimulant to the heart and 
vaso-motor system in puerperal fever, yellow fever, traumatic erysipelas, 
pneumonia, capillary bronchitis, etc. It is also useful in chronic bron- 
chial catarrh, chronic cystitis, subacute gonorrhoea and similar affections 
of the mucous surfaces generally. 

Inhalations of the vapor or atomized oil are extremely beneficial in 
chronic affections of the larynx and bronchi. The pure vapor is too 
irritating for inhalation, but it may be diluted with steam from a steam 
atomizer. 

Chian Turpentine is one of the many remedies which have been used 
for cancer. 

Terebene has been extensively used by Dr. Murrell, with excellent 
results, as a remedy for obstinate winter-cough and emphysema of the 
lungs, in flatulence, and flatulent dyspepsia, also in cystitis and in gleet, 
and as a spray in phthisis and post-nasal catarrh, also with Cocaine in 
solution as a spray for coryza and hay-fever. Other observers, of several 
years' experience with this remedy in England, praise it highly as an 
inhalant remedy in phthisis, bronchiectasis, chronic bronchitis, and other 
pulmonary affections characterized by profuse, purulent expectoration. 
Dr. Rieu employs it extensively in bronchitis and bronchorrhoea, in doses 
internally of gr. xv-xxx per diem, — but says that it does not affect the 



THEOBROMATIS OLEUM THUJA. 413 

mucopurulent expectoration of phthisis. It probably has no superior 
efficacy to Creosote, Venice Turpentine, etc., except that it is without 
much odor, and has no taste. 

Terpin Hydrate is praised very highly in chronic and recurrent 
bronchitis, night-cough from habit, cold, catarrhs and kindred affections. 
In fact, all acute and many chronic affections of the respiratory passages 
form the proper field for the therapeutical action of this preparation. 



THEOBROMATIS OLEUM, Oil of Theobroma (Cacao-butter),— is a fixed oil 
expressed from the seed of Theobroma Cacao, the Chocolate-tree, nat. ord. Sterculiaceee, 
growing in Mexico, the West Indies and South America. The oil is a yellowish-white 
solid, of faint odor, bland taste and neutral reaction, and melting at 86° to 95 F. 

The seeds are oval, about the size of almonds, and consist of shells and kernels, in 
both of which is found the alkaloid Theobromine C 7 H 8 N 4 2 , which closely resembles 
Caffeine, the latter being its methyl derivative. Chocolate is prepared by roasting the 
seeds, removing the shells, then crushing or grinding the kernels to a smooth paste, 
which is cast in molds. 

Oil of Theobroma consists chiefly of Stearin with a little Olein. Its action is demul- 
cent, and it does not become rancid on exposure to the air. Its chief use is as a 
basis for making suppositories. A Cerate is prepared by melting together Cacao-butter 
35, White Wax 35, Oil of Almond 30, adding a drop of Oil of Rose and coloring with a 
minute quantity of Carmine previously triturated with a drop of Water of Ammonia. This 
is known as Red Lip-salve. 

Theobromine has the same action and uses as Caffeine. [See under Caffea. for this 
principle and for Diuretin.] 



THUJA, Arbor Vitse (Unofficial), — the fresh tops of Thuja occi- 
dentalism a tree of the nat. ord. Coniferse, commonly though incorrectly 
called White Cedar, and growing in swampy ground in Canada and the 
northern U. S. Its twigs are flatfish and two-edged, with scale-like leaves 
appressed and closely imbricate in four rows, rhombic-ovate, obtusely 
pointed, having a roundish gland upon the back ; of a balsamic, some- 
what terebinthinate odor, and a pungently aromatic, camphoraceous and 
bitter taste. They contain a volatile oil, tannin, wax, resin, etc. ; also 
Pinipicrin, C 22 H 18 O n , a bitter principle, and Thujin, C 20 H 22 O 12 , a yellow, 
astringent and crystallizable coloring principle, which is separable into 
glucose and Thujetin, C u H u 8 . 

Preparations. 

The dose of a saturated, fresh tincture or fluid extract is gj 3-6 times daily. The 
Volatile Oil may be given in doses of n\j-v. 

Physiological Action and Therapeutics. 
Thuja resembles Savine in action very closely. It is stimulant, irritant, 
astringent, also aromatic, diuretic and emmenagogue. The oil is a 
gastro-intestinal irritant, and produces epileptiform convulsions in warm- 
blooded animals, and paralysis in cold-blooded ones. It causes rhythmi- 
cal contraction and dilatation of the vessels, lowers the temperature, and 



414 THYMI OLEUM. 

is anthelmintic. Thuja is indirectly an abortifacient when given in doses 
sufficient to cause violent gastro-enteritis, and is reported to have pro- 
duced an acute urethritis resembling gonorrhoea. 

Thuja in decoction has been usefully employed in coughs, rheumatic 
and arthritic pains, dropsy and amenorrhcea. It has also been given 
with benefit in intermittent fever and as an alterative blennorrhetic in 
chronic catarrh and bronchorrhcea. It is highly praised by Dr. Phillips 
for the cure of warts with narrow base and pendulous body, a strong 
tincture being applied locally and given internally at the same time in 
5 -minim doses twice daily. Dr. Piffard speaks strongly in its favor as a 
valuable agent for non-syphilitic warts (condylomata acuminata) of the 
penis and vulva, for papillomatous growths in general, and for gleets 
dependent on granular urethritis. It has been used in chronic gonorrhoea 
and prostatitis with asserted success, and is said to have cured epithelioma. 
The oil has been employed as a vermifuge. 



THYMI OLEUM, Oil of Thyme,— is a volatile oil distilled 
from Thymus vulgaris, Garden Thyme, a common shrub of the nat. ord. 
Labiatse, indigenous in France but cultivated in our gardens. This oil is 
a pale yellow or colorless, thin liquid, having a strong odor of thyme, a 
warm, pungent and afterward cooling taste, and a neutral reaction, of sp. 
gr. from 0.900 to 0.930, and readily soluble in alcohol. It consists of 
two portions, the more volatile being a mixture of the hydrocarbons 
Cymene and Thymene, the less volatile being chiefly Thymol, which is also 
official. 

Thymol, C 10 H u O, — is a phenol contained in Oil of Thyme and in 
the volatile oils of several other plants. It occurs in large, colorless, 
hexagonal crystals, of aromatic odor, pungent taste and neutral reaction; 
soluble in 1200 of water, 900 of boiling water, and in 1 of alcohol at 59 
F., freely in fats and oils, solutions of chloral and alkalies, ether, chloro- 
form, etc. It liquefies when triturated with about equal quantities of 
camphor, menthol or chloral. Dose, gr. ss-ij. 

Unofficial Preparations. 

Thymol Solution, — for antiseptic spray, 1 in 1000. 

Thymol Gauze, — contains I per cent, of Thymol. 

Thymol Ointments, — vary from 5 to 30 grains to the ^ . 

Thymol Inhalation, — Thymol gr. xx, Alcoholis 5 iij, Magnesium Carbonate gr. x, 
Water to # ^iij. A teaspoonful to a pint of water at 150 F. for each inhalation. 

Volkmann's Antiseptic Fluid, — has of Thymol I, Alcohol 10, Glycerin 20, and 
Water 100 parts. 

Physiological Action. 
Oil of Thyme has the same properties as the oils of other mints, and 
containing a large quantity of Thymol it is similar to the latter in action. 
Thymol in its action stands between Carbolic Acid and Oil of Tur- 



TIGLII OLEUM. 415 

pentine. Like the former it is a powerful antiseptic and disinfectant. It 
is a local irritant and anaesthetic to the skin and mucous membranes, 
paralyzing the end-organs of the sensory nerves. When absorbed it para- 
lyzes the nerve-centres in the spinal cord and in the medulla, lessening 
reflex action, slowing respiration, lowering the temperature and the 
arterial tension, and in poisonous doses causing weakness, coma and 
death. Internally administered in doses of 20 to 30 grains per diem it 
produces a sensation of epigastric heat, sweating, singing in the ears, 
deafness, a sense of constriction in the forehead, and increase of the 
urinary discharge, which assumes a dark, greenish hue. It is eliminated 
by the respiratory and urinary organs, which it irritates considerably dur- 
ing the process of its excretion. As an antiseptic it is much more power- 
ful and permanent than Carbolic Acid, and much less poisonous. 

Therapeutics. 
Thymol is chiefly employed in lieu of Carbolic Acid as an antiseptic 
for dressing wounds; as a gargle, spray or inhalation in laryngitis and 
diphtheria ; as an ointment in ringworm, eczema and psoriasis, and as an 
injection in ozsena. A solution of 1 part in 1000 is the strength usually 
employed. Internally it has been used with success in diphtheria, typhoid 
fever, and other intestinal affections, diabetes, phthisis, and vesical catarrh. 
Its fragrant odor renders it a very agreeable antiseptic application for 
ulcerated conditions of the mouth and fauces, but makes it very attractive 
to flies ; which fact, together with its high price, will prevent it becoming 
a favorite in hospital practice. A solution, used as a mouth-wash, is very 
efficient in removing the odor of tobacco from the breath. 



TIGLII OLEUM, Croton Oil,— is a fixed oil expressed from the 
seed of Croton Tiglium, a small tree of the nat. ord. Euphorbiaceae, and 
a native of India. The oil is of a pale or brownish-yellow color, some- 
what viscid and slightly fluorescent, of fatty odor, acrid taste and slightly 
acid reaction; sp. gr. 0.940 to 0.960, soluble in 60 of alcohol, freely in 
ether, chloroform, or carbon disulphide. Its composition is very complex 
and has not been thoroughly made out, but it is known to contain the 
glycerides of several fatty acids, also a peculiar acid named Tiglinic Acid, 
C 5 H 8 2 , which is isomeric with Angelic Acid. Dose of the oil, ttl ^3-ij, 
in pill, emulsion or tincture. 

Physiological Action and Therapeutics. 
Externally Croton Oil is highly irritant, producing a pustular eruption 
which heals by scabbing and may leave unsightly cicatrices. Internally 
it is a powerful drastic cathartic, producing in one or two hours copious 



41 6 TONGA TRAGACANTHA. 

watery stools, in overdoses causing great congestion of the intestinal canal 
and perhaps death from gastro-enteritis. Vomiting usually occurs after 
large doses, so that the irritant hyper-catharsis is not always observed. It 
is absorbed into the blood; and produces glandular hyperemia as well as 
direct inflammation of the intestinal mucous membrane, together with 
increased peristaltic action. Its cathartic power is increased by the addi- 
tion of an alkali, and is manifested, though in less degree, when applied 
to the integument. 

Croton Oil is used as a hydragogue cathartic when a speedy and com- 
plete evacuation of the bowels, diminution of arterial pressure and prompt 
derivative action are desired, as in apoplexy, impaction of the intestines, 
dropsy, lead constipation, paralysis, etc. It is contraindicated where 
there is debility, organic obstruction, and inflammatory conditions of the 
stomach and bowels. The smallness of the dose makes it a very easily 
administered and manageable purgative. A considerable fraction of a 
drop is absorbed by a pellet of sugar or bread, and may be given thus in 
repeated doses until the desired effect is obtained. It has been used as a 
vermifuge against tapeworm. 

Externally it is employed as a counter-irritant in ovaritis, bronchitis, 
pleurisy, rheumatism, neuralgia, glandular swellings and in laryngeal 
and pulmonary diseases. The Linimentum Crotonis of the British Phar- 
macopoeia contains i part of the oil in $% each of Alcohol and Oil of 
Cajuput, and is a useful pustulant preparation, being more manageable 
than the oil itself. 



TONGA (Unofficial), — is a mixed drug said to be obtained from the Fiji Islands, 
consisting of thin barks, root-fibres and leaves, tied into long bundles. The fibrous 
material is believed to be derived from Rhaphidophora vitiensis, a creeping plant of the 
nat. ord. Araceae, containing starch, potassium chloride and a volatile alkaloid Tongine. 
The barky portion is referred to Premna tatiensis, a shrub or tree of the nat. ord. Ver- 
benacese, and contains a little volatile oil, sugar, pectin, etc. A fluid extract is on the 
market, which may be given in doses of rr^xxx-gj thrice daily. 

Tonga was introduced by Drs. Ringer and Murrell as a remedy for neuralgia in 1880, 
stating that they had used it with gratifying results. Since then reports have differed 
considerably in regard to its efficacy, and from the fact that Dr. Ringer does not mention 
it in the later editions of his Handbook of Therapeutics, it may be inferred that his further 
experience with it has not borne out the claims first made. 



TRAGACANTHA, Tragacanth, — is a gummy exudation from Astragalus gum- 
mifer and from other species of Astragalus, shrubs of the nat. ord. Leguminosse, growing 
chiefly in the mountainous regions of Asia Minor and Persia. It occurs in shell- like, 
curved or contorted bands, translucent, faintly yellowish, horn-like, tough, swelling with 
water to a gelatinous mass, which is tinged blue by test-solution of iodine, and consists 
of a mixture of Arabin, or gum-arabic, which is soluble in water, and Bassorin, a gum 
which is insoluble in water but swells up in it, also a little starch. 



TRITICUM ULMUS UVA URSI. 417 

Mucilago Tragacanthse, Mucilage of Tragacanth, — Tragacanth 6, Glycerin 18, 
Water to 100. Dose, ^j or more. 

Tragacanth is demulcent, but in large quantities it may cause indigestion. It is chiefly 
employed to suspend resins and heavy powders in emulsion. The mucilage may be used 
as a vehicle for active agents in gargles for pharyngitis, and to cause cohesion in the 
preparation of pills, troches, etc. It is a constituent of 12 of the 15 official troches, and 
is a better agent than acacia for making emulsions of cod-liver oil. 



TRITICUM, Couch-grass, — is the rhizome, gathered in the spring and deprived of 
its roots, of Agropyrum repens, the Couch-grass, a perennial plant of the nat. ord. Gram- 
inese, abounding in meadows and cultivated grounds, where it ranks as a weed, though 
of the same genus as wheat. The rhizome is very long, but as met with in the shops is 
cut into two sections about f ths inch in length and T ^ inch thick, creeping, smooth, 
hollow in the centre, of straw color, and sweet taste. It contains much sugar and a 
gum-like principle, Trilicin. Dose, gj-^j, in infusion or decoction. 

Extractum Tritici Fluidum, Fluid Extract of Triticum. — Dose, ^j-^j, well 
diluted. 

Couch-grass is demulcent, emollient and a feeble diuretic. It is chiefly used in cystitis 
and irritable bladder. The infusion is a popular fever-drink in Europe, and has had of 
old a considerable reputation in dysuria. 



ULMUS, Elm, Slippery Elm, — is the inner bark of Ulmus fulva, an indigenous 
tree of the nat. ord. Urticese, and occurs in flat pieces of various sizes, having a slight, 
peculiar odor and a mucilaginous, insipid taste. It contains a large quantity of mucilage 
which it readily parts with to water. 

Mucilago Ulmi, Mucilage of Elm, — Elm 6, Water to 100, digested for an hour and 
strained. Dose, ad libitum. Should be freshly made, when wanted. 

Slippery-elm Bark is demulcent, slightly astringent and somewhat tonic. It is used 
internally in diarrhoea, dysentery and affections of the urinary passages, and externally in 
the form of poultice as an emollient application in cases of inflammation. It is also 
employed in the dilatation of fistulse, strictures and the os uteri. 



UVA URSI, Bearberry, — the leaves of Arctostaphylos Uva-ursi, a 
low, evergreen shrub, of the nat. ord. Ericaceae, inhabiting the northern 
latitudes and high mountains of Europe, Asia and America. The leaves 
are small, obovate, nearly sessile, shining, reticulated beneath, of a faint 
but hay-like odor, and a strongly astringent taste. They contain Tannic 
and Gallic Acids and 3 principles, viz., — Arbutin, C 24 H 32 O u , a bitter 
glucoside, neutral, crystalline, soluble in warm water and resolvable into 
glucose and Hydroquinone, C 6 H 6 2 ; — Ertcolin, C 34 H 56 2 , bitter and 
amorphous; — Ursone, C 20 H 34 O 2 , resinous, neutral, crystalline and taste- 
less. The Californian Manzanita (Arctostaphylos glaucd) is an allied plant 
and also contains Arbutin and Tannin. Dose of the powdered leaves, 
gr. X-3J in infusion or decoction. 
27 



41 8 VALERIANA. 

Preparations. 
Extractum Uvse Ursi, Extract of Uva Ursi. — Dose, gr. ij-x. 
Extractum Uvae Ursi Fluidum, Fluid Extract of Uva Ursi. — Dose, TT^x-^j. 
Infusum Uvae Ursi, Infusion of Uva Ursi (Unofficial), — ^j to Oj. Dose, Jj-ij. 
Arbutinum, Arbutin, C 24 H 32 O u (Unofficial). — Dose, gr. iij-v. 

Physiological Action and Therapeutics. 

Uva ursi is astringent, tonic and feebly diuretic. Used in large quan- 
tity it produces vomiting and purging, and is alleged to have oxytocic 
power. Arbutin is an efficient diuretic, and is decomposed in the body, 
yielding Hydroquinone which is excreted by the kidneys as Hydroqui- 
none-Sulphuric Acid. This is non-toxic, imparts a brown color, with 
antiseptic and slightly irritant qualities, to the urine. 

Bearberry was formerly used in all calculous affections and chronic 
disorders of the urinary passages. It has some reputation as an antilithic, 
and is no doubt useful in gravel, chronic nephritis, cystitis, urethritis, and 
kindred diseases. It relieves incontinence of urine, dysuria and strang- 
ury, and has proved serviceable even in uterine hemorrhages. Arbutin 
has been successfully employed in cardiac dropsy as a diuretic, also in 
urethritis. 



VALERIANA, Valerian, — is the rhizome and roots of Valeriana 
officinalis, a large, herbaceous plant of the nat. ord. Valerianeae, having 
small, white, or rose-colored flowers, and opposite pinnate leaves on an 
erect, round and channeled stem. The plant is a native of Europe, but 
is cultivated in Vermont and New York. The root is perennial, its 
rhizome about an inch long, upright, truncate at both ends, internally 
whitish or pale-brownish with a narrow circle of white wood under the 
thin bark. Odor peculiar, taste camphoraceous and bitter. It contains 
a complex Volatile Oil, from which are developed by oxidation Valerene, 
C 10 H 16 , which is a terpene, Valerol or Baldrian Camphor, C 12 H 20 O, and 
Valerianic Acid, C 5 H 10 O 2 , which occurs also in many other plants and in 
cod-liver oil. The Valerianic Acid of pharmacy is obtained as a product 
of the oxidation of Amylic Alcohol, and from it are formed the various 
Valerianates. It is not identical with the natural acid. Dose of the 
powdered root, gr. x-xxx. 

Preparations of Valerian. 

Extractum Valerianae Fluidum, Fluid Extract of Valerian. — Dose, nvx-^j. 

Tinctura Valerianae, Tincture of Valerian, — strength 20 per cent. Dose, gss-ij. 

Tinctura Valerianae Ammoniata, Ammoniated Tincture of Valerian, — has of 
Valerian 20, Aromatic Spirit of Ammonia to 100. Dose, gss-ij. 

Oleum Valerianae, Oil of Valerian (Unofficial), — the volatile oil, sp. gr. about 0.950, 
a greenish or yellowish, thin liquid, having the odor of valerian, an aromatic taste and a 
slightly acid reaction, readily soluble in alcohol. Dose, TTLij-v. 

The Oil is by far the best preparation for use, as the tinctures are extremely nauseous 
and the fluid extract is too bulky. The taste is best covered by Cinnamon. 



VALERIANA. 419 

Preparations of Valerianic Acid. 

Ammonii Valerianas, Ammonium Valerianate, NH 4 C 5 H 9 2 , — described under Am- 
monium. Dose, gr. ij-x. 

Ferri Valerianas, Ferric Valerianate, Fe 2 (C 5 H 9 2 ) 6 , — described under Ferrum. 
Dose, gr. j-iij. 

Quininse Valerianas, Quinine Valerianate, C 20 H 24 N 2 O 2 C 5 H 10 O 2 -\- H 2 0, — described 
under Cinchona. Dose, gr. j-iij. 

Zinci Valerianas, Zinc Valerianate, Zn(C 5 H 9 2 ) 2 -f- 2H 2 0, — described under 
Zincum. Dose, gr. )^-iij. 

The Valerianates are made with the acid produced from Amylic Alcohol, and do not 
represent the action of the plant, but rather that of the bases from which they are pre- 
pared. 

Physiological Action. 

Valerian is antispasmodic, and a gentle stimulant to the nervous and 
circulatory systems. It is sedative to reflex excitability, antagonizing the 
action of Strychnine, Brucine, Thebaine, etc., and is laxative, diaphoretic 
and anthelmintic. Its taste and odor are very disagreeable, but cats are 
extravagantly fond of it. In these animals it greatly excites the sexual 
appetite, probably from a resemblance between its odor and theirs when 
under venereal excitement. After a time it produces in them violent 
spasms and convulsions. 

In full doses it increases the action of the heart and raises the tempera- 
ture, in most persons producing exhilaration (in some, slight mental dis- 
turbance), with formication of the hands and feet. Long used it induces 
a condition of low melancholy and hysterical depression. Large doses 
cause hiccough, diarrhoea, nausea and vomiting, frequent micturition 
with tenesmus of the bladder and lithates in the urine, mental disturb- 
ance even to delirium, reduced motility and sensibility, and lessened 
reflex excitability. The Oil in large doses is paralyzant to the brain and 
the spinal cord, lowers the blood-pressure and slows the pulse. 

The Valerianates follow their bases in general action, but are sup- 
posed to combine therewith some of the sedative qualities of their acid 
constituent. 

Therapeutics. 

Valerian was formerly much employed in epilepsy, but it was probably 
useful only in the hysterical form of that disease (hystero-epilepsy). It is 
a valuable remedy in all forms of hysteria, especially when occurring in 
young and delicate women. It is also useful in flatulence of infants and 
in that of hypochondriacal and hysterical subjects, and in coughs of 
nervous type, whooping-cough, diabetes insipidus, convulsions due to 
worms and in delirium with vital depression. In the coma of typhus 
fever the oil proved remarkably efficient in a series of 135 cases out of 
172 cases treated by it. 

Ammonium Valerianate is used in the same class of disorders as is 
Valerian. It is often a good remedy for nervous headache, administered 
in 10-grain doses and in an elixir. 

Zinc Valerianate has been supposed to combine the antispasmodic 



< 



< 



420 VANILLA VERATRUM VIRIDE. 

power of valerian with the nerve-tonic effect of a zinc salt. It has been 
used in cholera, epilepsy and neuralgia, frequently with considerable 
success. 

The Ferric and Quinine Valerianates are used as are the other salts 
of their respective bases. 



VANILLA, — is the fruit of Vanilla planifolia, a perennial climbing plant of the 
nat. ord. Orchidese, native of the West Indies and tropical America, but cultivated in 
Java, etc. It has dark green, tough leaves, pale greenish-yellow sessile flowers, and long 
pods (6 to io inches), wrinkled, warty, one-celled, containing a blackish-brown pulp with 
numerous small seeds and acicular crystals, of peculiar and fragrant odor and taste. Its 
characteristic odorous principle is Vanillin, the Methyl-ether of Protocatechuic Aldehyd, 
which oxidizes slowly in damp air to Vanillic Acid, and may be resolved into Methyl 
Chloride and Protocatechuic Acid. Vanillin may be made synthetically from Coniferin 
or from Eugenol. Dose, indefinite. 

Tinctura Vanillse, Tincture of Vanilla, — io per cent. Dose, a few drops, according 
to the strength of flavor desired. 

Trochisci Ferri, Troches of Iron, — contain about ^ per cent, of Vanilla. 

Vanilla is an aromatic stimulant, with considerable influence on the nervous system. 
It is chiefly employed as a perfume and for flavoring purposes, but has been used in 
hysteria and low fevers. 



VERATRUM VIRIDE, American Hellebore,— is the rhizome 
and roots of Veratrum viride, the Indian Poke, Poke-root, or Swamp 
Hellebore, an indigenous plant of the nat. ord. Liliaceae, having a solid, 
round stem, furnished with bright green leaves, and terminating in a 
panicle of greenish-yellow flowers. The root is perennial, upright, 
externally blackish-gray, internally grayish-white, 2 to 3 inches long, 
with numerous, shriveled rootlets, inodorous but sternutatory when pow- 
dered, taste bitter and very acrid. It contains several alkaloids, Jervine, 
C 26 H 43 N0 2 , Pseudojervine, C 29 H 43 N0 7 , Cevadine, C 32 H 49 N0 9 , a very little 
Rubijervine, C 26 H 43 N0 2 , and traces of Veratrine, C 37 H 53 NO n , and Vera- 
tralbine, C 28 H 43 N0 3 . Veratroidine, formerly regarded as one of its alka- 
loids, is now thought to be a mixture of Rubijervine and a toxic Resin. 
Veratrum Viride also contains Gallic Acid and Sugar. 

Allied Plants. 

Veratrum Album, White Hellebore, — is a native of the mountainous 
regions of continental Europe, and so closely resembles V. Viride in 
appearance and characteristics that it may be considered a variety of the 
same plant. The rhizome was official in the U. S. P. 1870. It contains 
the alkaloids Jervine, Pseudo-jervine, Rubijervine, traces of Cevadine, 
and another powerful alkaloid Veratralbine , C 28 H 43 N0 5 . 

Veratrum Sabadilla, Cevadilla, Asagraa officinalis, — is a bulbous 
plant of the nat. ord. Liliaceae, indigenous in Mexico and Central 



VERATRUM VIRIDE. 421 

America. It contains the alkaloids Cevadine (formerly called Veratrine), 
Cevadilline and Veratrine, with Veratrlc and Sabadillic or Cevadic Acids. 
It is the source of the official Veratrine (see below). The seeds are 
official in the Br. Phar. under the title Sabadilla. 

Preparations. 
Extractum Veratri Viridis Fluidum, Fluid Extract of Veratrum Viride. — Dose, 

ny-iv. 

Tinctura Veratri Viridis, Tincture of Veratrum Viride, — strength 40 per cent. 
Dose, ri\jj-x. 

Norwood's Tincture of Veratrum Viride (Unofficial), — has a very high reputation 
for efficiency, — Dose, n\v, increased by rnj every 3 hours, until pulse is down to 65, when 
the original dose will hold it there. 

Veratrina, Veratrine, — is a mixture of alkaloids prepared from the seeds of Asagraa 
officinalis (see above). A white, or grayish-white, amorphous powder, highly irritant to 
the nostrils, of very acrid taste, producing tingling and numbness of the tongue and 
constriction of the fauces; slightly soluble in cold water, soluble in 3 of alcohol at 
59 F., in 6 of ether, 2 of chloroform, 96 of glycerin and in 56 parts of olive oil. Dose, 
err 1 _ 1 

Unguentum Veratrinae, Veratrine Ointment, — Veratrine 4, Olive Oil 6, Benzoinated 
Lard 90. For local use. 

Oleatum Veratrinae, Oleate of Veratrine, — Veratrine 2, Oleic Acid 98. For local 
use. 

Physiological Action. 

Veratrum Viride is in action closely allied to Aconite, being a power- 
ful cardiac depressant and spinal paralyzant. It differs from Aconite in 
affecting the respiration to a much less degree, — in being a systemic 
emeto-cathartic — in paralyzing the motor system centrally, impairing the 
reflexes, but leaving sensation unimpaired, — and in having little or no 
diaphoretic or diuretic action. It causes great depression, but is seldom 
fatal ; when death does result from its use it usually occurs by paralysis 
of the heart. 

In small doses Veratrum reduces the force of the pulse, but does not at 
first affect its rate. If continued for some time, the pulse becomes very 
slow, soft and compressible; rising, on the least exertion, to be very 
rapid and feeble. At the same time there is great muscular weakness, 
and frequently nausea and vomiting. Large doses increase these symp- 
toms very much, the pulse becoming very rapid and so small as to be 
almost imperceptible ; the skin is cold and clammy, and constant vomit- 
ing, extreme debility, giddiness, impaired vision, and partial unconscious- 
ness ensue. 

Jervine represents in part the depressant action on the circulation and 
on the central nervous system. It does not, however, affect the vagus, 
and but very slightly the voluntary muscles or the motor nerves. It irri- 
tates the motor centres in the brain, causing convulsions; and lowers the 
functions of the cord, of the centres in the medulla, especially the vaso- 
motor, and those of the cardiac ganglia, — slowing the heart by direct 
depression either of the cardiac muscle or its motor apparatus. It always 



^ 



422 VERATRUM VIRIDE. 

causes salivation, but never vomiting or purging ; and kills by asphyxia, 
the heart beating after respiration has ceased. 

Veratroidine, on the contrary, always causes emeto-catharsis, and 
produces less violent convulsions. It stimulates the vagus centre and 
paralyzes the vagus ends, depresses the cord, and paralyzes the respiratory 
centre, — but at the same time increases the excitability of the vaso-motor 
centre. The result is great slowing of the pulse-rate and of respiration, 
and lowering of blood-pressure, until the carbonized blood irritates the 
vaso-motor centre, when the blood-pressure rises greatly. It probably 
consists of Rubijervine and a toxic resin. 

Veratrum Album contains a very powerful alkaloid, Veratralbine, and 
also an irritant poisonous resin (?). Its general action is similar to that 
of its congener, but it is much more irritant to the gastro-intestinal 
mucous membrane, causing violent vomiting and purging, intense abdom- 
inal and oesophageal pain, greatly reduced temperature and pulse, col- 
lapse, and death from cardiac and respiratory paralysis. 

Veratrine is an acrid, intensely irritant powder, consisting of a mix- 
ture of alkaloids. It causes violent sneezing, a burning sensation, and 
free salivation. It affects the heart and circulation similarly to the other 
Veratrise, and in addition seems to be a direct poison to muscular tissue, 
and to cause violent convulsions before the muscular paralysis sets in. 
The alkaloids Jervine and Rubijervine both depress the circulation, while 
the latter produces the emeto-catharsis. 

Antagonists and Incompatibles. 

Alcohol, Opium, Belladonna and Ammonia counteract the cardiac depression. Mor- 
phine and Atropine should be administered hypodermically, or Laudanum internally with 
alcoholic stimulants ; the recumbent position should be enforced, and dry heat applied to 
the body. Caustic alkalies are incompatible, as they decompose the alkaloids. 

Therapeutics. 

Veratrum Viride is inferior to Aconite in most of the fevers and 
inflammations, by reason of its lacking power over excretion. It renders 
good service, however, in the early stages of many parenchymatous and 
serous inflammations when occurring in sthenic subjects, especially in 
pneumonia. It is highly esteemed in puerperal fever and in many cardiac 
disorders, as simple hypertrophy, irritable heart, etc. It has been used 
with remarkably good results in many cases of acute mania and puerperal 
convulsions, and it is of service in aneurism to depress the circulation to 
the lowest point, but in this case the recumbent position must be strictly 
observed, in order to secure safety. It should always be administered in 
small doses and its effects carefully watched. 

In puerperal eclampsia large doses have been administered without 
danger and with decided benefit, as much as 20 drops of Norwood's 
tincture having been administered every hour for 5 consecutive days and 



VERBASCUM VIBURNUM. 423 

nights in one case, the patient making a good recovery. The same pre- 
paration may be given hypodermically, in doses of ffLij-iv. 

Veratrum Album is the Hellebore of the ancient physicians, and was 
much used by them as a derivative in insanity. It is rarely used at 
present except by the homceopathists, who give it in the cold- stage of 
cholera, in colic, in the vomiting and purging of summer diarrhoea, in 
whooping-cough and asthma. 

Veratrine is chiefly used externally. The ointment or oleate may be 
used with benefit in many cases of superficial neuralgia, myalgia and 
headaches, a small quantity being rubbed in over the seat of the pain. It 
may be absorbed through an abrasion of the cuticle and give rise to dan- 
gerous symptoms. Internally it has been employed as a cardiac sedative 
in fevers and inflammation, also in acute articular rheumatism, dropsies, 
dysmenorrhcea and various nervous affections, but its uncertainty of action 
and the dangerous depression which it may produce have caused it to lose 
favor as an internal remedy. 



VERBASCUM, Mullein (Unofficial), — is the leaves of Verbascum Thaspus, the 
Mullein-weed, a common plant of the nat. ord. Scrophulariacese, having large woolly 
leaves and yellow flowers in dense spikes. Its chief constituent is mucilage, though the 
flowers contain an essential oil in very small proportion. An infusion of ^iv of fresh 
leaves to the pint of milk is the form in which it has generally been given; this quantity 
to be taken thrice daily. 

Mullein is emollient and demulcent, perhaps also slightly anodyne. It has long been 
a popular Irish remedy in pulmonary affections, as under its use the weight steadily in- 
creases in phthisis and other wasting disorders, while expectoration is rendered more 
easy, cough is palliated and the general condition improved. It is also recommended in 
cystitis, irritable bladder, and diarrhoea, and is employed as an enema in dysentery and 
as a poultice for hemorrhoids. The dried leaves may be smoked with benefit in aphonia 
from laryngeal irritation. 



VIBURNUM OPULUS, Cramp Bark,— is the bark of Viburnum Opulus, a shrub 
of the nat. ord. Capri foliaceae ; occurs in flattish or curved bands, or in quills, the outer 
surface ash-gray, marked with scattered and transversely elongated warts of brownish 
color, due to abrasion ; inodorous, taste somewhat astringent and bitter. 

Extractum Viburni Opuli Fluidum, Fluid Extract of Viburnum Opulus. — Dose, 
^ss-ij. 

Viburnum Opulus is highly valued by many practitioners as a remedy for uterine and 
abdominal pains. The so-called Viburnum Compound of Dr. Hayden is stated by its 
manufacturers to consist of " the active principles of the Viburnum Opulus, Dioscorea 
Villosa, Scutellaria Lateriflora, and a combination of aromatics, prepared by a process 
peculiar to ourselves." This they call publishing the formula of the preparation. 



VIBURNUM PRUNIFOLIUM, Black Haw,— is the bark of Viburnum pru- 
nifolium, an indigenous shrub of the nat. ord. Capri foliaceas, having sharply serrulate 
leaves, and small, white flowers in terminal cymes. The bark occurs in glossy, purplish 
brown, thin pieces or quills covered with scattered warts and minute black dots; inner 
surface whitish and smooth, inodorous, somewhat astringent and bitter. It contains 
tannic, oxalic, citric and malic acids, sulphates and chlorides ; also two resins, one of 
which is named Viburnin, and Viburnic Acid, which is identical with Valerianic Acid. 



i 



424 VIOLA TRICOLOR VISCUM VITELLUS. 

Extractum Viburni Prunifolii Fluidum, Fluid Extract of Viburnum Prunifo- 
Hum. — Dose, gss-ij. 

Viburnum Prunifolium is considered to- possess nervine, antispasmodic, astringent, 
diuretic and tonic properties, and to be especially useful in preventing abortion, in the 
nervous diseases of pregnancy, and in spasmodic dysmenorrhcea. It may be administered 
with cannabis indica, morphine, nerve-sedatives or simple aromatics. No exact observa- 
tions have been made regarding its action, and its therapeutical claims are denied by 
many who have used it. It often excites nausea and vomiting. 



VIOLA TRICOLOR, Pansy (Unofficial),— is the wild-grown, flowering herb of 
Viola tricolor, the Heart's-ease Pansy, a plant of the nat. ord. Violaceae, native in 
Europe, but naturalized in the southern U. S. It has an angular and nearly smooth stem ; 
leaves alternate, petiolate, ovate or oblong and crenate ; flowers with an obtuse spur and 
variegated petals, inodorous, taste somewhat bitter and acrid. It contains an active 
alkaloid, Violine, allied in many respects to Emetine, and poisonous. Dose, gr. x-^j, 
in decoction. 

Viola is mucilaginous, emollient, expectorant and slightly laxative. Its active princi- 
ple is emeto-cathartic, but exists in very small quantity in the plant. A decoction of the 
fresh herb in milk, with a poultice of the same, was formerly recommended highly in crusta 
lactea and impetigo. It is used with benefit in some forms of eczema, especially in that 
of the head and face, and has had some reputation in bronchitis and constitutional 
syphilis. 

Viola Cucullata, the common Violet, is used in Pennsylvania with success as an 
internal antidote against rattlesnake venom. The leaves are eaten, and a poultice of salt 
and indigo is applied to the wound. 



VISCUM, Mistletoe (Unofficial), — occurs in two species, (i) Viscum album, the 
European Mistletoe, a small, parasitic, evergreen shrub, of the nat. ord. Loranthaceae, 
growing chiefly on deciduous-leaved trees, and (2) Viscum Jlavescens, the American 
species, growing on oaks, elms, etc. They contain mucilage, starch, fixed oil, resin, salts, 
etc., and Viscin, or Bird-lime, which occurs also in Ilex aquifolium, Gentiana lutea and 
other plants. Dose, gr. x-3 j in decoction, or rt\,v-xxx of a ten per cent, tincture. 

The berries of the mistletoes have produced emeto-catharsis, with great thirst, tenes- 
mus, bloody stools, convulsions and even death in young children. The leaves and 
twigs have been used in epilepsy, hysteria, chorea, asthma and other nervous affections. 
The American plant is asserted to possess qualities similar to those of Digitalis, and to 
incite uterine contractions. It has been used in cardiac affections, dropsies, uterine hem- 
orrhages and amenorrhcea, also as an abortifacient. 



VITELLUS, Yolk of Egg,— is the yolk of the egg of the domes- 
tic fowl, Gallus Bankiva, var. domestica. It is a viscid, reddish-yellow, 
opaque liquid, of bland taste, alkaline reaction, odorless, and may be 
regarded as a dense emulsion of oil suspended in water by means of 
albumen. It is coagulated by heat or by alcohol, and contains Vitellin, 
which is a proteid related to casein, also Cholesterin and Albumin, besides 
fat, inorganic salts, sugar, etc. 

Preparation. 
Glyceritum Vitelli, Glycerite of Yolk of Egg {Glyconin), — consists of Vitellus 45, 
Glycerin 55, rubbed together until thoroughly mixed. 



XANTHOXYLUM. 425 

Yolk of Egg is highly nutritive and forms a useful article of diet in 
exhausted conditions of the system, but its chief use in medicine is for 
emulsionizing oils and camphors. The Glycerite has the consistence of 
honey and forms an opaque emulsion with water. It is a very good 
vehicle for cod-liver oil, and an excellent protective application for burns, 
erysipelas, fissure of the nipples and many cutaneous disorders. It is also 
used as a cosmetic, and may be employed as an aliment. 



XANTHOXYLUM, Prickly Ash,— is the bark of Xanthoxylum 
americanum, the northern species, and of Xanthoxylum Clava-Hei-culis, 
the southern species, of an indigenous shrub of the nat. ord. Rutacese, 
having small, greenish flowers, alternate, unequally pinnate leaves, leaf- 
lets punctate with pellucid dots, stems and leafstalks armed with prickles. 
The bark of both species comes in curved or quilled fragments, of a 
brownish-gray color externally with whitish patches, and minute black 
dots, faintly furrowed, inodorous, bitter and pungent ; that of the north- 
ern is about -^g- inch thick, has several two-edged spines each ^ inch 
long ; the bark of the southern is twice as thick as the other and is marked 
by many conical, corky projections, and by stout brown spines, arising 
from corky bases. It contains a volatile oil, a fixed oil, resin, gum, col- 
oring matter and an alkaloid, Xanthoxyline, which is identical with 
Berberine. Dose, of the powdered bark, gr. x-xxx. 

Preparations. 

Extractum Xanthoxyli Fluidum, Fluid Extract of Xanthoxylum. — Dose, gss-j. 
Decoctum Xanthoxyli, Decoction of Xanthoxylum (Unofficial), — ^j to the quart. 
Dose, a pint during 24 hours in divided doses. 

Physiological Action and Therapeutics. 

Xanthoxylum is a stimulant and aromatic bitter, a local and systemic 
sialagogue, also diaphoretic, diuretic and emmenagogue. Its taste is 
aromatic, soon becoming acrid and bitter, and causing profuse salivation, 
tingling in the tongue and increased secretion from the stomach, intestines, 
liver and pancreas. It also increases the cardiac action and raises the 
arterial tension, and is classed among the vegetable alteratives, with 
Mezereum, Guaiac, Stillingia, etc. 

Xanthoxylum has a high reputation in chronic rheumatism, myalgia, 
lumbago and similar disorders, also in jaundice from catarrh of the bile- 
ducts, in dropsies, chronic pharyngitis and constitutional syphilis. In 
old cases of pharyngitis, the mucous membrane being glazed and dry, the 
decoction should be used as a gargle and n^ x-xxx of the fluid extract 
taken internally thrice daily. The bark, used as a masticatory, is a popu- 
lar remedy for toothache, and has been frequently successful in paralysis 
of the tongue. 



< 



426 ZEA MAYS. 

ZEA MAYS, Maize, Indian Corn. — This well-known species of 
the nat. ord. Gramineae, though itself unofficial, is the source of the 
official Starch (see Amylum), and of two drugs, of which one is official, 
viz.: — 

Zea, Corn-Silk {Stigmata Maydis), — the styles and stigmas of Zea 
Mays, which should be gathered when the tassels have shed their pollen. 
It occurs thread-like, yellowish or greenish, soft-silky, inodorous, taste 
sweetish. Its active principle is thought to be Maizenic Acid. There 
are no official preparations. 

Extractum Zeae Fluidum, Fluid Extract of Zea (Unofficial), — is made by the 
general rule for fluid extracts. Dose, gj-ij. 

Ustilago, Corn Smut (Unofficial), — is Ustilago Maydis, nat. ord. 
Fungi, a smut grown upon the stems, the pistils and the male inflorescence 
(tassel) of Zea Mays. It occurs in irregular, globular masses, sometimes 
6 inches thick, and consisting of a blackish membrane, inclosing numerous 
globular, minute spores, their surfaces covered with echinulate warts. Its 
odor and taste are unpleasant, and it contains fixed oil, resin, pectin, 
gluten, sugar, an acid resembling the Sclerotic Acid of Ergot, and a 
volatile principle called Secaline, which is supposed to be identical with 
Trimethylamine. 

Extractum Ustilaginis Fluidum, Fluid Extract of Ustilago (Unofficial), — may be 
prepared by the general rule for fluid extracts. Dose, rr^x-gj. 

Physiological Action and Therapeutics. 

Zea is a certain but mild diuretic when given in full doses at short 
intervals. It is by some observers considered demulcent and anodyne, 
and is generally believed to have a specific or alterative influence over 
many disorders of the genito-urinary passages and the urinary bladder. 
It has been used with considerable success in incontinence of urine, 
uric and phosphatic gravel, gout, rheumatism, urethritis, pyelitis, acute 
and chronic cystitis, cardiac dropsy and obstructive valvular disease of 
the heart. 

The properties of Ustilago, so far as examined, resemble those of 
Ergot and Nux Vomica combined. It is a spinal excitant, exalts sensibil- 
ity and reflex action, producing tonic convulsions on the least irritation 
of the skin. It slows the heart by stimulation of the pneumogastric, 
dilates the pupils, causes muscular paresis, and death by tetanus of the 
respiratory muscles or by exhaustion. Experiments on its reputed oxy- 
tocic action have not substantiated the claims made for it in this respect, 
though it is said to have produced abortion in cows and other animals, 
after they had eaten the diseased grain. As a therapeutic agent Ustilago 
has been very little used, but when employed it has been as a substitute 
for Ergot. 



ZINCUM. 427 

ZINCUM, Zinc, Zn, — is metallic Zinc, in the form of thin sheets, or 
irregular, granulated pieces, and is a bluish-white metal, having the sp. 
gr. 6.9. It occurs native as a Sulphide {Blende), as a Carbonate and a 
Silicate {Calamine*), as a Red Oxide {Zincile), and as a mixture of Zinc 
Oxide with Oxide of Iron and Manganese (Franklinite). Zinc is soluble 
in the weakest acids, and therefore should never be used for culinary ves- 
sels. Its salts are all more or less active poisons. Metallic Zinc is 
official, but is not employed as a medicine. 

Zinc Sails and their Preparations. 

Zinci Acetas, Zinc Acetate, Zn (C 2 H 3 2 ) 2 -f- 2H 2 0, — soft, white, micaceous or pearly, 
six-sided tablets or scales, somewhat efflorescent in dry air, of faintly acetous odor, sharp 
metallic taste and a slightly acid reaction ; soluble in 3 of water and in 36 of alcohol at 
59 F., in \y 2 of boiling water and in 3 of boiling alcohol. Used locally as an astringent 
in solution of gr. j or ij to ^j, or internally in doses of gr. ^-ij. 

Zinci Carbonas Prsecipitatus, Precipitated Zinc Carbonate, — a white, impalpable 
powder, permanent in the air, odorless and tasteless, insoluble in water or alcohol, but 
soluble, in acids with copious effervescence. When strongly heated it loses water and 
carbonic acid gas, leaving a residue of oxide of zinc. Used locally as a protective. 

Zinci Chloridum, Zinc Chloride, ZnCl 2 , — a white, granular powder, or porcelain-like 
masses, or moulded into pencils, odorless, of such intensely caustic properties as to make 
tasting dangerous ; very soluble in water and in alcohol ; very deliquescent. Is tonic and 
escharotic. For internal use a solution in Spirit of Ether is the most convenient form, 
strength gj to ^j, of which four to eight minims may be given twice daily in water. 
Strength of injections and collyria, gr. j-ij to the ^ . 

Liquor Zinci Chloridi, Solution of Zinc Chloride, — is an aqueous solution, contain- 
ing about 50 per cent, of the salt. A clear, colorless, odorless liquid, of a very astringent, 
sweetish taste and an acid reaction. A powerful disinfectant for sinks, drains, etc. Used 
also as an injection in gonorrhoea, leucorrhcea, etc., in dilute solution, l / z to I per cent. 
Burnett's Disinfecting Fluid is similar to the above but slightly stronger. 

Zinci Iodidum, Zinc Iodide, Znl 2 , — a white, granular powder, very deliquescent, of 
sharp, saline and metallic taste and acid reaction ; very soluble in water and in alcohol. 
Dose, gr. ss-ij in syrup. 

Zinci Oxidum, Zinc Oxide, ZnO, — an amorphous, white powder, without odor or 
taste; insoluble in water or alcohol; soluble, without effervescence, in dilute acids, also 
in ammonia water. Dose, gr. j-x, in pill. 

Unguentum Zinci Oxidi, Ointment of Zinc Oxide, — has of Zinc Oxide 20, Ben- 
zoin ated Lard 80. 

Oleatum Zinci, Oleate of Zinc, — has of Zinc Oxide 5, in Oleic Acid 95. For ex- 
ternal use. 

Zinci Sulphas, Zinc Sulphate, ZnS0 4 +7H 2 0, — small colorless prisms or acicular 
needles, slowly efflorescing in dry air, odorless, of sharp, saline, nauseous and metallic 
taste and acid reaction ; soluble in 0.6 of water, insoluble in alcohol. Dose, as emetic, 
gr. x— xxx, — as a tonic and astringment, gr. ^q— ij, in pill. For Villate's Solution, see 
under Cuprum. 

Zinci Valerianas, Zinc Valerianate, Zn (C 5 H 9 2 ) 2 +2H 2 0, — white, pearly scales, 
having the odor of valerianic acid, a sweetish and styptic taste and acid reaction ; soluble 
in about 100 of water and in 40 of alcohol. Dose, gr. y^- ij, in pill. 

The Bromide is described under Bromum, and the Phosphide under Phosphorus. 

Physiological Action and Therapeutics. 
Zinc Salts are astringents, but milder ones than the salts of Lead. Its 
soluble compounds (the Chloride, Iodide, Sulphate and Acetate) are cor- 
rosive poisons, causing violent gastro-enteritis, and in some cases pro- 
found nervous depression. The Chloride is a very powerful and painful 
escharotic or rather mumminer of the tissues, having great affinity for 



428 ZINCUM. 

water, coagulating albumen and shrivelling the vessels. It is a very- 
active disinfectant. The Sulphate is also escharotic and a specific 
emetic, acting promptly by direct irritation of the stomach, and without 
much depression or after-nausea. In small doses it is tonic and astring- 
ent, in larger it would be a severe irritant but for its causing prompt 
emesis. The Acetate resembles the Sulphate in action. The Oxide 
used externally is a mild, soothing astringent ; used internally it enters 
the blood as a lactate or chloride, and acts as a mild astringent and as a 
nervous sedative. Being almost insoluble in the stomach, it has but 
feeble diffusive power and consequently but slight activity. The Car- 
bonate resembles the Oxide in action. The Iodide locally is a power- 
full escharotic and has been supposed to possess some alterative powers 
when given internally in addition to its astringent qualities as a zinc salt. 
The Valerianate acts as a nervous sedative, but its properties are in all 
probability due to its base and not to the acid combined with it. 

Continued use of Zinc salts produces symptoms similar to those of 
chronic lead-poisoning, but of much less gravity. They manifest much 
less tendency to accumulate in the system than other metallic salts, and 
are excreted much more rapidly. Elimination takes place chiefly by the 
liver and intestinal glands. 

The action of the Bromide and Phosphide are described respectively 
under Bromum and Phosphorus. 

Antidotes and Incompatibles. 

Lime-water, mucilaginous drinks, soap, Tannic Acid, milk, Potassium and Sodium 
Carbonates, if given early, are the antidotes in poisoning by the salts of zinc. Incom- 
patibles are — Lime-water, Alkalies and their carbonates, Silver Nitrate and vegetable 
astringents. Lead Acetate produces double decomposition with zinc salts, but it is often 
used in solution with the Sulphate as an injection. 

Therapeutics. 
Zinc salts are chiefly employed in weak solution as mild astringent 
applications in catarrhs of mucous membranes, such as conjunctivitis, 
gonorrhoea, etc., and as unguents and lotions in skin diseases, particularly 
eczema, impetigo, herpes, and erythema. The Chloride is made into a 
paste with flour and glycerin for the destruction of lupus, epithelioma and 
other morbid growths, and for opening abscesses in locations where punc- 
ture or incision might be dangerous. The cuticle, if unbroken, should 
be removed by strong water of ammonia before the paste is applied, as it 
will not act through the epidermic tissue. It is a commonly used disinfec- 
tant and deodorant, and in weak solution (riLiij-v of the Liquor to gj 
of water) makes a good lotion for putrid ulcers, and still weaker (gr. j-ij 
to the pint), is an excellent injection for gonorrhoea. The Iodide is not em- 
ployed as an escharotic, nor has it ever been a favorite remedy for internal 
use. It is chiefly employed in solution as an application to enlarged tonsils, 



ZINGIBER. 429 

and as an ointment (1 part to 8 of lard) for the reduction of glandular 
enlargements. The Sulphate is used locally as an astringent to mucous 
surfaces generally, internally as an emetic in narcotic poisoning and 
croup, and in small doses as a tonic and antispasmodic in convulsive 
diseases, as chorea, hysteria, epilepsy, angina pectoris, asthma, etc. In 
diarrhoeas and dysentery it is a good astringent, and is frequently com- 
bined with Opium and Ipecac. The Acetate is used for the same pur- 
poses as the Sulphate, but is usually preferred for collyria. The Oxide 
may be used as a dusting powder in intertrigo, and as an ointment in 
eczema and excoriated surfaces generally. In combination with Bismuth 
and Pepsin it is an excellent remedy for the summer diarrhoea of child- 
ren, and with Aromatic Powder and Morphine it is very efficient in gas- 
tralgia. It is a good remedy in 3-grain doses for the night-sweats of 
phthisis, and has been successfully employed in epilepsy and neuralgia, 
in whooping-cough, hysteria and nervous headache, and in bronchorrhcea 
to check the profuse secretion. It is much employed as an ingredient of 
cosmetics. The Carbonate is by some preferred to the oxide for local 
use in skin diseases. Calamine Ointment, which is a mixture of the im- 
pure carbonate (calamine) with the oxide and an unguent basis, was until 
recently a favorite application as a soothing protective to abrasions and 
inflammations of the integument. The Valerianate has been used in 
chorea, epilepsy, neuralgia, and various anomalous nervous affections, 
such as the nervous headache of hysterical women, nervous coughs and 
aphonia due to uterine and ovarian irritation. 

The Bromide and Phosphide are used entirely with reference to their 
respective non-metallic bases, under which titles their therapeutics are 
described. 



ZINGIBER, Ginger, — is the rhizome of Zingiber officinale, a plant 

of the nat. ord. Scitaminese, having dingy-yellow flowers on a leafless 

flower-stalk, and long, lanceolate leaves on a separate stem. The plant 

is a native of Hindostan, but is cultivated in Jamaica, Sierra Leone, etc. 

The rhizome is about -| inch broad, flattish, on one side lobed or clavately 

branched, of a pale-buff color, striate, agreeably aromatic and of a warm, 

pungent taste. It breaks with a mealy, fibrous fracture showing numerous 

small resin-cells and fibro-vascular bundles. It contains an aromatic, 

volatile oil and a resin. 

Preparations. 

Extractum Zingiberis Fluidum, Fluid Extract of Ginger. — Dose, TTLx-^ss. 

Tinctura Zingiberis, Tincture of Ginger, — alcoholic, 20 per cent. Dose, rrLxx-^ij. 

Syrupus Zingiberis, Syrup of Ginger, — has of the Fluid Extract 3 per cent, in 
sugar and water. Dose, ^ss-ij. 

Trochisci Zingiberis, Troches of Ginger, — each troche contains of the Tincture 2 
minims, with Tragacanth, Sugar and Syrup of Ginger. 



430 ZINGIBER. 

Oleoresina Zingiberis, Oleoresin of Ginger, — contains all the virtues of the root, 
and is extracted by ether. Dose, Tfl^-j, well diluted. 

Ginger is also a constituent of Pulvis Aromaticus and Pulvis Rhei Compositus. 

Physiological Action and Therapeutics. 
Ginger is sialagogue when chewed, sternutatory when inhaled, and 
externally a rubefacient. Internally it is a grateful stimulant and carmina- 
tive, produces a sensation of warmth at the epigastrium and promotes the 
expulsion of flatus. It is employed as a carminative in colic, as a masti- 
catory to increase the secretion of saliva*and in relaxedjconditions of the 
throat, also internally in atonic dyspepsia, to relieve flatulence, and as an 
adjunct to purgative agents to correct their griping properties. The 
syrup is in common use as a flavoring adjuvant in prescriptions. 






PART II. 



PHARMACY AND PRESCRIPTION WRITING. 



Pharmacy (Pharmakon, a medicament), — may be defined as the art of 
selecting and preserving medicines, and preparing them for administra- 
tion. It may be divided into — 

Official or Galenical Pharmacy, — dealing with the processes and prepa- 
rations of the Pharmacopoeia ; and — 

Extemporaneous or Magistral Phamiacy, — which includes the opera- 
tions of compounding and dispensing remedies as directed by the pre- 
scriptions of physicians. 

Pharmacopoeias and Dispensatories. 

A Pharmacopoeia is an official list of the drugs and their prepara- 
tions recognized by the medical profession of a certain country. In 
foreign countries the Pharmacopoeias are published under government 
auspices and have the force of a legal standard ; in the United States 
its publication is left to the medical and pharmaceutical professions and 
is revised every ten years by a convention called for that purpose. The 
official Pharmacopoeias in the English language, with the dates of their 
latest revision or additions, are as follows, viz. — 

The Pharmacopoeia of the United States of America, 7th Decennial 
Revision, 1890; official from January 1, 1894. 

The British Pharmacopoeia, 1885. Additions, 1890. 

Besides the above there are — The Pharmacopoea Germanica, 1882; the Pharmacopee 
Franeaise (Codex Medicamentarius), 1884 ; the Austrian, Pharmacopoea Austriaca, 1889; 
Russian, Ph. Rossica, 1880; the Swedish, Ph. Suecica, 1869; the Norwegian, Ph. Nor- 
vegica, 1879; the Danish, Ph. Danica, 1868, 1874, 1876; the Belgian, Ph. Belgica, 
1885 ; the Swiss, Ph. Helvetica, 1872, 1876; the Spanish, Farmacopea Espanola, 1884; 
the Portuguese, Ph. Portugueza, 1876; the Indian, Ph. of India, 1868 ; the Hungarian, 
Ph. Hungarica, 1888; The Netherlands', Ph. Neerlandica, 1889; the Roumanian, Ph. 
Romafia, 1874; the Finnish, Ph. Finnica, 1885 ; the Chilian, Farmacopea Chilena, 
1886; the Greek, Ph. Hellenica, 1868; the Japanese, Ph. Japonica, 1886; the Mexican, 
Nueva Farmacopea Mexicana, 1884; the Croatia-Slavonian, Ph. Croatico-Slavonica, 
1888 ; and the Italian, Farmacopea Italiana, 1887. 

431 



432 CONSTITUENTS OF VEGETABLE DRUGS. 

A Dispensatory is a commentary on one or more pharmacopoeias, 
giving in extenso the physical and medicinal history of the drugs and 
preparations, together with their doses, physiological action and thera- 
peutics, and includes similar information about many drugs which are not 
official in any pharmacopoeia, but are of occasional use or general inter- 
est. A dispensatory is a private publication, of authority according to 
the reputation of its author. The principal dispensatories are American 
publications, and are veritable drug-encyclopaedias, so elaborately do 
they deal with every subject embraced therein. Those of acknowledged 
value are — 

The Dispensatory of the United States of America, by Dr. Geo. B. Wood and 
Dr. Franklin Bache. 17th edition, revised and largely rewritten, by Professors H. C. 
Wood, J. P. Remington and S. P. Sadtler. Philadelphia, J. B. Lippincott & Co. 1894. 

The National Dispensatory. 5th edition, revised by Professors Stille, Maisch and 
Caspari. Philadelphia, Lea Bros. & Co. 1894. 

The American Dispensatory, by King & Lloyd, Cincinnati, is the recognized au- 
thority of the " eclectic" practitioners. 

A Companion to the U. S. Pharmacopoeia, by Drs. Oldberg and Wall; New 
York, Wm. Wood & Co. — is an excellent book, but not so exhaustive as the others in its 
method of treating the subjects embraced in it. 

A Companion to the British Pharmacopoeia, by Peter Squire; 15th edition, 
London, 1890; is the nearest English approach to the American dispensatories, and is 
the standard text-book on materia medica proper in Great Britain. Although a very 
good book it does not compare as a work of reference with either of the two great Ameri- 
can Dispensatories first above named. 



CONSTITUENTS OF VEGETABLE DRUGS. 



The Constituents of Vegetable Drugs may be classified as Soluble and 
Insoluble, the first group containing those ingredients which may be 
extracted by suitable menstrua, the second such as resist the action of all 
ordinary solvents. 

The Soluble Constituents comprise both Inert and Active Princi- 
ples, the inert being chiefly starch, gum and pectin, which may be readily 
separated by water. The active principles are alkaloids, acids, salts, 
glucosides and other neutral principles, volatile oils, resins, etc. Some 
few of these may be extracted by Water alone (e. g., Morphine), and in 
some cases the addition of acids or alkalies to the water will effect the 
chemical solution of many ingredients which are insoluble in water alone. 
As a rule, however, Alcohol is the most generally applicable of all simple 
solvents, but from its hardening the cell-membranes instead of softening 



CONSTITUENTS OF VEGETABLE DRUGS. 433 

them it prevents the osmosis of their contents. Drugs subjected to alco- 
holic or ethereal menstrua should have their cells thoroughly broken or 
torn, so that the solvent may be brought into actual contact with the 
principles contained in them. The degree of disintegration required 
depends upon the size of the cells, ducts, tubes, intercellular spaces, etc., 
in which the active principles are enclosed. A very finely powdered state 
is however open to objection from the packing of the particles together 
into an almost impenetrable mass when treated by the solvent. The 
average size of vegetable cells is about -g^- of an inch, while resin cells 
and other cavities are larger, averaging perhaps about y^ inch. The 
Pharmacopoeia prescribes in each instance the degree of fineness of the 
powdered drug employed in making certain of its preparations, or its 
bruising, slicing, etc., when such operations will answer. [Compare the 
article on Comminution in the following section.] 

Alkaloids are active, nitrogenous principles existing in plants, from 
which they are extracted by chemical art. They are organic bases, com- 
bining with acids to form crystalline salts without the production of water. 
They are regarded as compound ammonias, that is to say, one or more 
atoms of H in ammonia (NH 3 ) are in them replaced by various radicals ; 
and they may be considered to be products of albuminous decomposition 
in -the plant-cells during the process of growth. Like ammonia, they all 
contain N, with C and H ; most of them also contain O, though a few 
are devoid of the latter element, and occur as oily liquids, namely — Nico- 
tine, Coni'ine, Sparteine, Piperidine, Lupuline, Lobeline, Muscarine and 
Pilocarpine. Alkaloids are alkaline in reaction, the solid ones (except 
Berberine) are colorless; they are sparingly soluble or insoluble in water, 
but readily soluble in alcohol ; while their salts are more soluble in water 
than in any other liquid. Their solutions are intensely bitter. They are 
easily decomposed by alkalies or alkaline carbonates ; and are precipitated 
from their solutions by a solution of Iodine in Potassium Iodide, by Po- 
tassio-mercuric Iodide, and by Picric, Phospho-molybdic and Phospho- 
tungstic Acids. They generally have a powerful physiological action. 
They are closely related to Pyridene, and some of them may be synthet- 
ically prepared from pyridene bases. The names of alkaloids terminate 
in Latin in — ina, in English in — ine. 

Of the alkaloids 15 are official, under either their own names or those 
of their salts, besides Veratrine, which is described as a mixture of alka- 
loids. Of the official salts of alkaloids there are 10 Sulphates, 6 Hydro- 
chlorates, 3 Hydrobromates and 1 each Bisulphate, Acetate, Salicylate 
and Valerianate. The official alkaloids are as follows, viz.: — 

Apomorphina, (Apomorphine). Cinchonina, (Cinchonine). 

Atropina, (Atropine). Cinchonidina, (Cinchonidine). 

Caffeina, (Caffeine). Cocaina, (Cocaine). 

28 



434 CONSTITUENTS OF VEGETABLE DRUGS. 

Codeina, (Codeine). » Pilocarpina, (Pilocarpine). 

Hyoscina, (Hyoscine). Quinina, (Quinine). 

Hyoscyamina, (Hyoscyamine). Quinidina, (Quinidine). 

Morphina, (Morphine). Strychnina, (Strychnine). 

Physostigmina, (Physostigmine). Veratrina, (Veratrine). 

Unofficial but Important Alkaloids, are the following, viz.: — 

Aconitina, (Aconitine). Duboisina, (Duboisine). 

Berberina, (Berberine). Emetina, (Emetine). 

Brucina, (Brucine). Gelsemina, (Gelsemine). 

Colchicina, (Colchicine). Homatropina, (Homatropine). 

Coniina, (Coniiine). Muscarina, (Muscarine). 

Curarina, (Curarine). Pelletierina, (Pelletierine). 

Glucosides are organic bodies belonging to the group of Neutral 
Principles existing in plants ; which, when acted upon by acids or certain 
ferments, split up into Glucose and other substances (alcohols, aldehydes, 
phenols), different in each case. Few, if any, of these compounds, con- 
tain any N, — but among them are some very active agents. The official 
glucosides number six, and like other neutral principles, are designated 
by titles which end, in Latin in — inurn, in English in — in, viz.: — 

Chrysarobinum, (Chrysarobin). Picrotoxinum, (Picrotoxin). 

Elaterinum, (Elaterin). Salicinum, (Salicin). 

Glycyrrhizinum, (Glycyrrhizin). Santoninum, (Santonin). 

Besides these, there are several other substances recognized by pharma- 
copceial names which terminate in — inum, — in, but which have no 
relationship to the group of Glucosides. They are the following, viz.: — 

Aloinum, (Aloin), — a neutral principle from Aloes. 

Benzinum, (Benzin), — a purified distillate from Petroleum. 

Benzoinum, (Benzoin), — a balsamic resin from Styrax Benzoin. 

Chinoidinum, (Chinoidin), — a mixture of alkaloids from Cinchona, no longer 

official in the U. S. Phar. 
Glycerinum, (Glycerin), — a liquid obtained by the decomposition of vegetable or 

animal fats or fixed oils. 
Lupulinum, (Lupulin), — the glandular powder of the Hop plant. 
Naphtalinum, (Naphtalin), — a hydrocarbon obtained from coal-tar. 
Pancreatinum, (Pancreatin), — a mixture of enzymes from the pancreas of the hog. 
Pepsinum, (Pepsin), — a ferment from the glandular layer of the stomachs of healthy 

pigs. 
Piperinum, (Piperin), — C 17 H 19 N0 3 , — a neutral principle obtained from pepper. 
Pyroxylinum, (Pyroxylin), — Soluble Gun-cotton. 
Resorcinum, (Resorcin), — C 6 H 4 (OH) 2 , — a diatomic phenol. 

The Insoluble Constituents are Cellulose, Lignin and Sclerogen, 
which make up the cell-walls of vegetable substances, and are extremely 
intractable. 



WEIGHTS AND MEASURES. 



435 



WEIGHTS AND MEASURES. 



The working formulae of the U. S. Pharmacopoeia of 1880 were con- 
structed on the system of parts by weight for all articles, whether solids 
or fluids, except in the case of fluid extracts, for which the metric weights 
and measures were employed. On this system it really made no differ- 
ence what unit of weight was adopted in official pharmacy. The phar- 
macopoeia of 1890 has, however, in most cases employed definite weights 
for solids, and measures for liquids, in terms of the metric system. In 
certain cases, where weighing is decidedly more convenient, or where the 
product is adjusted to a percentage by weight which would be rendered 
uncertain if the ingredients were taken by measure, liquids are ordered 
to be weighed. And in some cases (Aqua Destillata, Aqua Aurantii 
Florum, etc.) the quantities are directed simply by volume. In most 
cases, therefore, solids are officially directed to be weighed by grammes, 
and liquids to be measured by cubic centimeters. At the same time, how- 
ever, the weights and measures generally used by physicians in prescrib- 
ing, and by pharmacists in dispensing medicines, are, and will doubtless 
continue to be, in the United States, those of the Apothecaries' or Troy 
System of weights, (having 480 grains to the ounce and 5760 grains to 
the pound) ; and the Wine Measure. The drachm (60 grains) and the 
scruple (20 grains), are intermediate units of weight which are still used, 
but are becoming obsolete. 

The units of the Wine Measure are the minim (fib), which in water at 
its maximum density equals gr. 0.95; the fluidrachm (60 minims), and 
the fluidounce (8 fluidrachms or 480 minims). The signs used to denote 
these units are tt^ minim, 9 scruple, 3 drachm, g ounce, and in the case 
of liquids an f to denote fluid is often placed before the sign, thus fjj for 
fluidrachm, f% for fluidounce. The relations between these units of 
weight and measure are as follows : — 



Measure. Weight. 


Weight. 




Measure. 


TT\j, One minim = 0.95 grains. 
f 3 j, One fluidrachm = 56.96 " 
f Jj, One fluidounce = 455.69 " 


grain j 

¥ 


. 


I.05 minims 
63.20 
505.60 « 



Table of Troy or Apothecaries' Weight. 



Pound. 




Ounce. 


Drachm. 




Scruple. 




Grain. 


Libra. 




Uncia. 


Drachma. 




Scrupulus. 




Granum. 


lb 
I 


= 


1 
12 

I 


= $ 

= 8 

1 


== 


9 

288 

24 

3 


= 


5760 

480 

60 

20 



43^ WEIGHTS AND MEASURES. 

Table of Apothecaries' or Wine Measure. 



Gallon. 


Pint. 


Fluidounce. 




Fluidrachm. 




Minim. 


Congius. 


Octarius. 


Fluiduncia. 




Flu idra ch m a . 




Minimum 


c. 


0. 


{ \ 




*?> 




VI 


I = 


8 


= 128 


= 


1024 


— 


61440 




1 


= 16 


= 


128 


z= 


7680 






I 


= 


8 

1 


= 


480 
60 



The British Pharmacopoeia recognizes only the Imperial Standard 
(avoirdupois) weights, having 487^ grains to the ounce, 16 ounces to the 
pound (instead of 12), and 7000 grains to the pound; and the Imperial 
Measure, having 20 ounces to the pint (instead of 16, as with us). 

Table of British Pharmacopoeial Weight. 

Troy grain, Avoirdtipois ounce and pound. 

Pound. Ounce. Grain. 

Libra Uncia. Granum. 

It) OZ. gr. 

I = 1 6 = 70OO 

1 = 437}i 

The Troy ounce contains 42^ grains more than the avoirdupois ounce, but the Troy 
pound contains 1 240 grains less than the avoirdupois pound. The grain is the only unit 
common to both. 

Table of British Imperial or Pharmacopoeial Measure. 



Gallon. 


Pint. 


Fluidounce. 


Fluidrachm. 




Minim. 


Congius. 


Octarius. 


Fluiduncia. 


Fluidrachm a . 




Minimum 


c. 


0. 


floz. 


fldr. 




min. 


I = 


8 


= l6o 


= 1280 


= 


76800 




1 


= 20 


= 160 


= 


9600 






I 


= 8 


= 


480 



I = 60 

The Metric, or Decimal System of Weights and Measures, is now 
the official system in the United States, having been adopted throughout 
the last revision of the U. S. Pharmacopoeia. It is in general use on the 
continent of Europe, and is employed by French and German physicians 
in this country. Its three standard units are as follows, viz.: — 

A Meter, the standard unit of linear measure and also of the whole system, is the ten- 
millionth part of the quadrant of the earth, i. «?., the forty- millionth part of the earth's 
circumference around the poles. One-tenth of the Meter is the Decimeter, one-hundredth 
is the Centimeter, and one thousandth is the Millimeter. 

A Liter, the unit of measure of capacity, is the volume of one kilogramme of pure 
water at the temperature of its maximum density, in vacuo. Theoretically, the Liter is 
equal to one cubic decimeter, or 1000 cubic centimeters. Per contra one-thousandth of 
a Liter is the Milliliter (or Cubic Centimeter), which measure of pure water at its maxi- 
mum density weighs one Gramme. 

A Gramme, the unit of weight, is the weight of the one-thousandth part of a liter of 
water at its maximum density. Its tenth is the Decigramme, its hundredth is the Centi- 
gramme, and its thousandth part is the Milligramme: 

The metric measures above noted are those used chiefly in pharmaceu- 



WEIGHTS AND MEASURES. 437 

tical practice, but the system embraces many other terms of increase 
which are set forth in the following table : — 



IOOOO 




Myriameter. 


IOOOO 




Myrialiter. 


IOOOO 




Myriagramme. 


IOOO 




Kilometer. 


IOOO 




Kiloliter. 


IOOO 




Kilogramme. 


IOO 




Hectometer. 


IOO 




Hectoliter. 


IOO 




Hectogramme. 


IO 




Dekameter. 


10 




Dekaliter. 


10 




Dekagramme. 


I 




Meter. 


1 




Liter. 


I 




Gramrhe. 




.1 


Decimeter. 




.1 


Deciliter. 




.1 


Decigramme. 




.01 


Centimeter. 




.01 


Centiliter. 




.or 


Centigramme. 




001 


Millimeter. 




001 


Milliliter, or 
Cubic Centimeter. 




001 


Milligramme. 



The relations between the Metric Weights and Measures and the 
Apothecaries' are as follows, viz. : — 



I meter 


= 


39.370432 


inches. 


I liter 


= 


2.1 13433 


pints. 


1 gramme 


= 


l5-43 2 34874 


grains. 


I grain 


= 


0.06479895 


gramme. 


1 minim 


= 


0.061613 


cubic centimeter. 



The Metric System is making way but slowly in this country although 
its progress is aided by every process of forcing which scientific bodies 
can bring into action, and it remains to be seen how much its adoption 
in the last edition of the U. S. Pharmacopoeia will influence the medical 
profession in its favor. With all the influence brought to bear in its 
favor it certainly has not yet been adopted by any considerable propor- 
tion of native-born and home-educated physicians and pharmaceutists. 
Its chief disadvantage is one which is inherent to any decimal system, 
viz. — that the number ten cannot be divided more than once without 
producing a fraction. This is partly compensated for by the practice of 
dividing five into the three parts of 2, 2 and 1, and on this principle 
metric weights are usually constructed. 

In writing or reading prescriptions it is sufficiently accurate to consider 
a gramme as equivalent to 15 Troy grains, and a cubic centimeter 
(milliliter) as equivalent to 15 minims, or one-fourth of a fluidrachm. 
All other terms, units or prefixes belonging to the metric system may be 
wholly ignored by the physician and the pharmacist. The term gramme, 
when abbreviated, is written Gm. ; and the term cubic centimeter, when 
abbreviated, is written Cc. In expressing quantities by weight or by 
measure, in writing, in terms of the metric system, the common or Ara- 
bic numerals are used, and are always placed before the terms or abbrevi- 
ations designating the units, thus, 2.50 Gm., 30 Cc. When Apotheca- 
ries' Weight is employed, the numerals are always to be placed after the 
sign or symbol designating the unit, and in Roman characters, thus : . gr. 
x > 9ij» 3J ss j E v ]> The decimal point after the figure representing the 
number of grammes or cubic centimeters should be replaced by a line, in 
order to avoid such errors as might arise from the misplacement of a point, 



438 



WEIGHTS AND MEASURES. 



the dropping of a drop of ink or the intrusion of a fly-speck, which 
might prove serious in many cases. 

Approximate or Domestic Measures become necessary in appor- 
tioning doses for a patient, when liquid medicines are used. Of these 
the measure most commonly employed in the teaspoonful, which is gener- 
ally taken as equivalent to a fluidrachm, though in most cases as now 
manufactured the teaspoon contains about 75 minims, or 25 per cent, 
more than the theoretical quantity. The dessertspoonful is about equal 
to 2 teaspoonfuls, and the tablespoonful to about 4 teaspoonfuls or fgss, 
while the wineglass is supposed to contain about fgij. The use of gradu- 
ated medicine glasses is strongly recommended instead of the above 
approximate measures. They may be obtained at a trifling cost in any 
well-stocked drug store. 



Drops (Guttae) are very variable in size, though popularly supposed to 
equal minims, the variations in their relative dimensions being due to the 
viscidity of the liquid, the shape and surface of the orifice from which 
they escape, and sundry other circumstances. The Syrups and Mucilages 
produce large drops, while Bromine, Chloroform and other heavy mobile 
liquids produce very small ones. These differences are well illustrated in 
the following table, which gives the number of drops in a fluidrachm of 
several liquids of certain classes. [See the Appendix for a fuller table.] 



Syrupus Acaciae, 44. 

Syrupus Scillse, 75. 

Aqua, 60. 

Liquor Potassae, 62. 

Liquor Hydrargyri Nitratis, 131, 

Acetum Opii, 90. 

Vinum Opii, 100. 

Tinctura Opii Deodorati, 1 10. 

Tinctura Opii Camph., no. 

Tinctura Opii, 130. 

Tinctura Iodi, 148. 

Tinctura Aconiti, 146. 

Alcohol Dilutum, 137. 

Alcohol, 146. 



Oleum Ricini, 77. 
Oleum Copaibae, 123. 
Oleum Juniperi, 148. 
Spiritus Camphorae, 143. 
Spiritus Chloroformi, 150. 
Ext. Digitalis Fluid., 134. 
Ext. Ipecac. Fluid., 120. 
Ext. Cinchonas Fluid., 138. 
Ext. Zingiberis Fluid., 142. 
Ext. Buchu Fluid., 150. 
Ext. Hyoscyami Fluid., 160. 
iEther, 176. 
Bromum, 250. 
Chloroformum, 250. 



Specific Gravity is the relative weight of equal bulks of different 
bodies. The specific gravity of water at a certain temperature (generally 
59 F.) is taken as 1, and that of all other substances is expressed in terms 
of this unit. The Pharmacopoeia gives very complete tables of per- 
centages and specific gravities of Alcohol, Ammonia Water, Acetic, 
Hydrobromic, Hydrochloric, Nitric, Sulphuric and Phosphoric Acids, 
and aqueous solutions of Potassa and Soda. The specific gravity of any 
substance is expressed by the quotient obtained by dividing the weight of 
a given measure of the substance by the weight of an equal measure of 



PRESCRIPTIONS. 439 

water. In pharmacy the specific gravity of solids is not of any impor- 
tance, but that of liquids is a matter of constant value, and is determined 
in most cases by means of a specific gravity bottle or by a hydrometer, 
instruments which are described in any standard work on chemistry or 
physics. Modifications of the hydrometer with scales adapted to par- 
ticular work are the urinometer, saccharometer, lactometer, etc. 

Specific Volume is the relative bulks of equal weights of different 
bodies. In pharmacy it means the volume of the weight of a liquid com- 
pared with the volume of an equal weight of water at 59 F. The specific 
volume of a body is therefore inversely as its specific gravity, and is ex- 
pressed by the quotient obtained by dividing unity by the specific gravity. 
i^F. — S P- v °l- an d therefore sp. gr. X sp. vol. = 1. 

A table of the specific gravity and specific volume of several liquids 
will be found in the Appendix. 



PRESCRIPTIONS. 



Extemporaneous Prescriptions are formulae written by the phy- 
sician on the instant (ex tempore) to meet the requirements of individual 
cases. A prescription should begin with the name of the person for whom 
it is designed, and the date on which it is written. Then follows the 
Latin word Recipe, usually abbreviated to the sign B, and signifying 
"Take," or "Take thou;" next the names and quantities of the ingre- 
dients to be used, which are also expressed in Latin ; then the directions 
to the compounder, followed by the directions to the patient, the last 
being now usually expressed in English ; and finally the signature of the 
prescriber. 

A prescription then consists of four parts, viz. — the 

Superscription, — Consisting of the name of the party, the date and the sign R . 
Inscription, — the body of the prescription, which may consist of the — 

Basis, — or chief, active ingredient. 

Adjuvant, — to assist the action of the basis. 

Corrective, — to correct some injurious quality of the other ingredients. 

Vehicle or Excipient, — giving it a suitable form. 
Subscription, — the directions for the compounder, usually expressed in contracted Latin. 
Signature, — the instructions for the guidance of the one administering the medicine, in 

English, followed by the signature of the prescriber. 

A prescription may, however, contain the base alone, or the base with 
the adjuvant, or the base with a simple vehicle or diluent, etc. A single 
ingredient may serve a double or treble office, as the Syrupus Rhei Aro- 
maticus with Quinine, in which case the syrup serves as an adjuvant to 



44Q 



PRESCRIPTIONS. 



increase the action of the quinine, as an excipient to cover the taste, and 
as a vehicle to facilitate the administration of the dose directed. The 
basis may not need any aid in doing its work, and may require no correc- 
tive of its action nor any special vehicle. On the other hand there is no 
limit to the number of ingredients which may be used, provided the 
prescriber has a clear idea of something to be accomplished by each one, 
and also provided that there is no chemical or medicinal incompatibility 
between them. In olden times prescriptions were very complex, and 
contained a great many curious and incongruous ingredients. As Dr. 
Piffard well says "the tendency of the present age is toward mono- 
rather than poly-pharmacy, and prescriptions with the orthodox adjuvans 
and corrigens are less frequently seen than formerly." There is danger, 
however, in carrying this simplicity too far, for there is no doubt but that 
proper combinations of medicines will often produce effects for the 
patient's good, which could not be obtained from the use of any one 
remedy. 

An example will perhaps make the foregoing analysis more comprehen- 
sive, and at the same time serve to indicate the style of abbreviation 
usually employed. The following formula is an adaptation of that of the 
Pharmacopoeia for the Compound Infusion of Senna, or the old-time 
" Black Draught," approximate weights and measures being substituted 
for the pharmacopoeial ones: — 

For Mrs. Steele. July 6th, 1886. 

Recipe, Take, — 

f Senna, semiunciam, 

Of Senna, half an ounce ; 
Magnesii Sulphatis, 
Magnesium Sulphate; 
j Mannce, ana uncia?n unam, 
\ Manna, of each an ounce ; 
j Fceniculi, drachmam unam, 
\ Of Fennel, one drachm; 
f Aquce Bullientis,fluidzt,ncias octo, 
\ Of Boiling Water, eight fluid ounces. 
Macera per horam in vase clauso, deinde cola. 



(Basis.) 

(Adjuvant.) 

(Corrective.) 

(Vehicle.) 



Superscription. 



Inscription. 



Macerate for an hour in a closed vessel, then strain. 

Signa, Mark, or Write thus — A wineglassful every four hours till it 



operates. 



Subscription. 



Signature. 



T. F. Wood, M.D. 



Abbreviated in the style usual with physicians the above prescription 
would read as follows, viz.: — ■ 

For Mrs. Steele. July 6, 1886. 

R. 

Senna, 3 ss 

Magnes. Sulph., 

Mannce, aa £] 

Fceniculi, %] 

Aq. Bull., f !§ viij 

Mac. per hor. in vase clauso, deinde cola. 
Sig. — A wineglassful every four hours till it operates. 

Wood. 



PRESCRIPTIONS. 44 1 

The above is given as an example of an ordinary compound prescrip- 
tion, but as the result is nearly identical with an official preparation, we 
might write the prescription simply as follows : — 

R. Infusi Sennce Compos., ^viij. 

and this is the manner of prescribing the official compound preparations. 
It will be noticed that the term "basis" in the analysis of the formula 
covers two ingredients ; but either of the two might be considered the 
principal agent ; and the other one classed as an adjuvant. 

As Pareira says, " These four parts of a formula are intended to accom- 
plish the object of Asclepiades, curare cito, tute et jucunde ; in other words 
to enable the basis to cure quickly, safely, and pleasantly. 

The Principles of Combination are so well laid down by Dr. H. 
C. Wood, that his words are appended verbatim, as follows: — 

The art of combining medicines is not a difficult one ; but in practice certain principles 
should not be lost sight of. Chief of these are, to prescribe as few remedies as possible, 
and to use no powerful drug without a very distinct idea of what it is intended to do. 
Whenever it is desired to give a powerful remedy in increasing doses until its physiolo- 
gical effect is produced, it should always be given by itself. Thus, it may be necessary to 
give Arsenic so as to impress the system, at the same time that Iron is indicated ; but the 
two remedies should be given separately, so that the dose of either can be increased or 
diminished independently of the other. 

The principles of combination formulated below were long ago enunciated by Dr. Paris, 
but are to-day as imperative as ever. Medicines are combined — 

First. To augment, correct, or modify the action of a medicine. Thus, purgatives act 
much more kindly when a number of them are united together. The chief reason of this 
probably is, that as different remedies affect different portions of the gut, the whole intes- 
tine is best reached by a union of the diverse substances. It may take an intense irritation 
of the mucous membrane to purge as actively as does a mild irritation of both the mucous 
membrane and the muscular coat. 

There are powerful medicines which act similarly upon some parts of the organism but 
dissimilarly upon other parts. By combining such remedies powerful effects can be 
obtained at the points where the two lines of action cross each other, without influencing 
to a great extent other portions of the system. Thus, Chloral produces sleep by its action 
upon the brain, and also has a distinct influence upon the heart, but none upon the intes- 
tinal tract. Morphine acts upon the brain, and does not influence the heart, but has a 
powerful effect upon the intestinal tract. By combining Chloral and Morphine we get an 
overwhelming conjoined influence upon the brain in producing sleep with the least possi- 
ble disturbance of the heart and of the intestinal tract. 

Second. To obtain the joint action of two or more diverse remedies. Thus, in a cough 
mixture Morphine may be included to quiet the cough, whilst Ipecacuanha and Squill (in 
accordance with the first principle) are added to affect the mucous membrane. The appli- 
cation of this principle requires caution, or the practitioner will be led into that chief 
abomination — polypharmacy. It is worse than futile to attempt to prescribe for every 
symptom. It is the underlying cause of the disorder or the under-stratum of bodily con- 
dition which must be sought out and prescribed for simply. 

Third. To obtain a special combination, which is really a new remedy, or which expe- 
rience has shown acts almost as a new remedy. Thus, when to Iodide of Potassium in 
solution Corrosive Sublimate is added, a new chemical compound is formed, which expe- 
rience has shown to be of great value in syphilitic diseases. Griffith's antihectic mixture 
is another instance of the use of chemical changes, the Proto-carbonate of Iron being 
formed out of the Sulphate of the metal and the Carbonate of Potassium. In the famous 



44 2 PRESCRIPTIONS. 

Dover's powder no chemical change occurs, but the ordinary action of Opium upon 
the skin is so enhanced that the combination may be looked upon almost as a new- 
remedy. , 

Fourth. To afford a suitable form. Thus, Acacia is added to make an emulsion, or 
Confection of Rose to make a pill. In the choice of excipients care should be exercised 
to select a substahce free from medical properties, having no chemical incompatibility 
with the medicinal agent, and of suitable physical character. Bread crumbs often make 
a good basis for pills; but with Nitrate of Silver they are chemically incompatible, on 
account of the chlorides in them. When writing a prescription, the utmost care should 
be taken to use such excipients that the combination should not only be attractive to the 
eye, but also as little repulsive to the palate as may be. Whenever possible, the pill-form 
should be employed with bitter or disagreeable medicines. The pill may be readily coated 
with silver- foil; tonic pills may be coated with Iron by shaking or rolling them in Ferri 
Pulvis while soft and sticky. Sugar-coated pills and " compressed pills" are apt to get 
so hard and insoluble that their use requires caution. In regard to mixtures, flavoring oils 
should be freely used, and the power of Glycerin to conceal the disagreeable taste of many 
substances should be remembered. {Therapeutics, yth edition, page 708, et sea.) 



In Writing an Extemporaneous Prescription, the first step is 
to put down the superscription, consisting of the name, date, and the 
sign R. Next the name of each ingredient should be written in Latin 
and in the genitive case, each one on a separate line. Then the quantity 
of each article sufficient for one dose should be mentally determined and 
multiplied by the number of doses which the mixture is to contain, and 
the result set down in signs and Roman numerals. The directions to the 
pharmacist and patient being added, and the prescriber's name or initials 
affixed, the prescription is completed ; but when very active agents are 
used, it is a good plan to go over the calculations a second time before 
letting it leave the hands of the person most responsible for its action. 
For pills or powders the same process should be employed, slightly varied 
according to the requirements of each case. Frequently the ingredients 
and quantities for but one pill, powder or suppository are named, with 
instructions to ma'ke a certain number after the formula. When an 
unusually large dose of any poisonous drug is prescribed, it is customary 
to underline the quantity, so as to call the attention of the compounder 
to the fact that the prescriber is aware that the dose is above the average. 

There is no royal road to prescription-writing; practice, care and 
knowledge of the whole subject is necessary to enable one to turn out 
habitually those elegant prescriptions which are properly termed "magis- 
tral," being the work of a magister, or master of his business. A fair 
knowledge of the Latin language is a sine qua non to every professional 
man, but especially to the physician. It is pitiable to see a Doctor write 
ignorantly of even the genitive-case endings of the drug-names which he 
uses. The teaching of Latin is not within the scope of this work, and 
hence this part of the subject will be dismissed with the advice to the phy- 
sician who is ignorant of that language to write his prescriptions wholly 
in English if he cannot write them in decent Latin. 



PRESCRIPTIONS. 443 

Writing a Metric Prescription. The simplest rule for writing a 
prescription in metric terms by one who is not practiced in the use of the 
system, is the following, viz. : — 

Write as though prescribing but one dose of each ingredient in grains or 
minims and decimals thereof ; then substitute the term ' ' grammes ' ' or 
1 ' cubic centimeters ' ' for grains or minims, and the prescription is correct 
for ij doses in metric terms. 

Of course, when writing for a mixture or solution, the proper quantity 
of vehicle must be added to complete the one dose, and must also be 
expressed first in grains or minims. For example, — 

One dose. 15 doses metric. 

R . Quininse Sulphatis, gr. j, 1 

Strychninae Sulph., gr. -^ or 0.016, 016 

Ext. Glycyrrhizae Ft., rt^iv, 4 

Syrupi, ir^ lx, 60 

This gives a two-ounce mixture approximately, of which the dose would be a tea- 
spoonful. 

One dose. 15 doses metric. 

R . Quininae Sulphatis, . gr. j, I 

Massse Ferri Carb., gr. ij, 2 

Ext. Nucis Vomicae, gr. }( or 0.25, 25. 

Ft. pil. no. xv. Sig. — One pill thrice daily after meals. 

The above rule will answer for all liquids except those which are very 
heavy (as Syrups and Chloroform), or very light (as Ether). Measures 
may be entirely discarded, and all fluid quantities expressed in grammes. 
The average drop of water may be considered equivalent to 0.05 cubic 
centimeter (or gramme), the average teaspoonful to 5 Cc, the tablespoon- 
ful to 20 Cc, the Troy ]§ to 30 grammes, the fluidounce to 30 Cc, and 
8 fluidounces to 250 Cc 

Iii prescribing Syrups or Chloroform, each Troy fluidounce should be 
reckoned at something more than 30 grammes — say 40 ; and if this be 
done, the difficulty of converting one scale into the other will be obviated. 
As to Syrups, Chloroform, etc., the following table shows the actual 
weight in grammes of each fluidounce of the substances named :— 

Fluid Oz. 

gii. 

liv. 

J vm. == 

A table of equivalents between Apothecaries' and Metric Weights and 
Measures will be found in the Appendix. 

Abbreviations, though very commonly used by physicians in pre- 
scribing, are a source of much annoyance to the compounder, and fre- 



Water. 


Tinctures. 


Syrup. 


Chloroform. 


Ether. 


(Grammes.) 


(Grammes.) 


(Grammes.) 


(Grammes.) 


(Grammes.) 


29.52 

59-04 
Il8.o8 
236.16 


28.OO 

56.OO 

II2.00 

224.OO 


38.OO 

76.OO 

152.OO 

304.OO 


43-70 

84.40 

174.80 

349.60 


22.14 

44.28 

88.56 

177.12 



444 



PRESCRIPTIONS. 



quently one of great danger to the patient. Physicians who never knew 
anything of the Latin grammar, or those who have forgotten its rules, 
are very apt to use abbreviations to conceal their ignorance of case-end- 
ings. Many others use them through sheer laziness, and some from force 
of habit. The educated and conscientious man will take pride in turning 
out a full and clear prescription, free from cabalistic letters and all ele- 
ments of uncertainty. In the Appendix will be found a list of the Latin 
terms used in prescriptions, with the abbreviations in vogue, and the 
English meanings. Ambiguous contractions may result fatally to the 
patient, as is readily seen by studying the following list, which gives a 
few examples of the dangers of careless abbreviation : — 



Aconit. . 
Amnion. 
Aq. Chlor. 
Aq. Fontis. 

Chlor. 



Hyd. Chlor. 



Acid Hydroc. — may mean 

f Aconitine. 
* \ Aconitum. 

j Ammonia. 

\ Ammoniacum. 

f Aqua Chlori. 

\ Aqua Chloroform! . 

f Might easily be read 
' | Aqua Fortis. 

f Chlorine. 
. \ Chloral. 

( Chloroform. 

{Calomel. 
Corrosive Sublimate. 
Hydrate of Chloral. 



Acidum Hydrochloricum. 
Acidum Hydrocyanicum. 

Hydrargyrum. 



Hydr. 



Sod. Sulph. 



Sufrh. 



Zinci Pkos. 



Hydras. 

Hydriodas. 

Hydrochloras. 

Hydrocyanas. 

Sodium Sulphate. 

Sodium Sulphite. 

Sodium Sulphide. 

Sulphur. 

Sulphide. 

Sulphate. 

Sulphite: 

Zinc Phosphate. 

Zinc Phosphide. 



Prescription Blanks. After many years' experience in prescribing 
on blanks furnished by druggists, the writer has come to the conclusion 
that it is much better, for many reasons, for the physician to have his own 
blanks, without the address of any drug-store thereon. These blanks 
should be furnished with stubs on which to write the prescription at first 
in rough, afterwards copying it out cleanly on the main blank. A care- 
ful prescriber always writes a formula twice before letting it go out of his 
hands. If he does the first writing on the stub of a book of blanks he 
will always have a copy of such prescription in his possession, for which 

The blank used by the writer measures 4^ 



inches by 3^, joined by a perforated edge to a stub 3^ inches by 2^ 



he will often be thankful. 

inches. On the main blank the physician's name and address are printed, 
together with his office-hours, and a place for number and date, also the 
sign R., and a line for signature. On the stub there are printed the 

words, li Copy of Prescription No 189 . . For " 

These blanks are bound up in books of 1.00 each, with a flexible 
morocco cover, from which the book of stubs may be slipped and a fresh 
book inserted as required. The size is ample for all ordinary require- 
ments, and permits of the book being carried in the breast-pocket. 



PRESCRIPTIONS. 445 

Renewals. — It would be advisable for physicians to always write the 
words "Non Repetatur" or some similar direction, on all prescriptions 
which should not be repeated without their sanction. By so doing they 
would doubtless cut off a good many renewal charges from the receipts 
of druggists who would fear the legal consequences of disobeying the 
mandate. This inconvenience to the drug-seller would be more than 
compensated for in the protection to the drug-taker, who too frequently 
carries in his pocket-book a stock of receipts for his various complaints ; 
and in protection to the physician, who by giving up the dispensing of 
his own medicines has placed it in the power of the druggist to connive 
at a direct robbery of the just reward of professional skill and knowl- 
edge. 

It is doubtless a fact familiar to every observer, that the old-time con- 
fidential relations between the professions of physician and pharmacist 
have almost passed into oblivion. In fact, the tendency of pharmacy 
now-a-days is towards the position of a mere money-making trade, instead 
of in the exalted direction of a profession. The indiscriminate renewing 
of prescriptions, the open sale of quack nostrums and homoeopathic pel- 
lets, the readiness with which counter-prescribing is indulged in, the 
insinuations too frequently made over the drug-counter in reflection 
on physicians, and many other similar practices, have caused the non- 
combatant profession to regard the average druggist with suspicion. If 
physicians boldly took the dispensing of medicines more into their own 
hands many of these evils would soon eliminate themselves from the drug- 
stores. Right here it may be said that there is nothing unprofessional or 
derogatory in the dispensing of his own medicines by the physician. In 
England it has been the universal practice for centuries in all places 
except the largest cities, and it has only been given up by a part of the 
medical profession as a matter of convenience, not as a right. The homoeo- 
paths fought for the reclamation of this practice as a right belonging to 
the medical profession, and succeeded in its legal establishment, but not 
from a worthy motive. They dispense their own medicines in order to 
cover up the many frauds of which they are daily guilty, and to give them 
the power of administering full doses of powerful drugs in a form which 
is apparently <' homoeopathic," with no tell-tale prescription on file in a 
drug-store to give mute but dangerous evidence against their honesty. In 
this way they administer several grains of Calomel or eighth-grain doses 
of Morphine, or correspondingly large quantities of active alkaloids, 
triturated with sugar of milk, or dissolved, as many of the latter may be, 
in alcohol. Chemistry, by isolating the active principles of plants, and 
furnishing them to commerce in the form of soluble salts, has enabled the 
homoeopath to practice this fraudulent method of dispensing drugs, which 
the innocent and ignorant patient, who believes in the power of the mini- 



446 INCOMPATIBILITY. 

mum dose, supposes to be infinitesimal in amount. But the physician of 
the regular profession is too apt to think that if he adopts a practice which 
charlatans have appropriated to themselves, he may be classed with them 
by his professional competitors. Hence, many regular physicians are 
absolutely afraid to use such drugs as Aconite, Belladonna, Gelsemium, 
Arnica, Rhus, etc., all of which are official, and most of which are older 
in medicine than homoeopathy; and avoid pocket-cases, drachm-vials, 
and triturations, as badges of charlatanism. It is high time that we 
asserted our independence in all these matters, and made use freely of 
those means which are recommended by our individual judgments as pro- 
motive of the best results to our patients and to ourselves. With a small 
stock of reliable fluid extracts, and an equally moderate supply of gelatin- 
coated pills and compressed tablet-triturates from the best houses, 
physicians could check-mate the unscrupulous practices of many drug- 
gists to a great extent, save their patients many dollars, and retain many 
a dollar for their own pockets, which under the present system goes to 
their enemies. The homoeopaths understand the money part of the 
argument well. When their patients' medicine is exhausted, the doctor 
must be seen for a fresh supply, meaning of course another consultation 
about symptoms, a change perhaps from Mercurius Dulcis to Mercurius 
Vivus, and another fee. The expense is nothing, sugar of milk being 
cheap, and there is no prescription in the patient's pocket-book, to be 
renewed scores of times (paying toll however every time to the drug- 
gist), and finally to be copied by aunts, mothers, and friends, as a 
" sovereign remedy " for a cough, ora a really wonderful receipt " for a 
case of croup. 



INCOMPATIBILITY. 



Incompatibility may be Chemical, Pharmaceutical or Therapeutical, 
according as the prescribed combination results in chemical decomposi- 
tion, physical disassociation or antagonistic action. In the first case the 
incompatibility may be unintentional or intentional on the part of the 
prescriber, for in many cases the result of the chemical action affords the 
substance desired. 

Instances of intentional incompatibility are the mixtures of Calomel or Corrosive Sub- 
limate with Limewater, producing the Black and Yellow Oxides of Mercury respectively, 
and commonly known as " Black Wash " and " Yellow Wash." Such a combination 
should not be filtered (as a novice might suppose), but should be dispensed with a 
" Shake-label," that the precipitate may be uniformly distributed before using. 

Chemical Incompatibility generally results from neglect on the 



INCOMPATIBILITY. 



447 



part of the prescriber of the most common chemical reactions, such as 
that — 

i. Acids tend to combine with bases and to form salts. 

2. Weak acids or bases are displaced from their combinations by 
stronger ones, so that salts in solution when brought together generally 
exchange their radicles, especially if by doing so an insoluble compound 
can be formed. 

3. A salt in solution is easily decomposed by a strong alkali if the salt 
is one having a weak or volatile base. 

4. A substance in solution may be decomposed by another without 
precipitation, the product being soluble in the solution. 

5. Alkaloidal salts are precipitated from their solutions by the addition 
of fixed alkalies, their salts, or salts which produce insoluble compounds. 
Oxides of the fixed alkalies decompose salts of the metals proper, and 
those of the alkaloids, precipitating their bases; but the base may be 
soluble in an excess of the alkali. 

6. Tannic and Gallic Acids and vegetable substances containing them 
precipitate albumen, alkaloids and most of the metallic oxides, and form 
inky solutions when brought into contact with the persalts of Iron. 
Tannic Acid precipitates gelatin. 

7. Glucosides are incompatible with free acids or Emulsin. 

Examples of the neglect of these principles are seen in the prescribing of Quinine Sul- 
phate in mixture with Potassium Acetate, resulting in a voluminous precipitate of Quinine 
Acetate which cannot be poured from the bottle ; — Vinegars or Syrups containing Acetic 
Acid (Syr. Allii, Syr. Scillae) added to a solution of alkaline carbonates, causing decom- 
position of the latter with evolution of C0 2 ; — the addition of Liquor Potassae to a solu- 
tion of Ammonia-alum, setting free gaseous ammonia; — the mixing of Strychnine Sul- 
phate and Potassium Bromide in solution, causing the decomposition of the alkaloid sul- 
phate and precipitation of strychnine ; — preparations of Cinchona with salts of Iron, 
forming an inky tannate of iron ; Elixir of Chloral with alkalies, causing the elimination 
of chloroform and its subsequent evaporation, etc., etc. 

The following table shows the most important instances of Solutions 
which Mutually Precipitate each other, the letter P meaning "forms a 
precipitate with ": — 

Table of some Mutually Precipitant Solutions. 



Solutions of — 


3J1 

It c • 


11 
g-2 


O uj 

otfl 

'•5 "a 

"3 *> 

tfiJ 


O « 

.5 > 

cflco 


°"c3 

gcO 

.2 6 

J3.3 

m 6 


C 'in « 


< 
C 

§l 

I" 

"3 
CO 


Si 

in 




P 
P 

P 


P 
P 
P 


P 
P 
P 
P 
P 
P 
P 
P 
P 
P 
P 
P 


P 
P 
P 
P 
P 
P 
P 
P 
P 
P 
P 
P 


p 


P 








p 


P 


Carbonic Acid and Carbonates, 


p 

p 
p 


P 
' P ' 


Phosphoric Acid and Phosphates, .... 
Boric Acid and Borates, 


P 
P 


P 

P 










Hydriodic Acid and Iodides, 


P 


* P " 
P 
P 


Arsenical Preparations, 




Albumen, 









448 INCOMPATIBILITY. 

Insoluble Salts. — The following more or less Insoluble Salts will be 
formed whenever the materials of which they are composed are brought 
together in solutions : the Hydrates, Carbonates, Phosphates, Borates, 
Arsenates and Tannates of most earthy and heavy metals and alkaloids, 
and the metallic Sulphides; the Sulphates of Calcium and of Lead, and 
the subsalts of Mercury ; the Chlorides, Iodides, and Bromides of Bis- 
muth, Silver, Lead, and subsalts of Mercury ; the Iodides of Quinine, 
Morphine, and most alkaloids. 

Instances are — Limewater or Aromatic Spirit of Ammonia with Tincture of Chloride 
of Iron, or solutions of Mercury salts, or neutral solutions of Quinine or Morphine salts. 

Ammonium, Potassium, and Sodium Carbonates or Bicarbonates with Limewater. 

Solutions of Magnesium Sulphate, Alum, Zinc Acetate, or Sulphate, with solutions of 
salts of Iron, Manganese, Bismuth, Antimony, Lead, and most alkaloids. 

Ammonium or Sodium Phosphates with solutions of Iron salts, with Limewater, solu- 
tion of Magnesium Sulphate, of Alum, etc. 

Liquor Potassii Arsenitis with Limewater, with solutions of basic salts of Iron, and of 
neutral salts of Quinine and Morphine, etc. 

Solutions, Decoctions, Tinctures, and Extracts containing Tannic Acid with solutions 
of salts of Iron, Mercury, Antimony, Lead (as also with solutions containing albuminous 
substances and Gelatin). 

Limewater with solutions of Quinine or Morphine Sulphates. 

Solutions of Lead Acetate with Zinc Sulphate or Alum. 

Sodium Chloride with Silver Nitrate. 

Morphine Hydrochlorate with Lead Acetate. 

Alkaline Iodides or Bromides with Bismuth Carbonate or Subnitrate, with Lead Ace- 
tate, with Subchloride of Mercury, or with neutral solutions of Quinine, Morphine, and 
Strychnine salts. 

Explosive Compounds result from the admixture of powerful oxid- 
izing agents with substances which are readily oxidizable. The most 
important members of these two classes are as follows : — 

Oxidizers. Oxidizable or Combustible. 

Nitric Acid. Chromic Acid. Glycerin, Sugar, Alcohols. 

Free Hydrochloric Acid. Oils and Ethers. 

Nitro-hydrochloric Acid. Sulphur and Sulphides. 

Potassium Chlorate. Dry Organic Substances. 

Potassium Permanganate. Phosphorus. 

Explosions have resulted from mixing Fluid Extract of Uva Ursi with certain sam- 
ples of Spirit of Nitre, Chromic Acid with Glycerin, Potassium Permanganate with 
Glycerin, Nitric Acid with Glycerin, Silver Nitrate with Creosote, Silver Oxide in pill 
with Extract of Gentian, Potassium Chlorate with Glycerin and Tincture of Ferric Chlo- 
ride. Calcium Chloride triturated with Sulphur in a mortar has exploded, so also has 
Calcium or Sodium Hypophosphite when triturated alone. Tincture of Iodine with 
Ammonia forms the Iodide of Nitrogen, which is highly explosive, especially if triturated 
in the presence of water. Catechu and Potassium Chlorate in a dentifrice have exploded 
in the mouth from the friction produced by a dry tooth-brush. 

Poisonous Compounds may be formed by the admixture of many 
substances in solution, such as — 

Potassium Chlorate with Potassium Iodide, in solution together do not 
react at ordinary temperatures, but in the system they evolve a poisonous 
agent, probably Potassium Iodate. 



INCOMPATIBILITY. 



449 



Potassium Chlorate with Syrup of Ferrous Iodide, liberates Iodine from 
the Iodide in the warm stomach, causing severe gastric irritation, perhaps 
gastritis of dangerous degree. 

Dilute Hydrocyanic Acid or Potassium Cyanide, with Calomel, forms 
the Bichloride and Bicyanide of Mercury, both virulent poisons ; — with 
metallic hydrates, carbonates, sub-nitrates, or sub-chlorides, cyanides of 
the metals are formed which are even more poisonous than the acid itself 
in its usual diluted form. 

Pharmaceutical Incompatibility differs from chemical incompati- 
bility in the absence of chemical action, and is generally produced by 
adding one substance to another which, through differences in solubility, 
causes a precipitation of solid matter or a separation of part of the liquid. 
The constituents separated may be active and hence important, or inert 
and therefore unimportant. 

Instances of this are — the addition of an acid to a Quinine and Liquorice mixture, 
resulting in precipitation of the Glycyrrhizin (relied on to cover the taste of the Quinine) 
by the acid ; or the use of Quinine, Tincture of Ferric Chloride and Liquorice together; 
— or the prescribing of solutions of Chloral and Potassium Bromide with an alcoholic 
preparation, the Chloral separating to the top as an alcoholate, and therefore dangerously 
in excess for the first few doses ; — or the neglect to prescribe Acacia or some other emul- 
sifier in mixtures of an alcoholic fluid extract of a resinous body with an aqueous prepara- 
tion, which would result in the separation of the resin to the surface and an overdose with 
the first teaspoonful. 

When a fluid extract is diluted with a liquid differing in composition 
from those used in the fluid extracts, the gum, albumen, resin, and mucil- 
age are often separated. In such a case as Fluid Extract of Cannabis 
Indica the active resin would be thrown out of solution, and floating on 
top might cause serious symptoms ; but in many other instances the pre- 
cipitate would be inert and filtration would be in order. Water is the 
solvent for albuminous, gelatinous, gummy, and saccharine bodies and for 
a large number of inorganic salts ; while Alcohol is the solvent for vola- 
tile oils and resins, gum-resins, resinoids, balsams, and all drugs contain- 
ing these as their active principles. The solvent power of either Alcohol 
or Water for their particular substances decreases in proportion to the 
amount of the other added. 

Instances of Pharmaceutical Incompatibility. 

Resinous Tinctures or Fluid Extracts with aqueous solutions. 
Tincture of Guaiac with Spirit of Nitrous Ether. 
Compound Infusion of Gentian with Infusion of Wild Cherry. 
Compound Infusion of Cinchona with Compound Infusion of Gentian. 
Essential oils with aqueous liquids in quantities exceeding I drop to ^ j. 
Fixed oils and Copaiba with aqueous liquids (except excipients). 
Tinctures made with Alcohol with those made with Diluted Alcohol. 
Alcoholic Tinctures and Fluid Extracts with aqueous preparations. 
Spirit of Nitrous Ether with strong mucilages. 
Infusions generally with metallic salts. 
29 



450 INCOMPATIBILITY. 

Therapeutical Incompatibility arises when two agents are admin- 
istered together which oppose each other in their action on the human 
system, — as for instance Belladonna in any form with Physostigma. But 
in many cases physiological antagonists are designedly prescribed together, 
one as a guard against the action of the other, as in the hypodermic ad- 
ministration of Morphine guarded by Atropine. The antagonists to each 
of the active medicinal agents may be found in the section on Materia 
Medica under their various titles ; but they may be well summarized as 
to the most important ones in the following list. 

Physiological Antagonists. 

Aconitine, — Atropine, Digitalis, Strychnine. 

Alcohol, — Strychnine, Chloral, Bromides. 

Ammonitim Chloride, — Chloral. 

Atropine, — * Aconitine, *Bromal Hydrate, ^Chloral, Hydrocyanic Acid, Jaborandi, Musca- 
rine, *Morphine, Physostigmine, Phytolaccine, Pilocarpine, Quinine. [Those marked * 
will not prevent death from a lethal dose of Atropine, though the latter will prevent 
death from a lethal dose of either of them.] 

Bromal Hydrate, — Atropine. 

Brucine, — Chloral. 

Carbolic Acid, — Atropine. 

Chloral, — Ammonium Chloride, Atropine, Brucine, Calabarine, Carbolic Acid, Codeine, 
Physostigmine, Picrotoxin, Strychnine, Thebaine. 

Chloroform, — Amyl Nitrite, Atropine. 

Cocaine, — Morphine, Chloral, Amyl Nitrite. 

Codeine, — Chloral. 

Digitalis, — Aconite, Muscarine, Saponin, Senegin. 

Gelsemium, — Opium, Atropine, Digitalis. 

Morphine, — Atropine, Caffeine, Chloroform, Cocaine, Hyoscyamine, Physostigmine. 

Muscarine,— Atropine. 

Opium, — Atropine, Gelsemium, Caffeine, Strychnine, Amyl Nitrite. 

Physostigma, — Atropine, Chloral, Morphine. 

Saponin, — Digitalis. 

Strychnine, — Alcohol, Chloral, Hydrocyanic Acid, Nicotine, Amyl Nitrite. 

Thebaine, — Chloral. 

Veratrum Viride, — Opium, Morphine. 

The Dangers of Incompatibility may in a great measure be 
avoided by the use of the utmost simplicity in prescribing. The subject 
can only be glanced at within these pages, but the following simple rules 
may help the burdened memory of the student and the practitioner. 

Never use more than one remedy at a time, if one will serve the purpose 
for which you are prescribing. 

Never use Strong Mineral Acids with other agents, unless you know 
exactly what reaction will ensue. They decompose salts of the weaker 
acids, and form ethers when combined with alcohol. Never combine 
Free Acids with hydrates or carbonates. 

Select the simplest solvent, diluent or excipient you know of, remem- 
bering that the solvent power of alcohol and of water for their respective 
substances decreases in proportion to the quantity of the other added. 

Generally do not combine two or more soluble salts; for such salts in 



INCOMPATIBILITY. 45 I 

solution, when brought together, usually exchange their radicles, thereby 
forming an insoluble compound. [See ante, page 448.] 

Never prescribe a drug with any of its Tests or Antidotes. 

Never prescribe a Glucoside (as Santonin, Colocynthin, etc.), in com- 
bination with free acids or with a substance containing Emulsin, as these 
agents will decompose it. 

Aconite should be ordered in water alone, Mercuric Chloride by itself 
in water or in simple syrup. The latter drug is incompatible with almost 
everything, even the Compound Syrup of Sarsaparilla being said to decom- 
pose it. 

Potassium Iodide decomposes most of the metallic salts, and is one of 
the drugs which are best administered alone. 

The following-named substances are incompatible with so many others 
that it is best to always prescribe them alone ; they are best given in sim- 
ple solution : — 

Alum. Morphine Acetate. 

Dilute Hydrocyanic Acid. Morphine Hydrochlorate. 

Dilute Nitro-hydrochloric Acid. Quinine Sulphate. 

Sulphuric Acid. Liquor Calcis. 

Mercuric Chloride (Corr. Sub.). Liquor Pot assse. 

Iodine and Iodides. Liquor Potassii Arsenitis. 

Syrup of Ferrous Iodide. Liquor Ferri Nitratis. 

Potassium Permanganate. Tinct. Ferri Chloridi. 

Potassium Acetate. Zinc Acetate. 

Potassium Bromide. Iron and Quinine Citrate. 

Tartar Emetic. Free Chlorine in Solution. 

Tincture of Guaiac. Tannic and Gallic Acids. 

Silver Nitrate and Lead Acetate and Subacetate, though incompatible 
with almost everything, may be combined with Opium, the latter forming 
therewith a compound which though insoluble is therapeutically active 
as an astringent and anodyne lotion. Silver Nitrate with Creosote forms 
an explosive compound. 

Tannic and Gallic Acids, and substances containing them (as the 
Astringent Bitters), precipitate albumen, alkaloids and most soluble 
metallic salts. They may be prescribed with the proto-salts of Iron, but 
not with its per-salts. Calumba is the best vegetable tonic to use with 
ferric salts, as it contains neither tannic nor gallic acids. Tannic Acid 
precipitates gelatin. 

Iodine and the soluble Iodides are incompatible with the alkaloids and 
substances containing them, also with most metallic salts. 

Alkalies neutralize free acids, and precipitate the alkaloids and the 
soluble non-alkaline metallic salts. Oxides of the Alkalies decompose 
salts of the metal proper, and salts of the alkaloids, precipitating their 
bases ; but the base may be soluble in an excess of the alkali. 

Resinous Tinctures or Fluid Extracts, (e. g., Tinct. Cannabis Indicse), 
when combined with aqueous solutions should always have Acacia or 



452 EXTEMPORANEOUS PHARMACY. 

some other emulsifying agent added, to prevent the separation of the 
resin, which otherwise will be deposited on the sides of the bottle or will 
float on top of the mixture. 

Tincture of Digitalis should not be mixed with aqueous or syrupy solu- 
tions, for in such cases precipitation or decomposition of the active 
principles may occur. This tincture is injured by admixture, and is best 
administered on sugar or dropped on a piece of bread. 



EXTEMPORANEOUS PHARMACY. 



This is the most important division of the whole subject of Pharmacy, 
embracing as it does the preparation and dispensing of those medicines 
which are designed for immediate use and which are compounded on the 
prescriptions of physicians. Hence it comprises the chief portion of the 
daily work of the pharmacist, and can only be learned at the dispensing 
counter and under the personal supervision of a competent master. In 
the following pages are given the most important of the general directions 
pertaining to this subject, with the object of enabling the young medical 
practitioner to familiarize himself with the compounding and dispensing 
of drugs so far as the limits of the book will admit of. The drug-store of 
the present day has degenerated so far from its legitimate business that ere 
long physicians will be compelled in self-defence to dispense their own 
medicines, thereby protecting themselves and their patients from the 
patent-medicine vending, the counter-prescribing, and the many other 
nefarious methods which have degraded the pharmacist from his old pro- 
fessional position to that of a mere trader in drugs and nostrums. The 
first outfit of every young doctor should include a few pharmaceutical 
instruments and a small stock of drugs. By the daily handling of these, 
the tools of his profession, he will insensibly become familiar with the 
technique of the art, and even if he does not continue to dispense his medi- 
cines in after years he will never regret the practical knowledge which 
such a course will give him. 

Compounding means the mixing or preparing of the drugs ordered 
in a prescription, and comprises all the operations of official pharmacy 
together with many other manipulations which will be described in their 
appropriate places. 

Dispensing is the operation of putting up and issuing the drugs 
ordered in a prescription, and may apply to the already compounded prepa- 
rations of official pharmacy as well as to those prepared extemporaneously. 



EXTEMPORANEOUS PHARMACY. 453 

Filling a Prescription means a combination of operations which 
requires great care, undivided attention, and a special practical appren- 
ticeship at the dispensing desk. In the following discussion of extempo- 
raneous preparations such hints are incorporated as are particularly 
applicable to the compounding of each article under consideration ; and 
they may be prefaced by a few general suggestions which will serve to 
point out the most approved method of dealing with this important part 
of the druggist's work. 

The prescription should first be slowly read over in a critical spirit, but 
no word or action of unfavorable criticism should reach the ears or eyes 
of the messenger. To shrug the shoulders when scanning the items, to 
laugh or even smile at the phraseology, to question the person offering it 
as to whom it is for, or what complaint it is given for, are instances of 
such flagrant treason to the prescriber as would justify the most complete 
professional ostracism of the offender. The compounder has no business 
whatever with the propriety of the recipe for its purpose. It might have 
been given as a placebo for reasons eminently wise and judicious; or if 
not so constituted it has at least been ordered by one who is in possession 
of facts about which the druggist knows nothing, even if by education 
and experience he were competent to judge in the matter, which he sel- 
dom is. His criticism should be directed only to the dosage and the 
pharmaceutical compatibility of the ingredients. Even in the latter case 
he must remember that incompatibles are often prescribed with the view 
of forming another agent from the chemical reaction produced. If he 
thinks that there is any mistake and the drugs ordered are in any degree 
poisonous, it is his duty to make an excuse for delay to the messenger and 
at once communicate with the physician. This course, in these days of 
telephones, is nearly always practicable. 

After reading the prescription, it is well to number it and write the label. 
This gives time for the label to dry, and avoids the use of blotting paper, 
which often mars the writing and renders the directions all but illegible. 

A clearly defined method should next be decided on by which to com- 
pound the prescription. Directions for such plans of procedure will be 
found in the succeeding pages under the titles of the various prepara- 
tions. Next, the ingredients should be carefully weighed or measured 
out, each one being checked off so as to avoid the danger of its being 
duplicated. In many cases the excipient is not specified, its choice being 
left to the druggist ; but in all such a note should be made on the pre- 
scription to show the article used, in order that in the event of a renewal 
being ordered there may be no difference perceptible. No alteration or 
addition should ever be made which would in any degree affect the 
medicinal action of the prescription, or interfere with the obvious inten- 
tion of the prescriber. 



( 



454 EXTEMPORANEOUS PHARMACY. 

The labelling of the package and the numbering and filing of the pre- 
scriptions are matters of mechanical detail which are best learned at the 
counter. Various devices for simplifying these operations are in vogue 
and may be seen in any well-appointed drug-store. Poisonous articles 
sold by the druggists should always be labelled " Poison," and the trans- 
action entered in a book usually required by law to be kept for that pur- 
pose; but in the case of prescriptions the word "Poison" should not 
appear on the package or label unless so directed by the prescriber. 

Stock Solutions of the salts most frequently prescribed are kept in 
many establishments for convenience in dispensing. Those most gener- 
ally used are the following : — 

Alum, — |;ijssin a quart of distilled water. Of this solution each fluidounce repre- 
sents 3 ss of the salt. 

Potassium Bicarbonate, — ^j in f^iv of distilled water ; of which ^ss contains gj 
of the salt. 

Potassium Chlorate, — I in 24 of distilled water, will not crystallize as the tempera- 
ture changes. 

Potassium Bromide, — 1 in 3 of distilled water, makes a very convenient solution 
for dispensing purposes. 

Chloral Hydrate, — 1 in 1 of distilled water ; of which each minim contains one 
grain of Chloral Hydrate. 

Morphine Sulphate, — gr. xvj in ^j of distilled water, with a grain of Salicylic acid 
or 3 drops of Carbolic Acid to prevent change. Of this solution, known as Magendie's, 
each minim contains gr. -^ of the salt, and Tt\x contain gr. i. A safer solution for dis- 
pensing purposes, as it requires less mental calculation, is one of one-half the above 
strength, viz. — gr. viij in ^j, of which each fluid-drachm contains gr. j of Morphine Sul- 
phate. 

Carbolic Acid, — ^j in f|jiv of glycerin, makes a convenient solution which will mix 
with water in all proportions. TTLivss represent gr. j of Carbolic Acid. 

Tannic Acid, — ^j in f% iv of glycerin, dissolved by the aid of a gentle heat. TT\ivss 
represent gr. j of Tannic Acid. 

Rules for the Pharmaceutical Student. The following are 
quoted from the Chemist'' 's and Druggist' s Diary for 1885. They are 
well worth remembering. 

Read through a prescription, rapidly and in a manner suggesting no suspicion or doubt. 

Write directions invariably before dispensing. Avoid thus the use of blotting-paper ; 
a good dispenser uses almost none. 

If a mixture contains readily soluble ingredients, never use a mortar. 

Avoid effecting solution by heat, for fear of recrystallization. 

With syrups and also ingredients not water, arrange in dispensing to rinse out the 
measure and leave it clean ; a skilled dispenser shows very little traces of his work. 

Carefully clean and put away weights and scales after each operation. 

Hold the scales firmly by the left hand, never lift them high above the counter, and 
judge of the weight as much by the indicator as by the position of the scale. 

Select glass pans for scales, preferably of heavy make, and discard flimsy brass material, 
which corrodes speedily and becomes inaccurate. 

Learn to judge of the quantity to be weighed with tolerable accuracy ; train the eye 
as well as the hand. 

If in doubt, always begin with that about which you have no doubt. 

Be rapid in manipulation. Finish wrapping, tying, or sealing quickly. Slow dis- 
pensing is bad dispensing, and arises either from deficient practice or want of knowledge. 

Never, when in a shadow of doubt, hesitate to ask advice from a fear of compromis- 
ing your own dignity. 



PHARMACEUTICAL OPERATIONS. 455 

OFFICIAL PHARMACY. 



Official Operations are those processes which are directed in the 
pharmacopoeia to be used in the preparation of medicines. Many of them 
are processes which are common to both chemistry and pharmacy, as pre- 
cipitation and crystallization, — while others are peculiar to pharmacy, as 
percolation, trituration, etc. The most important of the pharmaceutical 
operations are briefly described below ; for full details of the various 
apparatus used the student is referred to the more exhaustive treatises on 
Pharmacy. 

PHARMACEUTICAL OPERATIONS. 
Carbonization is the heating of organic substances without exposure 
to the air until the volatile constituents are driven off, and the residue 
assumes the characteristic appearance of carbon. 

Clarification is the separation from liquids of solid matter, which 
prevents their being transparent, without using filters or strainers. It may 
be effected by heat (as in the case of Mel Despumatum), by adding a 
lighter liquid, by adding albumen, gelatin, milk, or paper-pulp, by fer- 
mentation, or by subsidence of the particles in the form of a sediment 
through long standing. 

Colation, or Straining is usually a very simple operation, so familiar 
to every one of ordinary experience as to be scarcely worth describing. 
The strainers are made of cotton flannel, fine muslin, gauze, woolen felt 
and other fabrics. 

Comminution is the process by which the aggregation of the particles 
of a solid body is overcome, and the body is reduced to pieces of vary- 
ing sizes. Its object is to increase the surface exposed to the action of 
solvents, and it includes the mechanical operations of cutting, rasping, 
grating, crushing, stamping, grinding, pulverizing, triturating, levigating, 
elutriating, granulating, etc. Apparatus of various kinds, as cutters, 
mortars and pestles, mills, etc., are used for the comminution, while 
spatulas are employed to loosen the particles, and sieves to sift the 
coarser from the finer. These last-named contrivances are of five sizes, 
designated by the number of their meshes to the inch, 80, 60, 50, 40, and 
20, respectively permitting the passage of powders termed very fine, fine, 
moderately fine, moderately coarse and coarse. 

Crystallization is the process which bodies undergo in passing from 
the liquid or the gaseous state to the geometrical forms called crystals. 



i 



45^ PHARMACEUTICAL OPERATIONS. 

Six systems of crystals are recognized by crystallography, which has 
assumed the dignity of a separate science. Bodies which are not capable 
of crystallization are termed amorphous. Every crystallizable body 
assumes its own peculiar form, or some other form directly derived from 
or related to it. The process of crystallization is affected (1) by fusion 
and partial cooling, as in the cases of some metals and Sulphur ; (2) by 
sublimation, as Benzoic Acid, Mercuric Chloride, etc. ; (3) by deposition 
from hot saturated solutions while cooling ; (4) by deposition from a solu- 
tion during evaporation; (5) by deposition caused by passing a galvanic 
current through the solution ; (6) by precipitation, as in the case of the 
Mercuric Iodide; (7) by the addition to the solution of a substance 
having a strong affinity for water, as the adding of Calcium Chloride to an 
aqueous solution of Sodium Chloride, or Alcohol to a solution of Potas- 
sium Nitrate, or to an aqueous syrup. In a few cases amorphous solids 
may crystallize without undergoing liquefaction, as Sulphur, Barley- 
sugar, Iron or Brass wire. The methods most frequently employed are 
those by deposition from supersaturated solutions, and by deposition 
during evaporation. The more slowly the process is carried on the larger 
and more regular will be the crystals. The process is facilitated by 
use of foreign bodies as nuclei around which the crystals are deposited ; a 
familiar instance being the thread in the centre of a mass of rock-candy. 

The Water of Crystallization is the H 2 with which most substances combine in 
the act of crystallization, and the number of molecules thereof differs for each body and for 
the same body frequently under different conditions. Exsiccation is the driving off of this 
combined water by heat, the crystals assuming thereby the form of a dry powder. Efflo- 
rescence is a similar process occurring spontaneously on exposure of the crystals to the air, 
the effloresced portion appearing as a dry powder on the surface of the crystals. Deliques- 
cence, on the other hand, is the act of absorbing water from the atmosphere, a property 
possessed by some substances, which are therefore said to be hygroscopic. 

Decantation is the pouring or drawing off a supernatant liquid into 
another vessel. If done by pouring, a guiding-rod for the liquid to run 
on is an effective adjuvant ; if by drawing, the siphon in some form is 
usually employed. 

Decoloration, or the removal of coloring-matter from liquids or from 
solids in solution, is effected by the use of animal charcoal, which in small 
operations may be arranged in a funnel or a percolator, and the liquid 
placed thereon. It should not be forgotten that charcoal absorbs many 
other principles besides coloring-matter, especially alkaloids, bitters, and 
astringents, so that the process of decoloration may be one of serious 
injury to the efficiency of the preparation. 

Deflagration is the heating of an inorganic substance with another 
which yields oxygen (usually a nitrate or a chlorate), the result being the 
decomposition of the body, with violent and sudden combustion. 



PHARMACEUTICAL OPERATIONS. 457 

Desiccation is the process of removing moisture from solids, and has 
for its object either the preservation of the substance, the reduction of 
its bulk or the facilitation of its comminution. The operation should be 
conducted at as low a temperature as possible. Roots, leaves and seeds 
are generally dried by being placed in trays of wire network and exposed 
to a uniform temperature in a room heated by steam. A better method is 
to suspend organic substances from the ceiling of an attic during warm 
weather; a slow process, but one which does not result in much loss of 
the active volatile principles. Crystals and precipitates require a higher 
temperature and are usually dried on a water-bath. When the water of 
crystallization is to be expelled, as in desiccating Alum and Ferrous Sul- 
phate, a temperature of about 400 F. is required. In absorbing water 
from alcohol Potassiifm Carbonate and slaked Lime heated are employed, 
and in several instances Sulphuric Acid is the desiccator used. 

Dialysis is a process by which crystallizable substances are separated 
from non-crystallizable ones, by suspending a solution containing both 
upon a porous diaphragm having its under surface in contact with water. 
The crystalloids pass through the diaphragm, while the non-crystalline 
remain above it, and are termed colloids. Examples of the latter class 
are gelatin, gum, glue, starch, dextrin, albumen and extractive matters, 
which are generally the inert and valueless constituents of vegetable 
drugs. Parchment-paper and bladders are used for the diaphragm ; the 
whole apparatus being termed the dialyzer, while the water into which 
the crystalloids pass is called the diffusate. 

The unofficial preparation known as Dialyzed Iron [Ferrum Dialysatum) is a colloi- 
dal substance obtained by treating Ferric Chloride in solution with Ammonia, whereby 
Ferric Hydrate is precipitated and then dissolved by agitation. The mixture being placed 
on a dialyzer, the crystalloids formed (Ammonium Chloride and Ferric Chloride), together 
with any free acid present, pass into the diffusate, leaving the neutral colloidal liquid 
(solution of Ferric Oxychloride) above on the septum. 

Distillation consists of two processes, (i) the evaporation of a liquid, 
(2) the condensation of the vapor into a liquid in a separate vessel. The 
agent used in the first part of the operation is heat, in the second part 
cold. Its object is to separate mixed volatile and fixed substances, or to 
combine volatile substances which cannot otherwise be mixed, as in the 
preparation of some of the official Waters. The apparatus used is of 
great variety, from the simple retort and receiver to the elaborate and 
costly stills. 

Destructive or Dry Distillation is a process of decomposing an organic substance 
by heat into volatile products, which are collected in a separate vessel, the residue being 
said to be carbonized. It is only employed by large manufacturers, for the preparation 
of Acetic and Succinic Acids, Oil of Amber, Wood Tar, etc. 

Fractional Distillation is the separation by distillation of substances which are 



45§ PHARMACEUTICAL OPERATIONS. 

volatile at different temperatures, each being separately driven over and received in a ves- 
sel by itself. Different degrees of heat are successively employed in accordance with the 
volatilizing points of the substances to be obtained. 

Expression is the forcible separation of liquids from solids, by sub- 
jecting them to pressure. Hand-pressure through straining-cloths may be 
employed, but mechanical presses are more efficient and are coming into 
general use. Oils obtained in this manner are called expressed or fixed 
oils, to distinguish them from the volatile oils obtained by distillation. 

Exsiccation or Calcination is the process of depriving a solid of its 
moisture or other volatile constituents by the application of heat without 
fusion. The term Exsiccation is usually applied to the vaporization of 
the water of crystallization from a crystalline body, Calcination to such 
operations as the expulsion of carbonic acid and water from carbonates, 
as in the manufacture of Lime, Magnesia, etc. 

Filtration is a process of straining through a medium so fine as to 
deliver the filtrate in transparent condition. The filters are made of paper 
usually, though charcoal, asbestos, sand and other articles are sometimes 
employed, and are supported in a funnel of glass or other material held by 
the ring of a retort-stand. The best filtering-paper is made in Sweden by 
Munktell, and is white; but a good paper for ordinary use is the " Prat 
Dumas White," which should always be employed for filtering alkaline or 
alkaloidal solutions. The gray French papers answer well enough for 
fluid extracts, tinctures or colored liquids, but should never be used for 
solutions containing free alkali. 

Filtering-paper is folded by doubling a sheet upon itself, and then folding it again 
directly in the middle. When opened four distinct sections appear, one of which is 
separated from the other three, and the filter thus formed is placed in a funnel. This 
arrangement is known as a plain filter, which by repeated creasing is converted into 
the plaited filter ; the latter being the form generally used in pharmaceutical operations 
of small extent. In large laboratories special processes of filtration are employed with 
apparatus of more or less complexity for hot filtration, rapid filtration, etc. 

Fusion is the process of liquefying solids by the application of high 
heat without the use of a solvent. It is employed in making ointments, 
plasters, etc., in purifying resins, and for the purpose of decomposition. 
The degree of heat required varies from a temperature of 90 F., suffi- 
cient to melt lard in an open vessel, to one of 8oo° F., employed in fusing 
Zinc in an earthen crucible; and may be regulated by the aid of the 
water-, steam- or sand-bath. The two former appliances limit the degree 
of heat applied, while the sand-bath prevents sudden changes in the tem- 
perature. Oil-baths and glycerin baths are employed in fractional distil- 
lation on a large scale. 



PHARMACEUTICAL OPERATIONS. 459 

Granulation is a process of reducing a coarsely crystalline substance 
to a granular powder, by dissolving it in water and evaporating the solu- 
tion with constant stirring until the product becomes perfectly dry. Many 
salts are thus treated for convenience in dispensing, as the Bromide, the 
Iodide, the Carbonate and the Citrate of Potassium. Ferrous Sulphate, 
though generally dispensed in the exsiccated powder, may be granulated 
into minute crystals by filtering an aqueous solution of it into alcohol. 

Ignition in pharmacy means the process of strongly heating solids or 
semi-solid substances, the residue left being the product desired. It is 
used in the official quantitative tests for Phosphoric Acid, Ammonium 
Phosphate and purified Antimony Sulphide. 

Incineration is the heating of organic substances with access of air 
until the carbon is consumed, the ashes remaining being the product 
desired. 

Maceration is one of the processes of extracting the soluble princi- 
ples from drugs, and consists in steeping or soaking the comminuted sub- 
stance in a suitable liquid called the menstruum, generally alcohol, for a 
period varying from 2 to 14 days, during which it is occasionally agitated. 
The liquid is then poured off, the residue is expressed, and the mixed 
liquors are filtered. Several of the official tinctures are prepared by this 
method, and many others are subjected to maceration first and percola- 
tion afterwards. 

Percolation or Displacement is a process of obtaining the soluble 
constituents of a substance in powder by the descent of a solvent through 
it. Though an ancient process for the making of lye from wood-ashes 
(lixiviation), it has only within the last forty years been adopted as an 
official process in pharmacy, and it is gradually taking the place of macera- 
tion as a means of extracting the soluble principles of drugs. The vessel 
used to hold the powdered drug is called the percolator, of which there 
are many forms employed by the manufacturers. The liquid used as a 
solvent is called the menstruum, and when coming from the percolator it 
is termed the percolate. The U. S. Pharmacopoeia gives the following 
directions concerning this process : — 

The process of percolation, or displacement, directed in this Pharmacopoeia, consists in 
subjecting a substance or a mixture of substances, in powder, contained in a vessel called 
a percolator, to the solvent action of successive portions of a certain menstruum in such a 
manner that the liquid, as it traverses the powder in its descent to the receiver, shall be 
charged with the soluble portion of it, and pass from the percolator free from insoluble 
matter. 

When the process is successfully conducted, the first portion of the liquid, or percolate, 
passing through the percolator, will be nearly saturated with the soluble constituents of 



460 PHARMACEUTICAL OPERATIONS. 

the substance treated; and if the quantity of menstruum be sufficient for its exhaustion, 
the last portion of the percolate will be nearly free from color, odor, and taste, other than 
those of the menstruum itself. 

The percolator most suitable for the quantities contemplated by this Pharmacopoeia 
should be nearly cylindrical, or slightly conical, with a funnel-shaped termination at the 
smaller end. The neck of this funnel-end should be rather short, and should gradually 
and regularly become narrower towards the orifice, so that a perforated cork, bearing a 
short glass tube, may be tightly wedged into it from within until the end of the cork is 
flush with the outer edge of the orifice. The glass tube, which must not project above the 
inner surface of the cork, should extend from 3 to 4 Cm. beyond the outer surface of the 
cork, and should be provided with a closely fitting rubber tube, at least one-fourth longer 
than the percolator itself, and ending in another short glass tube, whereby the rubber tube 
may be so suspended that its orifice shall be above the surface of the menstruum in the 
percolator, a rubber band holding it in position. 

The shape of a percolator should be adapted to the nature of the drug to be operated 
upon. For drugs which are apt to swell, particularly when a feebly alcoholic or an aque- 
ous menstruum is employed, a conical percolator is preferable. A cylindrical or only 
slightly tapering percolator may be used for drugs which are not liable to swell, and when 
the menstruum is strongly alcoholic, or when ether or some other volatile liquid is used 
for extraction. The size of the percolator selected should be in proportion to the quantity 
of drug extracted. When properly packed in the percolator, the drug should not occupy 
more than two-thirds of its height. The percolator is best constructed of glass or stone- 
ware, but, unless otherwise directed, may be made of any suitable material not affected by 
the drug or menstruum. 

The percolator is prepared for percolation by gently pressing a small tuft of cotton into 
the neck above the cork, a thin layer of clean and dry sand being then poured upon the 
surface of the cotton to hold it in place. 

The powdered substance to be percolated (which must be uniformly of the fineness 
directed in the formula, and should be perfectly air-dry before it is weighed) is put into a 
basin, the specified quantity of menstruum is poured on, and it is thoroughly stirred with 
a spatula, or other suitable instrument, until it appears uniformly moistened. The moist 
powder is then passed through a coarse sieve — No. 40 powders, and those which are finer, 
requiring a No. 20 sieve, whilst No. 30 powders require a No. 15 sieve for this purpose. 
Powders of a less degree of fineness usually do not require this additional treatment after the 
moistening. The moist powder is now transferred to a sheet of thick paper and the whole 
quantity poured from this into the percolator. It is then shaken down lightly and allowed 
to remain in that condition for a period varying from fifteen minutes to several hours, unless 
otherwise directed; after which the powder is pressed, by the aid of a plunger of suitable 
dimensions, more or less firmly, in proportion to the character of the powdered substance 
and the alcoholic strength of the menstruum ; strongly alcoholic menstrua, as a rule, per- 
mitting firmer packing of the powder than the weaker. The percolator is now placed in 
position for percolation, and, the rubber tube having been fastened at a suitable height, 
the surface of the powder is covered by an accurately fitting disk of filtering paper, or other 
suitable material, and a sufficient quantity of the menstruum poured on through a funnel 
reaching nearly to the surface of the paper. If these conditions be accurately observed, 
the menstruum will penetrate the powder equally until it has passed into the rubber tube 
and has reached, in this, a height corresponding to its level in the percolator, which is 
now closely covered to prevent evaporation. The apparatus is then allowed to stand at 
rest for the time specified in the formula. 

To begin percolation, the rubber tube is lowered and its glass end introduced into the 
neck of a bottle previously marked for the quantity of liquid to be percolated, if the per- 
colate is to be measured, or of a tared bottle, if the percolate is to be weighed ; and by 
raising or lowering this receiver the rapidity of percolation may be increased or decreased 
as may be desirable, care being taken, however, that the rate of percolation, unless the 
quantity of material be largely in excess of the pharmacopoeial quantity, shall not ex- 
ceed the limit of ten to thirty drops in a minute. A layer of menstruum must constantly 
be maintained above the powder, so as to prevent the access of air to its interstices, until 
all has been added, or the requisite quantity of percolate obtained. This is conveniently 
accomplished, if the space above the powder will admit of it, by inverting a bottle con- 
taining the entire quantity of menstruum over the percolator in such a manner that its 
mouth may dip beneath the surface of the liquid, the bottle being of such shape that its 
shoulder will serve as a cover for the percolator. 

When the dregs of a tincture, or of a similar preparation, are to be subjected to perco- 



PHARMACEUTICAL OPERATIONS. 46 I 

lation, after maceration with all or with the greater portion of the menstruum, the liquid 
portion should be drained off as completely as possible, the solid portion packed in a per- 
colator, as before described, and the liquid poured on, until all has passed from the sur- 
face, when immediately a sufficient quantity of the original menstruum should be poured 
on to displace the absorbed liquid, until the prescribed quantity has been obtained. 

Repercolation. 

Authority is given to employ, in the case of Fluid Extracts, where it may be applicable, 
the process of Repercolation, without change of the initial menstruum. 

Precipitation is the process of separating solids from their solutions, 
and is usually effected by chemical reaction, though it may be accom- 
plished by Other methods, as by adding a second liquid in which the sub- 
stance is insoluble, by heating albuminous solutions, or by exposing solu- 
tions of silver salts to the action of light. The most familiar example 
of chemical precipitation is the addition of a solution of Mercuric 
Chloride to one of Potassium Iodide, the result being a double decom- 
position of the salts and the formation of Mercuric Iodide, which falls 
to the bottom of the vessel as a brilliant, red, insoluble and crystalline 
powder. The Precipitate is the separated substance, which is usually 
thrown down, but it remains suspended in some cases, and in others it 
rises to the top. The Precipitant is the substance which is added to pro- 
duce the precipitation. A Magma is a thick, tenacious precipitant re- 
maining behind after the supernatant liquid is removed by decantation 
or otherwise. Precipitates are termed flocculent, gelatinous, curdy, gran- 
ular, crystalline, etc., according to the forms assumed. In small opera- 
tions they are usually collected on plain filters, and washed by the re- 
peated addition of water. 

Separation of liquids which do not mix with each other is a simple 
mechanical process performed with pipettes of various forms, or with fun- 
nels having stop-cocks in their necks. Special forms of receivers are 
used for the separation of volatile oils from the water which may accom- 
pany them during distillation. 

Solution is the dissolving of a solid or a gaseous substance in a 
liquid, and may be Simple when the substance undergoes no alteration, 
being recovered unchanged on evaporation ; or Chemical when the dis- 
solved body is chemically altered by the solvent of some other substance 
present, and cannot be recovered on evaporation. Simple Syrup is an 
instance of simple solution, the Syrup of Lime one of chemical solution. 
The liquid employed is termed a Solvent before the substance is added to 
it, after the operation is completed the combined preparation is called a 
Solution. If fully charged with the dissolved substance so that it will 
retain no more, it is known as a Saturated Solution. One liquid may be 
dissolved in another, or a gas may be dissolved in a liquid. The solution 



462 PHARMACEUTICAL OPERATIONS. 

of solids is greatly facilitated by pulverization and by stirring the men- 
struum. Heat generally aids solution, most substances being more solu- 
ble in hot liquids than in cold ones. A saturated solution of one sub- 
stance may still be capable of dissolving others. Rapid solution of solids 
without chemical change causes reduction of temperature, while chemi- 
cal solution produces elevated temperature. Circulatory Solution is per- 
formed by suspending the substance to be dissolved near the surface of 
the solvent in a gauze bag or on a porous shelf. The portion first acted 
on descends and produces a circulatory movement in the fluid, facilitat- 
ing the solution of the whole. 

Solvents employed are chiefly Water, Alcohol, Glycerin, Acids and Oils. Others less 
frequently used are Ether, Chloroform, Benzin and Carbon Disulphide. 

Sublimation is the distillation of a volatile solid, the product being 
termed a Sublimate. Its objects are to purify volatile solids from im- 
purities, and to collect such as result from chemical action at high tem- 
peratures. The operation is carried on in iron, glass or stoneware retorts, 
and results in Cake Sublimates or Powder Sublimates according as the 
temperature of the condensing surface is high or low. 

Testing and Assay are directed by the Pharmacopoeia in certain 
cases, for the purpose of determining the identity and purity of its drugs 
and their preparations. In the main portion of the book such Tests are 
frequently directed, according to a specified method in each case ; but 
processes of Assay are confined to Cinchona, Nux Vomica, Opium, and 
such of their preparations as are considered to require it. The Pharma- 
copoeia contains also a very complete section on Reagents, in which 
full directions are given for the preparation and use of Test-solutions and 
Volumetric solutions ; also instructions for Gasometric estimations, and 
for the determination of the Optical Rotation of organic substances. 

Pharmacopceial testing and the volumetric method of determination 
are necessary to the work of the practical pharmacist, and as the appar- 
atus used is simple and the operations are those in the line of his daily 
work, he should be familiar therewith. On the other hand the proxi- 
mate analysis of organic substances for their principles, and the ultimate 
analysis of the same bodies for their elements, require a high degree of 
skill and long experience, and should be left to the professional chemist. 

The apparatus used in testing consists of graduated flasks and jars, 
burettes, pipettes, funnels, beakers, test-tubes, capsules, crucibles, reagent- 
bottles, etc. The metric system is directed for all work, and the appar- 
atus employed should be graduated accordingly. 

Torrefaction or Roasting is the application of heat, in a less 
degree than for carbonization, to an organic substance for the purpose of 



PHARMACEUTICAL OPERATIONS. 463 

modifying some of its constituents, as in the roasting of coffee and 
rhubarb. The latter substance when subjected to this process, loses its 
cathartic properties but retains its astringency, and is known as Torrefied 
Rhubarb. 

Trituration is the comminution of a solid to an extremely fine pow- 
der by continued rubbing in a wedgewood mortar with an inert and gritty 
powder, Sugar of Milk being the substance directed to be used. The 
product is called a Trituration (see that title under Official Prepara- 
tions). The surfaces of the mortar and pestle-head should coincide 
closely, and the thorough comminution of the trituration is best accom- 
plished by a circular motion of the pestle in gradually increasing circles, 
until the side of the mortar is reached, then reversing the motion, and 
gradually lessening the circles until the pestle reaches the centre again. 
The process is greatly facilitated by having the pestle attached to a long 
handle playing in an opening made in a piece of wood which is nailed 
at a convenient height. A weight may be fixed on top of the handle if a 
greater degree of friction is desired. 

Pulverization by Intervention is only another name for trituration when performed 
in a mortar and with solid bodies, the foreign substance used being subsequently removed. 
Potassium Sulphate may be employed as the medium for the pulverization of Gold, and 
is then dissolved out with water. Alcohol or Chloroform may be added to Camphor to 
aid its pulverization, and then removed by evaporation. Phosphorus may be pulverized 
by placing it in water, gently heating the latter until the phosphorus is melted, and agita- 
ting the whole while cooling. 

Levigation is trituration of a substance made into paste with water or some othe r 
liquid, and resembles the old process of grinding oil paints by hand on a slab of stone- 
The process is used for coarse materials, as chalk, etc., where the refuse is rejected, or for 
such substances as Red Mercuric Oxide, Zinc Oxide, etc. When performed with a por- 
phyry slab and muller it is termed Porphyrization. 

Elutriation is a water-sifting process for separating the coarser particles of insoluble 
substances from the finer. The substance is mixed with water and after the larger par- 
ticles have fallen to the bottom, the liquid is decanted into another vessel, in which the 
light and powdery particles are collected. 

Vaporization includes the various operations by which volatile mat- 
ters are separated' from fixed substances or from other matters which are 
less volatile, heat at varying temperatures being the agent used. The 
operations under this head are — Evaporation, Distillation, Desiccation, 
and Sublimation. 

Evaporation in Pharmacy is the process by which the more volatile 
constituents of a liquid are driven off by heat for the purpose of reducing 
its volume or of purifying it, as in the preparation of extracts and fluid 
extracts, the crystallization of salts, etc. The vessels used should be shal- 
low so as to expose a large surface of the liquid to the atmosphere. The 
heat used may be regulated by a water-bath, a steam-bath or sand-bath, 
and ordinarily should be kept below but near to the boiling point of the 



464 PREPARATIONS. 

liquid treated. As organic substances are usually injured by long heating, 
small portions only of vegetable preparations should be subjected to this 
process, and the liquid should be frequently stirred in order to hasten the 
operation. In large laboratories vacuum-pans are employed to remove 
the atmospheric pressure, enabling the evaporation to be accomplished at 
a much less degree of heat than if the liquid were exposed to the air. 
Ebullition or Boiling is a form of evaporation. 

Spontaneous Evaporation is the evaporation of a liquid without the direct applica- 
tion of strong heat, but at the temperature of the room or closet used for the purpose. 
It is especially applicable to cases in which the residue is liable to injury or loss from 
much heat, or in order to secure finer crystals than can be obtained by quick evaporation 
of their solution. 

Washing is a simple mechanical process for separating soluble from 
insoluble matter, by pouring upon it a liquid which will dissolve the solu- 
ble portion. Various methods of doing this are in vogue and are often 
dignified with very high-sounding terms, as Lotion, Affusion, Ablution, 
etc. An ordinary wash-bottle, with the two glass tubes perforating the 
cork, is a convenient implement for directing a continuous stream upon a 
precipitate, while for continuous washing a combination of bottles with a 
funnel may be used. 



PREPARATIONS. 



The Pharmacopceial Preparations may be presented under various 
methods of classification, one of the simplest being that which divides 
them into liquids and solids, the former being subdivided into groups 
named after their principal bases, viz.: — 

Liquid Preparations. 
Aqueous, — Waters, Solutions, Infusions, Decoctions, Syrups, Honeys, Mucilages, 
Emulsions, Mixtures ; the last five containing sweet or viscid substances. 
Alcoholic, — Fluid Extracts, Tinctures, Wines, Spirits, Elixirs. 
Ethereal, — Oleoresins, Collodions. 
Oleaginous, — Liniments, Oleates. 



, — Vinegars. 


Glycerin 
Solid Preparations. 


es, — Glycerites. 


Extracts. 


Troches. 


Ointments. 


Resins. 


Confections. 


Cerates. 


Masses. 


Powders. 


Plasters. 


Pills. 


Triturations. 
Suppositories. 


Papers. 



In the following descriptions of the pharmaceutical groups the composi- 
tion and dosage of the various preparations are omitted, as they are fully 
detailed in the section on Materia Medica, under the title in each case of 
the principal constituent. 



PHARMACEUTICAL PREPARATIONS. 

PHARMACEUTICAL PREPARATIONS. 



465 



The Pharmaceutical Preparations include the pharmacopceial (official) 
as also those of extemporaneous pharmacy (unofficial). Both classes are 
described together in alphabetical order, for the sake of easy reference. 

Aceta, Vinegars, — are solutions of the active principles of certain 
drugs in Diluted Acetic Acid. They are made by percolation and each 
contains the soluble principles from 10 per cent, of drug. Acidulous 
menstrua form soluble salts with the alkaloids and possess antiseptic quali- 
ties. The official Vinegars number 2, viz. : — 

Acetum Opii. Acetum Scillae. 

Aquae, Waters, — are aqueous solutions of volatile substances, which 
may be either solids, liquids, or gases, dissolved either by solution in cold 
or hot water, by filtration through an absorbent powder, by percolation 
through cotton saturated with the substance, or by distillation. The offi- 
cial waters number 19, including the two forms of Aqua itself, as follows, 
viz. : — 



Aqua. 

Aqua Destillata. 

Aqua Ammoniae. 

Aqua Ammoniae Fortior. 

Aqua Amygdalae Amarae. 

Aqua Anisi. 

Aqua Aurantii Florum. 

Aqua Aurantii Florum Fortior. 

Aqua Camphorae. 

Aqua Chlori. 



Aqua Chloroformi. 

Aqua Cinnamomi. 

Aqua Creosoti. 

Aqua Foeniculi. 

Aqua Hydrogenii Dioxidi. 

Aqua Menthae Piperitae. 

Aqua Menthae Viridis. 

Aqua Rosae. 

Aqua Rosae Fortior. 



Of the above 5 are prepared by simple solution, 4 by passing gases through water, 3 
by distillation, and 6 by trituration of the medicament with precipitated calcium phos- 
phate, addition of water and filtration. 

All waters deteriorate when long kept, microscopic plants being propa- 
gated in them from spores derived from the atmosphere. They should 
be prepared only in such quantities as are needed for use within a reason- 
able time. 



Balnea, Baths (Unofficial). Baths are often medicated, and then be- 
come medicinal preparations. The ingredients only are ordered in a 
prescription, as per the following examples, each of which is intended for 
a bath of 25 to 30 gallons: — 

Balneum Acidi Nitrohydrochlorici. 



R. Acidi Nitrici, 

Acidi Hydrochlorici, . . . aa^j. 
M. Sig. — Use with 30 gallons of hot 
water, as a bath. 



30 



Balneum Sulphuris Compositum. 

R . Sulphuris Praecip., . . . . ^ij. 
Sodii Hyposulphitis, . . . ^j. 
Acidi Sulphurici Dil., . . . 3j ss 

Aquae, Oj. 

M. Sig. — For a 30 gallon bath. 



466 PHARMACEUTICAL PREPARATIONS. 

Capsulae, Capsules, (Unofficial). Gelatin Capsules are to be obtained 
from the drug stores, of various sizes from o to 10. They are a conve- 
nient means of administering oils or nauseous solids, and when filled may 
be swallowed as easily as a large pill. By some of the manufacturers 
Soluble Elastic Capsules are prepared, each containing an ordinary dose 
of such medicines as Castor Oil, Cod-liver Oil, etc. The largest of 
these capsules makes a bolus which may be swallowed with a little effort, 
as it is quite compressible and changes its shape to suit the calibre of the 
passage. The ordinary capsules are easily filled by the aid of a paper 
funnel, and the end of a pen-holder as a packer ; but simple devices 
(capsule-fillers) for facilitating the operation may be purchased. 



R . Pulv. Opii, gr. x. 

Pulv. Camphorse, . . . . gr. xx. 
Sacch. Alb., q. s. 
Triturat., et fiant capsulae x. 
Sig. — One at bedtime for chordee ; re- 
peat in two hours if necessary. 



R . Copaibae, 3 iss. 

Oleoresinae Cubebse, . . . sjss. 

M., et fiant capsulae xij. 

Sig. — Two capsules three times daily, 
soon after meals, for gonorrhoea. 



Cataplasmata, Poultices, — are usually prepared at the residence of 
the patient, the ingredients only being ordered from the druggist. They 
are generally employed as a means of applying heat and moisture to a 
certain portion of the body, but are sometimes medicated with anodyne, 
counter-irritant or disinfectant agents. Poultices are not official in the 
U. S. Pharmacopoeia, but are in the British, the following list including 
all so recognized : — 

Cataplasma Carbonis, Charcoal Poultice, — Wood Charcoal 1, Crumb of Bread 4, 
Linseed Meal 3, Boiling Water 20 parts. 

Cataplasma Conii, Hemlock Poultice, — Hemlock-juice 1, evaporated to half its vol- 
ume, Linseed Meal 4, Boiling Water 10 parts. 

Cataplasma Fermenti, Yeast Poultice, — Beer Yeast 3, Wheaten Flour 7, Water at 
loo° F., 3 parts. 

Cataplasma Lini, Linseed Poultice, — Linseed Meal 2, Boiling Water 5 parts, mixed 
with constant stirring. 

Cataplasma Sinapis, Mustard Poultice, — Mustard, Linseed Meal, Boiling Water and 
Water, of each a sufficiency. 

Cataplasma Sodae Chlorinatae, Chlorine Poultice, — Solution of Chlorinated Soda 1, 
Linseed Meal 2, Boiling Water 4 parts. 

Cerata, Cerates, — are unctuous preparations similar to ointments but 
of a much firmer consistence. They all contain Wax (Cera), and do not 
melt at temperatures below 104 F. They are intended for external use, 
and are generally spread on lint before being applied. There are 6 official 
Cerates, including Ceratum itself, which is made by fusing together 30 of 
White Wax and 70 of Lard. The composition of the others may be 
found in the section on Materia Medica under the appropriate titles, but 
the figures in parentheses below give the percentage of drug to basis in each. 

Ceratum. Ceratum Cetacei (10). 

Ceratum Camphorse (2). Ceratum Plumbi Subacetatis (5). 

Ceratum Cantharidis (32). Ceratum Resinae (35). 



PHARMACEUTICAL PREPARATIONS. 467 

Chartae, Papers, — consist of strips of paper medicated by impregna- 
tion of its fibers with medicinal substances, or by being coated therewith. 
Of the 2 official Papers 1 is made with sized paper, and intended for ex- 
ternal application as a vesicant or counter-irritant ; the other (Charta 
Potassii Nitratis) is unsized paper impregnated with Nitre and intended for 
the inhalation of its fumes while burning. Those officially recognized 
are — ■ 

Charta Sinapis. Charta Potassii Nitratis. 

Collodia, Collodions, — are liquid preparations having for their base 
a solution of Pyroxylin in a mixture of Ether and Alcohol. They are in- 
tended for external use, being applied to the skin by means of a brush, 
and producing a film on the surface after the evaporation of the men- 
struum. There are 4 official Collodions, viz. : — 

Collodium. Collodium Flexile. 

Collodium Cantharidatum. Collodium Stypticum. 

The Flexible Collodion contains 5 per cent, of Canada Turpentine, and 3 per cent, of 
Castor Oil. Styptic Collodion contains 20 per cent, of Tannic Acid. 



Confectiones, Confections, — consist of medicinal substances formed 
into a mass with Sugar, Honey, Water, etc., with the object of rendering 
them palatable and of preserving them from change. Electuaries are 
similar preparations, but this term is now obsolete. There are only two 
official Confections, viz. : — 

Confectio Rosse. Confectio Sennse. 

Confections and Electuaries are very seldom prescribed, and therefore 
can have but little place in extemporaneous pharmacy. A few old for- 
mulae for such preparations are given below as pharmaceutical curios. 
The first is a meritorious prescription. 



Electuary for Piles. 
R • Potassii Bitartratis, 
Potassii Nitratis, 
Pulv. Jalapse, . . . . . . aa j| ss. 

Confectio Senna;, .... ^j. 

Syrupi Zingiberis, q. s. 
M. Fiat electuarium. 
Sig. — A piece the size of a marble to be 
taken thrice daily. 



The Chelsea Pensioner. 

R. Sulphuris Loti, % ij. 

Potassii Bitart., %}. 

Pulv. Rhei, gij. 

Guaiaci Resinae, %]. 

MellisDespum., tbj. 

Myristicam Pulv., . . . . j. 
M. Fiat electuarium. 
Sig. — A dessertspoonful twice daily, as 
a laxative in chronic rheumatism. 



Confectio Damocratis. 

[An ingredient of Warburg's Tincture.] 

This preparation was official in the London Pharmacopoeia of 1745. It contained 1 
grain of Opium in i| ss, and consisted of 45 ingredients, as follows, viz. : Cinnamon, 14 
parts; Myrrh, 11 parts; — White Agaric, Spikenard, Ginger, Spanish Saffron, Treacle, 
Mustard Seed, Frankincense and Chian Turpentine of each 10 parts ; — Camel's Hay, 



468 PHARMACEUTICAL PREPARATIONS. 

Costus Arabacus, Zedoary, Indian leaf, Mace, French Lavender, Long Pepper, Seeds of 
Harwort, Juice of ripe Cistus, strained Storax, Opponex, strained Galbanum, Balsam of 
Gilead, Oil of Nutmeg, Russian Castor, of each 8 parts ; — Water Germunder, Balsam-tree 
Fruit, Cubeb, White Pepper, Seeds of Cretian Carrot, Poley Mont, strained Bdellium, of 
each 7 parts ; — Gentian-root, Celtic Hard, Leaves of Dittany of Crete, Red Rose, Seeds 
of Macedonium, Parsley, Sweet Fennel Seeds, Seeds of Lesser Cardamom, Gum Arabic, 
Opium, of each 5 parts ; — Sweet Flag, Wild Valerian, Anise-seed, Sagapenum, of each 3 
parts; — Spigrul, St. John's Wort, Juice of Acacia, Catechu, Dried Bellies of Skunk, of 
each 2)/ 2 parts; — the roots finely powdered and the whole mixed thoroughly into a paste 
with Clarified Honey. 

Decocta, Decoctions, — are made by boiling vegetable substances with 
water. As very few drugs contain active ingredients which are not 
injured by heat, these preparations have never obtained favor with scien- 
tific physicians. There are only 2 official Decoctions, viz/: — 

Decoctum Cetrariae. Decoctum Sarsaparillse Compositum. 

The official general formula for Decoctions prescribes that when the strength is not 
directed by the physician, nor specified by the Pharmacopoeia, they shall be prepared in 
the proportion of 5 grammes of the substance with 100 Cc. of water ; but that the strength 
of decoctions of energetic or powerful substances should be specially prescribed by the 
physician. Decoctum Cetrarise has the aforesaid official strength, while Decoctum Sar- 
saparillae Compositum has the strength of 10 per cent, as regards its principal ingredient. 

Elixiria, Elixirs, — are sweetened, aromatic and spirituous prepara- 
tions, containing active medicinal substances in small quantities. There 
are but 2 official Elixirs, viz r-t— 

Elixir Aromaticum. Elixir Phosphori. 

The first-named is intended to represent a type of the large class of 
unofficial elixirs employed in manufacturing and extemporaneous phar- 
macy. It is practically an alcoholized syrup, flavored with Orange, and 
is designed for use as an excipient for extracts, tinctures, salts, etc. The 
Elixir of Phosphorus has about % milligramme of Phosphorus to each 
cubic centimeter. The manufacturers have put on the market a great 
variety of elixirs, and most druggists keep a stock of them on hand pre- 
pared in the shop ; but they may be ordered by prescription just as any 
other mixture would be. The substances generally used in this form are 
as follows : — 

Arsenic. Guarana. 

Bismuth. Iron, Tincture of the Chloride. 

Ammonium Bromide. Iron, Phosphate. 

Lithium Bromide. Iron, Pyrophosphate. 

Potassium Bromide. Liquorice. 

Calisaya Bark. Pepsin. 

Chloral Plydrate. Quinine. 

Coca. Strychnine. 

Gentian. Taraxacum. 
Ammonium Valerianate. 

Many of these agents are combined with each other, as in the Elixir of Bismuth and 
Strychnine ; Elixir of Calisaya, Iron and Strychnine ; Elixir of Gentian with Tincture of 
Chloride of Iron; Elixir of Iron, Quinine and Strychnine, etc., etc. 



PHARMACEUTICAL PREPARATIONS. 469 

Emplastra, Plasters, — are solid compounds, insoluble in water, of a 
tenacious but pliable consistence and intended for external application to 
limited areas of the body surface. They are prepared by incorporating 
medicinal substances with certain bases, which are usually Lead Plaster 
(Oleate of Lead), a Gum-resin, or Burgundy Pitch. The heat employed 
should be low so as to avoid decomposing the active agents, and should 
not be continued long enough to drive off any volatile constituents. The 
plaster mass is then spread evenly on chamois skin, kid skin or muslin. 
The constituents of the following named 13 official Plasters may be found 
in the section on Materia Medica, under their appropriate headings. 

Emp. Ammoniaci cum Hydrargyro. Emplastrum Ichthyocollae. 

Emplastrum Arnicae. Emplastrum Opii. 

Emplastrum Belladonnae. Emp. Picis Burgundicae. 

Emplastrum Capsici. Emp. Picis Cantharidatum. 

Emplastrum Ferri. Emplastrum Plumbi. 

Emplastrum Hydrargyri. Emplastrum Resinse. 

Emplastrum Saponis. 

Of the foregoing only two are directed to be spread, viz. — Emp. Capsici upon muslin, 
and Emp. Ichthyocollae upon taffeta, the others having no pharmacopceial prescription for 
the material to be used. Plasters after being spread should remain soft, pliable and ad- 
hesive, without melting at the heat of the body. To soften the surface, if old, it should 
be brushed with a small portion of Tincture of Camphor. 

Plasters are rarely prepared extemporaneously, the official and many 
other ones being produced on a large scale by the manufacturers, and 
kept in stock by all druggists. As a consequence the compounding and 
spreading of a plaster by the pharmaceutist has become a lost art. The 
official plasters may be ordered by prescription in the manner illustrated 
below. Blisters may be produced by the application of any preparation 
of Cantharides sufficiently strong for the purpose. The official Cerate 
of Cantharides may be spread on Adhesive Plaster (Emplastrum Resinse), 
making a blistering plaster ; or Cantharidal Collodion may be painted 
over the surface. Plasters are usually ordered by the square inch, but a 
model of the shape and size may be drawn on paper, and the plaster be 
directed to conform thereto, as in the first of the following pre- 
scriptions. 

Emplastrum Vesicatorium. Counter-irritant and Anodyne. 



R . Cerati Cantharidis, q.s. 

Extende supra Emplastrum Resinaehujus 
formae et magnitudinis. 

Sig. — Blistering Plaster, to be applied 
over the region of the heart. 



R . Chartae Sinapis, 

Emplas. Belladonnae, aa 3 7/ x 6 // . 
Sig. — Apply the mustard paper first, to 
be followed by the plaster when the surface 
has been well reddened. 



Emulsa, Emulsions, — are aqueous, liquid preparations containing an 
insoluble medicinal substance (as an oil or resin) in a state of minute 
subdivision and suspended by the aid of some viscid excipient, as gum, 
which may be contained in the medicinal ingredient itself (Ammoniac, 
Asafetida), or may be added by the pharmaceutist. The official Emul- 



470 PHARMACEUTICAL PREPARATIONS. 

sions are 4 in number, all of which were classed as Mixtures in the 

pharmacopoeia of 1880, viz. — 

Emulsum Ammoniaci. Emulsum Asafoetidse. 

Emulsum Amygdalae. Emulsum Chloroformi. 

Natural Emulsions comprise two classes of substances, — (1) those 
emulsions which exist ready formed in nature, as milk, yolk of, egg, the 
milky juices of plants, etc. ; and (2) the mixtures formed by rubbing up 
gum-resins (as Ammoniacum, Myrrh, Asafetida) with water. Each of 
the latter substances contains, together with its resin, enough gum to make 
a perfect emulsion when triturated with water. The manufactured emul- 
sions are simply imitations of the natural ones, sufficient gum being added in 
case of a resinous substance to cause its suspension in the aqueous diluent. 

Emulsification consists in the division of the oily or resinous substance 
into very minute globules, and the surrounding of each globule with a thin 
envelope of the excipient. If properly done the globules will remain 
mechanically suspended in the water, without any tendency towards re- 
combination. Milk is the best illustration of a natural emulsion, its 
butter existing in the aqueous portion as very minute globules, each sur- 
rounded by a thin film of casein. Yolk of Egg is a dense emulsion, con- 
sisting of oil suspended in water by means of albumen. 

The Excipients which may be used for emulsification are the following, 
arranged in the order of their most frequent employment, viz. : — 

Mucilage of Acacia, — used for oils and resins. Powdered Acacia is even better, 
being made into a mucilage by the process of emulsification; such a mucilage having the 
advantage of being perfectly fresh when incorporated with the other ingredients. To 
give uniformly good results the following proportions in parts by weight should be used, 
viz. : — 

Gum Acacia. Water. 

I part of Fixed Oils or Copaiba requires, l / z ^ 

I " " Balsam of Peru " 2 Ij^ 

1 " " Oil of Turpentine " I 1 

Mucilage of Tragacanth, — may also be used for oils and resins, but it has not 
proved so satisfactory as the preceding. The same may be said of powdered Tragacanth. 

Vitellus, Yolk of Egg, — is an excellent agent for emulsifying oils, but mixtures made 
with it must be used within a few days, as they will not keep long. One yolk will emul- 
sionize an ounce of fixed oil, and is about equal to half an ounce of Acacia. It is best 
suited to emulsions of cod-liver oil intended for immediate administration. The official 
Emulsum Chloroformi is an emulsion made with yolk of egg. Glyceritum Vitelli or 
Glyconin is an official preparation consisting of glycerin and yolk of egg. One ounce of 
it will emulsify three ounces of fixd oil. 

Liquor Potassae, — may be used for oils, the resulting compound being however a soap 
rather than an emulsion. Copaiba is usually emulsified by using both a gum and an 
alkali ; a similar process being employed for many of the fixed oils. 

Tincture of Senega, — will emulsify fats and oils very efficiently, and even in very 
small quantities, rr^x emulsifying an ounce of fixed oil. 

Tincture of Quillaja (Soap-bark), — is a good emulsifier for oils, and is much used in 
Europe for this purpose. 

Milk, — is used to emulsify Scammony in the Mistura Scammonii, which is official in 
the British Pharmacopoeia. 

Syrups, Confections and Extracts, — may be used in making emulsions, but are 
rarely so employed. 

Soap, — is occasionally used for emulsifying Oil of Turpentine. 



PHARMACEUTICAL PREPARATIONS. 47 I 

The method of preparing an emulsion which experience has shown to 
be the best, is as follows : — Add the oil, resin, etc., to a proper quantity 
of the excipient, and mix both thoroughly in a wedgewood mortar. Then 
add enough water to equal one-half the weight of the previous mixture, 
and triturate the whole rapidly and unceasingly until the emulsion is homo- 
genous and of a whitish color. Next, add the remainder of the water 
slowly, with continual stirring ; finally incorporating the other ingredi- 
ents, if any. 

Emulsions are sometimes flavored and at the same time colored, with 
such a preparation as the Compound Tincture of Cardamom ; but they 
present a better appearance when perfectly white. Alcoholic preparations 
should not be added in large quantity to emulsions made with Acacia or 
Yolk of Egg, as alcohol will precipitate the emulsifying agent. Volatile 
Oils require admixture with a fixed oil before being made into an emul- 
sion. Soluble salts should never be prescribed with emulsions of oils. 
Acids are incompatible with mixtures which have been emulsified by an 
alkali. Mucilage used for emulsions should always be freshly prepared. 

The following examples of prescriptions for emulsions will represent 
those generally met with : — 



Cod-Liver Oil Emulsion. 

R. Olei Morrhuse, gij. 

Vini Albi, % iss. 

Ac. Phosphorici Dil., . . . . giij. 

Syrupi, 3 v. 

Vitellum, j. 

Aq. Amygd. Amar., q. 
Misce, et fiat emulsum. 

Sig. — Tablespoonful doses. 



Alkaline Emulsion of Copaiba. 
JJ . Copaibse, 

Liq. Potassae, aa gij. 

Misce, et adde — 
Pulv. Acacise, 

Pulv. Sacchari, .... aa £ij. 
Aq. Menth. Viridis, q. s. ad ifiv. 
Misce, et fiat emulsum. 

Sig. — Tablespoonful doses. 



Extracta, Extracts, — are solid or semi-solid preparations obtained by 
evaporating solutions of vegetable principles. The drug is first powdered, 
then percolated with the appropriate menstruum to exhaustion. The first 
third of the percolate is reserved, the remainder is evaporated at a tem- 
perature not above 122 F., until its weight is ten per cent, of that of the 
drug used, then mixed with the reserved portion, and both are evaporated 
to a pilular consistence. The above is the general rule, but in several 
instances maceration is directed for 1 to 4 days before percolation ; and 
in other cases, instead of reserving a portion of the percolate, the whole 
quantity is distilled until the alcohol is removed, and the residue is evapo- 
rated to a pilular consistence. The menstrua used are, — in 6 cases Alco- 
hol, in 13 cases Diluted Alcohol of varying strength, in 7 Water, in 
1 Water with Aqua Ammonise, in 1 a diluted Acetic Acid, and in 2 
Acetic Acid and Diluted Alcohol. One extract is an inspissated juice 
(Ext. Taraxaci) ; one is made by evaporating a fluid extract (Ext. Ergotse), 
one by mixing an extract with other ingredients (Ext. Colocynthidis 
Comp.), and one (Ext. Glycyrrhizse) is an ordinary commercial product. 



472 PHARMACEUTICAL PREPARATIONS. 

The official Extracts number 32, and are named as follows, the letters 
in parentheses indicating the ingredients of the menstruum used in 
extraction in each case, viz. — 

Extractum Aconiti (A). Ext. Glycyrrhizae. 

Ext. Aloes (W). Ext. Glycyrrhizae Purum (W). 

Ext. Arnicas Radicis (DA). Ext. Hyoscyami (AgWj,). 
Ext. Belladonnas Foliorum Alcoholicum Ext. Iridis (A). 

(AjjWj). Ext. Jalapas (A). 

Ext. Cannabis Indicas (A). Ext. Juglandis (DA). 

Ext. Cimicifugas (A). Ext. Kramerias (W). 

Ext. Cinchonas (AgWj). Ext. Leptandrse (A 3 Wj). 

Ext. Colchici Radicis (WAc). Ext. Nucis Vomicae (AgWj). 

Ext. Colocynthidis (DA). Ext. Opii (W). 

Ext. Colocynthidis Compositum. Ext. Phvsostigmatis (A). 

Ext. Conii (DA, Ac). Ext. Podophylli (A 4 W X ). 

Ext. Digitalis (AJN X ). Ext. Quassias (W). 

Ext. Ergotas (DA,Ac). Ext. Rhei (A^Wj). 

Ext. Euonymi (A 2 W l ). Ext. Stramonii Seminis (DA). 

Ext. Gentianae (W). Ext. Taraxaci (W). 

Ext. Uvae-ursi (A 2 W 5 ). 

The Proximate Principles generally present in extracts, besides the 
peculiar principles of plants, are Sugar, Tannin, Extractive, Chlorophyll, 
Coloring-matter, and Salts. When an alcoholic solvent is used there are 
also present Resins, Fats, and often a Volatile Oil, and when the men- 
struum is not purely alcohol there is more or less gum and starch. One 
of these ingredients, named Extractive or Apotheme, is a deposit, soluble 
in water and alcohol, which has the singular property of passing into an 
insoluble substance under the influence of the atmospheric air with heat. 
It also has a tendency, when precipitated from solutions, to unite with 
other principles, carrying them down with it. It is frequently present in 
extracts, hence its name. 

Extracta Fluida, Fluid Extracts, — are permanent and concentrated 
solutions of vegetable drugs, of uniformly definite strength if the crude 
drugs are so, a cubic centimeter (n^ 16.23) m each case representing the 
medicinal powers of one gramme (gr. 15.43) of the drug, or approxi- 
mately a minim of the finished preparation representing the active con- 
stituents of a grain of the drug. They are officially directed to be pre- 
pared by percolation and partial evaporation, the menstrua employed 
being usually Alcohol, diluted Alcohol, or Alcohol and Water in various 
proportions, though a few are percolated with water, the alcohol being 
afterwards added. In several instances Glycerin in different proportions 
is added to the first menstruum ; and in the menstrua used for the fluid ex- 
tracts of Conium, Ergot, Nux Vomica and Sanguinaria, Acetic Acid is 
an ingredient. In the preparation of the fluid extract of Prunus Virgin- 
iana, the extraction is preceded by maceration with water and glycerin, 
in order to permit of the formation of Hydrocyanic Acid by the reaction 
of the amygdalin and emulsin of the bark upon each other, which takes 



PHARMACEUTICAL PREPARATIONS. 



473 



place only in the presence of water. The glycerin aids to keep the dis- 
solved matters in perfect solution, and also to better retain the acid and 
volatile oil formed during the process. The fluid extract of Glycyrrhiza 
is prepared by maceration for 48 hours in a menstruum containing Am- 
monia-water, then by percolation, using a mixture of alcohol and water. 
The menstruum directed to be used in each case is intended to be that 
which will thoroughly extract all the active constituents of the drug and 
at the same time leave the inert soluble matters behind in the rejected 
portion, known as the marc. In manufacturing fluid extracts on a 
large scale, modifications of the official processes are necessary, and the 
methods used are generally percolation and maceration with hydraulic 
pressure, vacuum maceration followed by percolation, percolation with 
incomplete exhaustion, or repercolation. 

The official Fluid Extracts number 88, and are named in the following 
list; the letters and figures following in parentheses showing the ingre- 
dients of their respective menstrua, by the initials of Alcohol, Diluted 
Alcohol, Water, Glycerin and Ammonia-water. The interrogation sign 
(?) signifies that the several proportions cannot be represented by figures. 



Extractum Aconiti Fl. (AjWj). 

Ext. Apocyni Fl. (A 65 W 25 G 10 ). 

Ext. Arnica? Radicis Fl. (AgW,). 

Ext. Aromaticum Fluidum (A). 

Ext. Asclepiadis Fluidum (DA). 

Ext. Aspidospermatis Fl. (A 6 W 3 G 1 ). 

Ext. Aurantii Amari Fl. (A 2 W X ). 

Ext. Belladonna Radicis Fl. (A 4 W X ). 

Ext. Buchu Fluidum (A). 

Ext. Calami Fluidum (A). 

Ext. Calumba? Fluidum (AgWj). 

Ext. Cannabis Indica? Fl. (A). 

Ext. Capsici Fl. (A). 

Ext. Castanese Fl. (A^WgGj. 

Ext. Chimaphila? Fl. (DA). 

Ext. Chirata? Fl. (A 2 W a ). 

Ext. Cimicifuga? Fl. (A). 

Ext. Cinchona? Fl. (AWG?). 

Ext. Cocas Fluidum (DA). 

Ext. Colchici Radicis (Fl. A 2 W X ). 

Ext. Colchici Seminis Fl. (AjNJ. 

Ext. Conii Fl. (DA). 

Ext. Convallaria? Fl. (DA). 

Ext. Cubeba? Fluidum (A). 

Ext. Cusso Fluidum (A). 

Ext. Cypripedii Fluidum (DA). 

Ext. Digitalis Fluidum (AjW^. 

Ext. Dulcamara? Fluidum (DA). 

Ext. Ergota? Fluidum (DA). 

Ext. Eriodyctii Fluidum (A 4 W,). 

Ext. Eucalypti Fluidum (AgWj). 

Ext. Eupatorii Fluidum (DA). 

Ext. Frangula? Fluidum (A 5 W 8 ). 

Ext. Gelsemii 'Fluidum (A). 

Ext. Gentianse Fluidum (DA). 

Ext. Geranii Fluidum (DAjGj). 



Ext. Glycyrrhiza? Fl. (A 30 W 65 Am 5 ). 

Ext. Gossypii Radicis Fl (AgGj). 

Ext. Grindelia? Fluidum (A). 

Ext. Guarana? Fluidum (AgWj). 

Ext. Hamamelidis Fl. (A^G^. 

Ext. Hydrastis Fluidum (AgWgG^. 

Ext. Hyoscyami Fluidum (AjWj). 

Ext. Ipecacuanha? Fluidum (A 3 W 1 ). 

Extractum Iridis Fluidum (A). 

Ext. Krameria? Fluidum (DAgGj). 

Ext. Lappa? Fluidum (DA). 

Ext. Leptandra? Fluidum (A 3 Wj). 

Ext. Lobelia? Fluidum (DA). 

Ext. Lupulini Fluidum (A). 

Ext. Matico Fluidum (AgWj. 

Ext. Menispermi Fluidum (A 2 W X ). 

Ext. Mezerei Fluidum (A). 

Ext. Nucis Vomica? Fluidum (AgWJ. 

Ext. Pareira? Fluidum (AWG?). 

Ext. Phytolacca? Radicis Fl. (A 2 W X ). 

Ext. Pilocarpi Fluidum (DA). 

Ext. Podophylli Fluidum (A 4 W X ). 

Ext. Pruni Virginiana? Fl. (AWG?). 

Ext. Quassia? Fluidum (A X W 2 ). 

Ext. Rhamni Purshiana? Fluidum (DA). 

Ext. Rhei Fluidum (A 4 W X ). 

Ext. Rhois Glabra? Fluidum (DAfij). 

Ext. Rosa? Fluidum (DAgGj). 

Ext. Rubi Fluidum (AgWgGj). 

Ext. Rumicis Fluidum (DA). 

Ext. Sabina? Fluidum (A). 

Ext. Sanguinaria? Fluidum (AgWJ. 

Ext. Sarsaparilla? Fluidum (A^V.J. 

Ext. Sarsaparilla? Fl. Co. (AgWgG^. 

Ext. Scilla? Fluidum (AgW^. 

Ext. Scoparii Fluidum (DA). 



474 



PHARMACEUTICAL PREPARATIONS. 



Ext. Scutellariae Fluidum (DA). 
Ext. Senegae Fluidum (A 75 W 20 Am 5 ). 
Ext. Sennee Fluidum (DA). 
Ext. Serpentariae Fluidum (A^Wj). 
Ext. Spigeliae Fluidum (DA). 
Ext. Stillingiae Fluidum (DA). 
Ext. Stramonii Seminis Fl. (AgWj). 
Ext. Taraxaci Fluidum (DA). 



Ext. Tritici Fluidum (AjWj). 
Ext. Uvse Ursi Fluidum (A 2 W 5 G 3 ). 
Ext. Valerianae Fluidum (AgWj). 
Ext. Veratri Viridis Fluidum (A). 
Ext. Viburni Opuli Fluidum (AgWj). 
Ext. Viburni Prunifolii Fl. (A3WJ. 
Ext. Xanthoxyli Fluidum (A). 
Ext. Zingiberis Fluidum (A). 



In 14 instances only does the Pharmacopoeia direct the making of 
other preparations from corresponding fluid extracts, these being the 
Syrups of Ipecac, Krameria, Rhubarb, Rose, Rubus, Senega and Ginger ; 
the Compound Syrups of Sarsaparilla and Squill ; the Tincture of Ipecac 
and Opium, the Wine of Ipecac, the Extract of Ergot, the Liniment of 
Belladonna, and the Mixture of Rhubarb and Soda. Notwithstanding 
this fact it is a common practice for dispensing pharmaceutists to make 
tinctures, syrups, infusions, etc., from fluid extracts ; and some manufac- 
turers put a label on the bottles containing their fluid extracts, giving the 
formulae for so preparing other preparations. This practice is illegitimate, 
and tends to still further degrade the profession of pharmacy into a mere 
trade, so far as dispensing is concerned. 

A large number of unofficial fluid extracts are manufactured and for sale, one house 
alone carrying over 400 such on their catalogue. Normal Liquids are a class of superior 
fluid extracts introduced by Parke, Davis & Co., which are claimed to be adjusted to a 
maximum strength by accurate assays for alkaloidal strength made at each stage of their 
manipulation, irrespective of the amount of material required, which in the case of official 
fluid extracts is prescribed by the Pharmacopoeia, regardless of the varying quality of drugs 
in the market. This firm prepares Normal Liquids of Aconite, Veratrum Viride, Bella- 
donna (root or leaves), Cannabis Indica, Cinchona, Calisaya, Cinchona Rubra, Colchicum 
(root or seed), Conium, Ergot, Digitalis, Gelsemium, Hyoscyamus, Ipecacuanha, Podo- 
phyllum, Nux Vomica, Rhubarb, and Stramonium (seed or leaves). Of these prepara- 
tions one cubic centimeter is equivalent to one gramme of the corresponding drug of 
standard alkaloidal strength. A fluid extract of Belladonna leaves may contain .25 or 
.45 per cent, of Atropine, according to the quality of the drug employed ; a Normal 
Liquid will contain invariably .4 per cent, of the alkaloid, so that in a given dose it may 
be relied upon to produce a certain effect. 

Gargarysma, A Gargle, — is a mixture or solution for application to 
the pharynx or the mouth (mouth-wash). It should never contain any 
very active drug, which would produce dangerous symptoms if swallowed ; 
nor any agent which would injure the teeth or the mucous membrane. 
Gargles are ordered and compounded in the same manner as mixtures. 
They usually contain astringent or disinfecting salts (Alum, Borax, Zinc 
Sulphate, Potassium Chlorate), with a vegetable astringent, and often 
Honey. The following formulae will illustrate prescriptions of this 
class : — 
R . Tr. Guaiaci Ammoniatae, 

Tr. Cinchonae Comp., . . aa 25 ss. 

Mellis Despumat., oJ ss - 

Bene simul agita, et adde — 

Potassii Chloratis, ,^ij ss - 

Aquae, q. s., ad ^ viij. 

Fiat gargarysma. Sig. — Gargle. 



R. Aluminis, ^ij. 

Granati Corticis, £iv. 

Petal. Rosse Rubr., 3J. 

Mellis Despumat., %]. 

Aquae Bullientis, ifvj. 

M. Sig.— Gargle. 

{Goddard.) 



PHARMACEUTICAL PREPARATIONS. 475 

Glycerita, Glycerites, — are mixtures of medicinal substances with 
Glycerin, in which, some of them are dissolved. They are very useful 
preparations for dispensing purposes, as they can be readily diluted with 
water or' alcohol without precipitation. There are 6 official Glycerites, 
the figures following their names in the list below indicating the percent- 
age of drug in each. The Glycerite of Starch contains 10 per cent, of 
water, and that of Hydrastis has for its menstruum a mixture of glycerin, 
alcohol and water. 

Glyceritum Acidi Carbolici, 20. Glyceritum Boroglycerini, 31. 

Glyceritum Acidi Tannici, 20. Glyceritum Hydrastis, 100. 

Glyceritum Amyli, 10. Glyceritum Vitelli, 45. 

Haustus, A Draught, — is an extemporaneous mixture consisting of 
a single dose, and usually ordered in a vial containing from one to two 
fluidounces. 

Effervescing Draught is one of the best known. It is prepared by neutralizing a 
watery solution of Potassium Bicarbonate with Lemon-juice or Citric Acid, and may be 
drunk during effervescence. "When the C0 2 has escaped it is a solution of Potassium 
Citrate in water, and corresponds to the official Liquor Potassii Citratis, or Neutral 
Mixture. 

Black Draught is another well-known preparation of this class. It is official as In- 
fusum Sennas Compositum. 

Infusa, Infusions, — are prepared by treating vegetable substances 
with hot or cold water without boiling. Cold water is preferred when the 
drug contains a desirable volatile principle, or when its active ingredient 
is injured by heat. The drug should be coarsely comminuted, sliced or 
bruised, and treated by maceration or percolation with the proper quan- 
tity of water, which in the absence of specific directions to the contrary 
should be 5 parts by weight of the drug to 100 of water, or 5 grammes 
in 100 Cc. Infusions should be freshly made as required, for they are 
very prone to decomposition. Those official number 4, and are named 
in the following list, the figure after each representing the percentage of 
drug to menstruum, viz. — 

Infusum Cinchonae, 6. Infusum Pruni Virginianae, 4. 

Infusum Digitalis, i}4.. Infusum Sennas Compositum, 6. 

The last named infusion contains also 12 per cent, each of Manna and Magnesium 
Sulphate and 2 of Fennel. The Infusion of Cinchona has of Aromatic Sulphuric Acid 
1 per cent. Alcohol, in the proportion of 10 per cent, is an ingredient of the Infusion 
of Digitalis to prevent decomposition. 

Many dispensing pharmaceutists are in the habit of making infusions 
from concentrated alcoholic tinctures or from fluid extracts. It is a very 
reprehensible practice, especially in those cases where the active ingre- 
dients are of a resinous nature and therefore precipitate when the alco- 
holic solution is added to water. 



476 



PHARMACEUTICAL PREPARATIONS. 



Injectiones, Injections, — are liquid preparations intended for intro- 
duction into the cavities of the body by means of a syringe. When 
thrown into the rectum they are termed Enemas (Enemata), or Clysters, 
and are usually prepared at the bedside. Enemata may be demulcent, 
laxative, nutritive, stimulant, or vermifuge in character; and always have 
warm or tepid water as their diluent, with which are incorporated such 
medicaments as may be desired. They may consist simply of water to 
act as a wash for the cleansing of the bowel. Injections are termed vagi- 
nal, urethral, vesical, nasal, hypodermic, etc., according to the locality in 
which they are employed. A special form of syringe is employed in each 
case, the discussion of which belongs rather to the domain of surgery 
than that of medicine. Those used for the nasal cavities are often 
arranged with small holes or an atomizing attachment, so as to deliver 
the injection in the form of a fine spray. A Collunarium is a nasal 
douche or wash. In the Appendix will be found a list of formulae for 
hypodermic injections ; a. few prescriptions for other forms are appended 
below. 



Enema for Stricture of the Rectum. 

R. Bismuthi Subcarb., . . . ^j. 

Extracti Opii, . . . . gr. ij. 

Glycerini, Aquae, . . aa 3" ij. 
M. Fiat enema. Sig. — Two table- 
spoonfuls to be injected thrice weekly. 



Demulcent Enema. 



R. 



Tincturae Opii, 
Decocti Amyli, 
M. Fiat enema. 



n\,xx. 

E iv - v J- 



R. 



Vermifuge Enema. 
Extr. Quassiae Y\., . . . ,^jss. 



Aquae, 3 ijss. 

M. Sig. — A tablespoonful with an equal 
quantity of warm water, as an enema, to 
be retained as long as possible. 



R 



Nasal Injection [DobelPs). 

Ac. Carbolici, 3J SS - 

Sodii Bicarb., 

Sodii Boratis, .... aa^iv. 

Glycerini, £xivss. 

Aquae q. s. ad .... ^viij. 
M. Sig. — A tablespoonful diluted with 
an equal quantity of tepid water to be used 
thrice daily with a nasal sprayer. 



Injection for Gonorrhoea. 

(Injection Brou.) 

R . Zinci Sulphatis, . . . . gr. viij. 

Plumbi Acetatis, . . . . gr. xv. 

Tincturse Opii, .... 3*ij. 

Tinct. Catechu, . . . . zj. 

Aquae Rosae, q. s. ad . . 3 vj. 



M. Fiat injectio. 
urethral syringe. 



Sig. — Use with a 



Injection for Chronic Urethritis. 



R. 



Hydrarg. Chi. Corrosivi, gr. ^4. 

Zinci Chloridi, gr. ss. 

Aquae Destillatae, . . . ^ viij. 
M. Sig. — A teaspoonful to be injected 
well down into the urethra thrice daily, 
through a gum-catheter. 



Vaginal Injections for Leucorrhcea. 

R. Aluminis, 3"j. 

Zinci Sulphatis, .... 3 ss. 

Sodii Boratis, gr. iv. 

M. Sig. — Dissolve in half-a-pint of 
warm water, and use with a vaginal sy- 
ringe. 

R. Acidi Tannici, 3*j. 

Glycerini, ^ iv. 

M. Sig. — One-half with an equal 
quantity of water to be injected twice 
daily. 



Inhalationes, Inhalations, and Vapores, Vapors, — are medicines in 
the form of a vapor, a gas or an atomized spray, to be inhaled by the 
patient for their local action on the respiratory tract. The well-known 
steam-atomizer is the agent by which most of these preparations are 



PHARMACEUTICAL PREPARATIONS. 



477 



administered, though many substances may be inhaled from the surface of 
hot water, from a sponge in a bottle surrounded by a hot cloth, or from a 
heated shovel. They are prescribed in the usual manner, as follows : — 



Stimulant Inhalation. 

R. Olei Cubebae, g.-ij. 

Magnesii Carbonat., . . . t ^j. 

Aquae, ^iij. 

M. Sig. — A teaspoonful in a pint 
water at 150 F., for each inhalation. 



of 



Oil of Pine. 
R. 01. Pini Sylvestris, ... ^ij. 
Magnesii Carb., .... 7,). 

Aquae, ^iij. 

M. Sig. — A teaspoonful ou a pint of 
hot water for each inhalation. 



R 



Carbolized Inhalation. 
Acidi Carbolici TtVxlviij. 



Aquae, q. s. ad .... |j ij. 
M. Sig. — Use one-half in the cup of a 
steam- atomizer for each inhalation. 



Tar and Turpentine. 



R. 



01. Picis Liquidae, 

01. Terebinth, . . . aa Jfij. 
M. Sig. — Pour slowly on a hot shovel 
in the sick-room, keeping the vapor con- 
fined therein. 



The official Charta Potassii Nitratis (Nitre-paper), is a preparation in- 
tended for use as an inhalation, its vapors while burning being taken into 
the lungs. 



Linimenta, Liniments, — are very thin ointments for external applica- 
tion, intended to be applied with friction to the skin. They are solutions 
of various substances in oily liquids or in alcoholic liquids containing 
fatty oils. Of the following 9 official Liniments 2 have as their basis 
Cotton-seed Oil, 1 Linseed Oil, 1 Oil of Turpentine, 1 Alcohol, and 
3 Alcohol and Water. 



Linimentum Ammoniae. 
Linimentum Belladonnas. 
Linimentum Calcis. 
Linimentum Camphorae. 



Linimentum Chloroformi. 
Linimentum Saponis. 
Linimentum Saponis Mollis. 
Linimentum Sinapis Compositum. 
Linimentum Terebinthinae. 



Extemporaneous Liniments may correspond to the official ones or they 
may be simple mixtures of fluids without either fat or soap. A prescrip- 
tion for each kind is appended. The official Linimentum Saponis (Soap 
Liniment) is a good basis for extemporaneous preparations of this class. 

Stoke? Liniment. 



Cot?ipound Chloroform Liniment. 
R. Ext. Belladon. Rad. FL, . .. gss. 
Extracti Aconiti FL, 
Chloroformi Venalis, . . aa % ij. 
Spiritus Camphorae, ... £]. 
Alcoholis Diluti, q. s. ad . Jj viij. 
M. Fiat linimentum. 
Sig. — Poison. To be rubbed on the 
painful part. 



R 



Anodyne Liniment. 
. Tinct. Aconiti, gij. 

Tinct. Opii, ^iv. 

Tinct Arnicae, ^j. 

Chloroformi, gij. 

Linim. Saponis, q. s. ad. . |j iv. 
M. Fiat linimentum. 
Sig. — Poison. Liniment. 



R 



. Olei Terebinthinae, .... ^iij. 

Acidi Acetici, ^ ss. 

Olei Limonis, gj. 

Vitellum, j. 

Aquae Rosae, 5jiij 

M. Fiat linimentum. 
Sig. — Liniment. 



R 



Army Medical Wagon Liniment. 

. Liq. Ammoniae, 

01. Terebinthinae, 

01. Olivae, 

aa, partes aequales. 
M. Fiat linimentum. 
Sig. — Liniment. 



478 



PHARMACEUTICAL PREPARATIONS. 



An Embrocation is a similar preparation, but of thinner consistence. 
The term is almost obsolete. 



Liquores, Solutions, — comprise all aqueous solutions of non-volatile 
substances, except the syrups, infusions and decoctions, which naturally 
form distinctive classes. There are 24 official solutions, 7 of which are 
simple aqueous solutions of the medicament, the rest being chemical 
aqueous solutions, in which the dissolved substances are altered by 
chemical action, and new ones formed. They are named as follows, viz. — 



Liquor Acidi Arsenosi. 

Liquor Ammonii Acetatis. 

Liquor Arseni et Hydrargyri Iodidi. 

Liquor Calcis. 

Liquor Ferri Acetatis. 

Liquor Ferri Chloridi. 

Liquor Ferri Citratis. 

Liquor Ferri et Ammonii Acetatis. 

Liquor Ferri Nitratis. 

Liquor Ferri Subsulphatis. 

Liquor Ferri Tersulphatis. 

Liquor Hydrargyri Nitratis. 



Liquor Iodi Compositus. 

Liquor Magnesii Citratis. 

Liquor Plumbi Subacetatis. 

Liquor Plumbi Subacetatis Dilutus. 

Liquor Potassae. 

Liquor Potassii Arsenitis. 

Liquor Potassii Citratis. 

Liquor Sodas. 

Liquor Sodae Chloratse. 

Liquor Sodii Arsenatis. 

Liquor Sodii Silicatis. 

Liquor Zinci Chloridi. 



Lotio, A Lotion or Wash, — is a solution or mixture of medicinal 
agents, intended for external application ; and usually consists of some 
soluble, astringent salt, dissolved in water, with perhaps some glycerin or 
alcohol. A Fomentation (Fotus) is a similar preparation used hot. A 
Colly rium is an eye-wash, and generally contains a soluble astringent salt 
dissolved in rose-water or distilled water, in the proportion of gr. j-iv to 
the % The only official preparation suitable for a lotion is the Liquor 
Plumbi Subacetatis Dilutus, or Lead-water. A well-known anodyne, re- 
frigerant and astringent lotion is that represented by the upper two of the 
following prescriptions. 



B 



Lead-water and Laudanum. 
. Liq. Plumbi Subacetatis, . . %]. 

Tinct. Opii, jfj. 

Aquae, q. s. ad ifviij- 

M. Fiat lotio. Sig. — Lotion. 

Gross. 



Collyrium. 

R . Sodii Boratis, gr. x. 

Aquae Camphorae, gij. 

Mucil. Cydonii, 

Aquae Destil., aa^ss. 

M. Fiat collyrium. Sig. — Eye-water; 
a few drops to be put into the eye three or 
four times daily. 



Lead and Opium Wash. 
R . Liq. Plumbi Subacetatis, 

Tinct. Opii, i 

Aquae, q. s., ad 

M. Fiat lotio. Sig. — Lotion. 



I viij. 



Sturgis. 



Collyrium of Four Sulphates. 
& . Zinci Sulphatis, 
Ferri Sulphatis, 
Cupri Sulphatis, 

Aluminis, aa gr. j. 

Aquae Destillatae, ^j. 

M. Fiat collyrium. Sig. — For use with 
brush to palpebral conjunctivae, and to be 
washed off with clean water. 



Massse, Masses, — are Pill-masses prepared as described in the next 
paragraph. The official Masses number 3, viz.: — 

Massa Copaibae. Massa Hydrargyri. Massa Ferri Carbonatis. 



PHARMACEUTICAL PREPARATIONS. 479 

Mellita, Honeys, — differ from syrups merely in their being prepared 
with honey as a base. The Oxytnel and Oxymel Scillce of the B. P. are 
similar preparations, containing also Acetic Acid. There are 3 official 
Honeys, including two forms of honey itself, viz.: — 

Mel. Mel Despumatum. Mel Rosse. 

Misturae, Mixtures, — in official pharmacy are aqueous preparations of 
insoluble substances held in suspension by a suitable vehicle. In extem- 
poraneous pharmacy the term mixture has a wider signification, as 
explained below. Mixtures are generally prepared extemporaneously 
upon prescriptions, as few of them are of the stability necessary to insure 
their preservation beyond a few days. The official Mixtures are 4 in 
number, and are named as follows, viz.: — 

Mistura Cretse. Mistura Glycyrrhizae Composita. 

Mistura Ferri Composita. Mistura Rhei et Sodae. 

In extemporaneous pharmacy the term Mixture is applied to every fluid 
compound intended for internal use, except a few which bear distinctive 
titles, such as Emulsions, Draughts, Enemas, Elixirs and Drinks. The 
simplest form of mixture in this extended sense is that in which two or 
more liquids are mixed together ; but a great variety of substances may 
be prescribed in this form, chief among which are most of the soluble 
salts, light insoluble powders, salts which may be diffused by agitation, 
extracts, gum-resins, and the fixed essential oils. They are generally or- 
dered in 2, 3, 4, 6, 8, 10 and 12-ounce vials. 

Substances suitable to the mixture-form, properly so called, are 
those which, though more or less insoluble in water, will mix with it by 
agitation, trituration, etc. Those most frequently ordered are as 
follows : — 

Diffused by Agitation : — Miscible only by Trituration : — 

Calcii Phosphas Praecipitatus. Ammoniacum. 

Cinchona (powdered). Asafcetida. 

Ipecacuanha (powdered). Confectio Rosae. 

Magnesia. Confectio Sennas. 

Quininae Sulphas. Extractum Aconiti. 

Sulphur Praecipitatum. Ext. Belladonnas Fol. Alcohol. 

Ext. Conii. 

Suspended by Viscid Excipients : — Ext, Hyoscyami. 

Essential Oils. Ext. Stramonii. 

Oleum Amygdalae. Ext. Glycyrrhizae. 

Oleum Morrhuae. Ext. Krameriae. 

Oleum Olivae. Ext. Taraxaci. 

Oleum Ricini. Guaiacum. 

Copaiba. Scammonium. 

Ferri Carbonas Saccharatus. Myrrha. 

Best Suspended by the aid of a Fixed Oil or Yolk of Egg : — 

Ext. Cannabis Indicae. Oleum Terebinthinae. . 

Camphora. Chloroformum. 



48O PHARMACEUTICAL PREPARATIONS. 

Solutions intended for internal administration are classed as Mixtures 
in extemporaneous pharmacy, for the reason stated above. The follow- 
ing list of acids and salts comprises most of the solids which are best 
adapted for use in liquid form, by reason of their solubility in water. 

Acidum Citricum. Potassii Bromidum. 

Acidum Tannicum. Potassii Carbonas. 

Acidum Tartaricum. Potassii Citras. 

Alumen. Potassii Chloras. 

Ammonii Chloridum. Potassii Hypophosphis. 

Antimonii et Potassii Tartras. Potassii Iodidum. 

Barii Chloridum. Potassii Tartras. 

Calcii Chloridum. Potassii et Sodii Tartras. 

Calcii Hypophosphis. Morphinse Acetas. 

Ferri Pyrophosphas. Morphinse Hydrochloras. 

Ferri Sulphas. Morphinae Sulphas. 

Ferri et Ammonii Citras. Sodii Bicarbonas. 

Ferri et Potassii Tartras. Sodii Boras. 

Ferri et Quininse Citras. Sodii Carbonas. 

Magnesii Sulphas. Sodii Chloridum. 

Mangani Sulphas. Sodii Hypophosphis. 

Potassii Acetas. Sodii Phosphas. 

Potassii Bicarbonas. Sodii Sulphas. 

A few require the use of viscid substances as vehicles or correctives. 
They are as follows : — 

Ammonii Carbonas. Potassa. 

Plumbi Acetas. Potassii Cyanidum. 

Hydrargyri Chloridum Corrosivum. 

Certain salts are best ordered by prescribing such agents as will when 
in solution together react upon each other and produce the desired salt. 
Instances of this may be found in the pharmacopceial processes for most 
of the official Liquores ; some of the salts so produced being the follow- 
ing :— 

Ammonii Acetas. Ferri Acetas. Potassii Arsenis. 

Magnesii Citras. Ferri Chloridum. Potassii Hydras. 

Potassii Citras. Ferri Nitras. Sodii Hydras. 

Ferri Citras. Hydrargyri Nitras. Soda Chlorata. 

Zinci Chloridum. 

Certain other substances require the addition of other agents in order 
to form eligible solutions. Such are the following : — 

Quininae Sulphas, — requires acidulated water for its solution, the acid used being gen- 
erally Diluted Sulphuric, or the Aromatic Sulphuric. This method of prescribing the salt 
develops its bitter taste to the utmost, and is often avoided by ordering the drug to be sus- 
pended in a viscid liquid, such as Pulv. Acaciae in Syrup of Ginger. In such a case an 
officious dispenser anxious to show his smartness by adding some dilute Sulphuric Acid to 
dissolve the Quinine would thereby defeat the object of the prescriber. 

Quinine Sulphate, may be prescribed with Aromatic Spirit of Ammonia, Spirit of Nitrous 
Ether, Tinctures or other alcoholic preparations together with Glycerin or Syrup and 
Water. In such cases the salt should be first dissolved in the alcoholic portion of the 
prescription ; then the glycerin or syrup, and finally the aqueous portions should be added 
gradually. It may also be ordered with Diluted Sulphuric Acid and some vegetable in- 
fusion containing Tannin, in which case a precipitate of Quinine Tannate will be produced. 
This of course should not be filtered, but should be dispensed with a " Shake-label." 



PHARMACEUTICAL PREPARATIONS. 48 I 

For the use of " Velatine " as a vehicle for the use of Quinine Salts, see ante under the 
title Cinchona. 

Chinoidin, Cinchonine Sulphate and Quinidine Sulphate, — also require the addi- 
tion of a dilute mineral acid for their solution in aqueous mixtures. 

Iodine, — requires the addition of Potassium Iodide for its solution in a convenient 
quantity of water, as in the case of the official Liquor Iodi Compositus. 

Hydrargyri Iodidum Rubrum, Red Mercuric Iodide, — requires the addition of 
Potassium Iodide or Mercuric Chloride for its aqueous solution. 

Potassii Bitartras, Cream of Tartar, — requires the addition of Borax or Boric Acid 
for its solution in water. 

Benzoic Acid, — requires the addition of Borax to aid its solubility in water, an equal 
part of the latter making it 5 times more soluble than when alone. 

Lime, — is more soluble in sweetened water than in plain water, the sugar aiding its 
solution. 

Excipients are substances which give form and consistence to prescrip- 
tions, and serve as vehicles for the exhibition of the other ingredients. 
Some of the excipients are Diluents, or agents which effect the dilution or 
division of the active ingredients ; while others act in the double capacity 
of diluents and Flavoring agents. The Excipients most generally used in 
mixtures may be tabulated as follows, viz. : — 

Diluents. True Excipients. 

Water (Aqua). Acacia (in powder or mucilage). 

Medicated Waters (Aquae). . Tragacanth (in powder or mucilage). 

Syrups. Sugars. 

Mel Rosae. Confections. 

Elixir Aromaticum. Some Extracts. 

Yolk of Egg (Vitellus). 

Flavoring Agents. 

Oleum Amygdalae Amarae. Tinct. Tolutana. 

Oleum Cari. Tinct. Vanillae. 

Oleum Caryophylli. Tinct. Zingiberis. 

Oleum Cinnamomi. Spiritus Anisi. 

Oleum Gaultherise. Spiritus Lavandulae. 

Oleum Sassafras. Spiritus Limonis. 

Tinctura Aurantii Dulcis. Spiritus Myristicae. 

Tinct. Cardamomi. Spiritus Menthae Piperitae. 

Tinct. Cardamomi Comp. Spiritus Menthae Viridis. 

Tinct. Cinnamomi. Syrupus Limonis. 

Tinct. Gentianae Comp. Syrupus Tolutanus. 

Syrupus Zingiberis. 

Compounding the Mixture is a matter of no slight importance, 
and one which is best learned at the dispensing counter, though a few 
directions may not be out of place. In the case of the simplest form of 
mixture, where two or more fluid preparations are prescribed together, 
the only operations required are the measuring of the several ingredients 
and pouring them into the designed vial. In doing this the compounder 
should pursue a regular and definite order of procedure. Taking in his 
left hand a graduate of sufficient capacity to hold the whole quantity pre- 
scribed, he should walk along the shelves, and with the right hand pour 
from the stock-bottles the requisite quantity of each ingredient in the 
order in which they are entered on the prescription. A skillful clerk will 
31 



l 



482 PHARMACEUTICAL PREPARATIONS. 

hold the graduate between the thumb and first finger, the prescription be- 
tween the second and third fingers, and the stopper of the stock-bottle 
between the little finger and the hand, leaving his right hand free for the 
manipulation of the bottles containing the ingredients. 

When an actively poisonous agent is ordered it should always be the 
last thing put into the mixture. Attention to this rule will prevent the 
danger of the toxic substance being put in twice. 

The order in which the ingredients are put together is not of so much 
importance in compounding a simple mixture as in the case of an emul- 
sion, and the order of the prescription can usually be followed, with the 
exception noted in the preceding paragraph. Still, when several alcoholic 
preparations, syrups and waters are ordered together, it is good practice 
to first mix the alcoholic fluids, then to add the syrups and finally the 
water, so as to avoid the precipitation of resinous principles which would 
occur if the alcoholic solutions were added to the water. Distilled water 
should always be used, in order to insure uniformity in taste and appear- 
ance, and also as a matter of purity and cleanliness. All mixtures should 
be well shaken before being labelled. 

Solids which are comparatively insoluble or only slowly soluble require 
to be rubbed up in a mortar with one or more of the fluid ingredients. 
Glass mortars are much employed for this purpose, and many compounders 
mix all the ingredients in such a mortar before transferring them to their 
vial. Vegetable powders (as Rhubarb, Ipecac, etc.), or finely pulverized 
inorganic substances, are often ordered in intimate mixture with water, 
thickened with mucilage or syrup. In such cases the mixture should be 
made in a porcelain or wedgewood mortar, enough mucilage or syrup 
being added at first to make a thick paste, and after this is rubbed smooth 
the water may be gradually added during the continued process of mix- 
ing. This process will answer for all inorganic substances in powder, 
except Magnesia, which is best mixed by being thrown on the surface of 
the water, and after it has sunk to the bottom as a uniform sediment the 
other ingredients may be added, and the whole well shaken. Froth upon 
the surface of the liquid, which often arises after agitation, and may pre- 
vent the corking of the bottle, will quickly subside on the addition of a 
few drops of alcohol. 

The following are samples of prescriptions for medicines to be admin- 
istered in mixture form : — 



Bismuth Mixture for Children. 
& . Bismuthi Subcarbonatis, ^ij. 

Syrupi Acacise, 

Aquae Cinnamomi, aa |j ij. 

Misce. Signa. — A teaspoonful every 
<hour in choleraic diarrhoea. 



Quinine Mixture for Children. 
R. Quininae Sulphatis (pulv.), ^ss, 

Acaciae (pulv.), .... £ss. 

Syrupi Zingiberis, ... £ iv. 
Fiat mistura. Signa. — A teaspoonful 
thrice daily. 



PHARMACEUTICAL PREPARATIONS. 483 

Mucilagines, Mucilages, — are thick, viscid liquids prepared by dis- 
solving gum in water, or by extracting with water the mucilaginous prin- 
ciples from certain plants. They are easily spoiled and should be kept 
only in small quantities. The official Mucilages number 4, as follows, 
the two first -named being prepared without heat, the two last-named with 
heat, viz. : — 

Mucilago Acaciae. Mucilago Tragacanthae. 

Mucilago Sassafras Medullas. Mucilago Ulmi. 

Oleata, Oleates, — are liquid solutions of metallic salts or alkaloids in 
Oleic Acid, intended for external administration. They are not definite 
chemical compounds, though the term is also employed in trade to desig- 
nate certain solid preparations which are claimed to be chemical com- 
pounds of the same acid with various bases. [See under Acidum Olei- 
cum, ante, page 78.] There are three official Oleates, as follows, viz. : — 

Oleatum Hydrargyri (20 percent.). Oleatum Veratrinae (2 per cent.). 

Oleatum Zinci (5 per cent.). 

Oleoresinse, O/eoresins, — are liquid preparations consisting principally 
of natural oils and resins extracted from vegetable substances by percola- 
tion with Ether. They differ from fluid extracts in not bearing any uni- 
form relation of Cc to the gramme of drug, in containing principles 
which though soluble in ether are not in alcohol, and in some instances 
being devoid of principles which are insoluble in ether but soluble in 
alcohol. They are the most concentrated liquid preparations of drugs 
which can be produced, and are prepared by percolating the powdered 
drug with Ether until exhausted, recovering the greater part of the ether 
by distillation, and exposing the residue in a capsule to spontaneous 
evaporation until the remaining ether has evaporated. There are 6 official 
Oleoresins, viz. : — 

Oleoresina Aspidii (10-15). Oleoresina Lupulini (50). 

Oleoresina Capsici (5). Oleoresina Piperis (5). 

Oleoresina Cubebae (18-25). Oleoresina Zingiberis (6-8). 

The figures in parentheses show the percentage of oleoresin yielded by 
each drug. 

Paints, Pigmenta, — are preparations for external use, which cannot 
be classed with the preceding. They are generally prescribed in skin- 
diseases, for use over inflamed joints, or for application to the throat with 
a camel' s-hair brush. 



i 



&. Tinct. Iodi, gj. 

^Etheris, 5§iij. 

Tinct. Aconiti, 3 ss. 

Ext. Belladon. Rad. FL, . giv. 

Morph. Sulph., gr. ij. 

Iodi, 3J SS « 

Sig. — Paint 4 or 5 coats freely over the 
inflamed and painful parts. 



R . Alcoholis, Saponis Viridis, 

Olei Cadini, aa ^j. 

Sig. — Paint over the part. 



R. OleiTiglii, zj. 

^Etheris, gij. 

Tinct. Iodi, 3 v. 

M. Sig. — Paint on once in 3 days. 



484 PHARMACEUTICAL PREPARATIONS. 

Pilulae, Pills, — are spherical masses composed of medicinal agents and 
intended to be swallowed whole. The "mass" consists of the active 
ingredients and the excipient, the latter being the substance which gives 
to the mass its adhesive and plastic qualities. In official pharmacy the 
excipients are specified both as to composition and quantity in each case, 
and those directed to be used in the preparation of the 3 official Masses 
and the 15 official Pills are as follows, viz. : — 

5 are made with Soap and Water, viz. — Pil. Aloes, Pil. Aloes et Asafoetidae, Pil. Asa- 
foetidae, Pil. Opii, Pil. Rhei. 

4 are made with Water alone, viz. — Pil. Aloes et Mastiches, Pil. Catharticse Comp., 
Pil. Cathartics Vegetables, Pil Rhei Comp. 

I with Syrup, viz. — Pil. Aloes et Myrrhae. 

I with Mucilage of Tragacanth, viz. — Pil. Antimonii Comp. 

1 with Acacia and Water, viz. — Pil. Ferri Iodidi. 

2 with Glycerin and Water, viz. — Pilulae Phosphori, Pil. Ferri Carbonatis. 
I with Confection of Rose, viz. — Pilulae Aloes et Ferri. 
I with Honey, Syrup and Water, viz. — Massa Ferri Carbonatis. 
I with Glycerin and Honey of Rose, viz. — Massa Hydrargyri. 
1 has no excipient, viz. — Massa Copaibae, being a resin left after distillation. 

The pharmacopceial directions for the formation of the pill-mass vary 

in each case, but in general they prescribe that the ingredients shall be 

mixed intimately, then beaten with the excipient to form a mass and 

divided into a certain number of pills. Two of the official pills are 

directed to be coated with an ethereal solution of the Balsam of Tolu, 

viz. — Pilulae Ferri Iodidi and Pilulse Phosphori. Full descriptions of the 

various details of pill-making are given in the section on Extemporaneous 

Pharmacy. The number of official pills is 15, for the composition of 

which the student is referred to their several titles in the section of Materia 

Medica. They are named as follows, viz. : — 

Pilulae Aloes. Pilulse Catharticse Compositae. 

Pilulae Aloes et Asafoetidae. Pilulae Catharticae Vegetabiles. 

Pilulae Aloes et Ferri. Pilulae Ferri Carbonatis. 

Pilulae Aloes et Mastiches. Pilulae Ferri Iodidi. 

Pilulae Aloes et Myrrhae. Pilulae Opii. 

Pilulae Antimonii Compositae. Pilulae Phosphori. 

Pilulae Asafoetidae. Pilulae Rhei. 
Pilulae Rhei Compositae. 

Pills constitute a form of medicine very much used in extemporaneous 
pharmacy, and one with the preparation of which the compounder should 
be perfectly familiar, for it will constitute fully one-third of his work at 
the dispensing counter. Pills should not exceed 5 grains in weight, un- 
less the ingredients are very heavy, as Bismuth, Calomel, Hydrargyrum 
cum Creta, etc., of which 6, 8, or 10 grains may be made into a pill 
which may be readily swallowed. A Bolus is a similar mass, but larger 
than a pill, while the names Granule and Parvule are given to masses 
smaller than the average pill. 

The Process of Pill-Making is briefly as follows : The ingredients 
ordered in the prescription are separately weighed out in the order of 



PHARMACEUTICAL PREPARATIONS. 485 

their bulk, commencing with that one of which the smallest quantity is 
to be used. If any require pulverization they should first be placed in 
the mortar, and reduced to powder ; then the other dry ingredients, next 
the soft extracts and the excipient selected, and the whole is worked up 
into a mass, the Pill-mass, by the aid of the mortar and pestle. The 
perfect pill-mass should be uniform throughout, should not show any 
particles of any one ingredient, should have such a consistence that the 
pills made from it will retain their shape, should not be too hard, nor too 
dry, nor should it stick to the fingers. The mortar should be large and 
shallow, of unpolished wedgewood ware ; having a thick, smooth and 
well-formed bottom, and a pestle which fits it. The operation of working 
up the mass is one of kneading it between the end of the pestle and the side 
of the mortar, and if proper ingredients and excipient are used, and if 
the work is well done, the mass will eventually loosen itself from both 
mortar and pestle. If it does not do so it should be removed with a 
spatula when sufficiently worked, and may be kneaded for a few minutes 
between the fingers. It should then be placed upon the tile or slab pre- 
viously dusted with a little Lycopodium or Starch in fine powder, and 
rolled into a long cylinder by the aid of a broad-bladed spatula, until the 
mass is of a length corresponding to the divisions on the tile-scale which 
represent the number of pills to be made. The mass should then be 
placed along the scale, and a cut made through it with the spatula at each 
division of the scale, the pieces being at once rounded separately into pills 
by the thumb and two fingers of each hand. A pill-machine is often 
employed, consisting of two metal plates having semi-cylindrical grooves 
on one side, and set into wooden boards, the whole forming a convenient 
apparatus for rolling the mass and then cutting it into the required num- 
ber of pills by one movement. The pills are then left to dry upon the 
slab while the label is being written, after which they are placed in a pill- 
box, or in a wide-mouthed bottle if they contain volatile ingredients, 
and surrounded by a Conspergative powder (Lycopodium, powdered 
Chalk, dusted Talc), to prevent their adhering together or losing their 
shape. 

Excipients used in pill-making are seldom mentioned in the prescrip- 
tion, but are usually left to the choice of the compounder. Some sub- 
stances need no excipient, but may be made at once into pills ; such 
being the softer Extracts and some Gum-resins, the former if too hard 
only needing a little water, and the latter a few drops of spirit to soften 
them to the required degree of plasticity. Every druggist has his favorite 
pill-excipient, many using a paste made of powdered Tragacanth 1 , Glycerin 
3% and Water 1 part, while others use Extract of Malt, or a mixture of 
Syrup and powdered Acacia, for general use. Powdered Tragacanth to 



486 PHARMACEUTICAL PREPARATIONS. 

give tenacity, Glycerin to keep the mass soft, and Water to develop the 
adhesive qualities of many ingredients, will answer for fully nine-tenths 
of all the cases which occur in practice. These three excipients should 
stand on the dispensing -counter ready for use, and all ready-made pastes 
or mixtures should be discarded, as being slovenly, dirty, and liable to 
change. The excipients described below are those in general use, and are 
arranged in the order of their comparative importance, viz. : — 

Liquid Excipients. 

Glycerin, — is a very valuable excipient, as it continually attracts moisture from the 
atmosphere, and pills made from it do not get hard. It should be always used for Qui- 
nine pills. Glycerites of Starch or Tragacanth are generally useful excipients. The 
former is official, the latter is made in the proportion of 3 ss to the ^ . 

Glucose, — is a good excipient, being colorless, adhesive, and not readily volatilized at 
ordinary temperatures. Since its introduction by Mr. Lascheid for this purpose it has 
steadily grown in favor. 

Honey, — may be used for dark-colored substances. It should be evaporated to one- 
half its bulk, ancLthen if mixed with a little Tragacanth, it makes an excellent excipient 
for insoluble powders. 

Extract of Malt, — is a pretty fair excipient, but has the disadvantage of its dark color. 

Syrup, — is a fair excipient for powders, but it should not be used for metallic salts, es- 
pecially Calomel, which it reduces in a short time. Syrup of Acacia is good where there 
is little room left for the excipient, but if kept too long, pills made with it become very 
hard and insoluble. 

Mucilage of Acacia, — is very adhesive, but not a good excipient for the same reason 
as given for the syrup. 

Water, — is only used alone as an excipient when the ingredients possess sufficient ad- 
hesiveness to be developed by the water. Such are the following powders : Aloes, Rhu- 
barb, Kino, Tannic Acid, Opium, Squill, Asafetida, — also Ferric Citrate, Berberine Sul- 
phate, etc. 

Alcohol, — is used to soften Camphor, Compound Extract of Colocynth, Guaiac, resinous 
extracts, gums, etc. 

Solid Excipients. 

Tragacanth, — is an excellent excipient, especially for substances which are too soft, 
giving them body and elasticity. 

Acacia, — is added to give more adhesiveness than can be obtained from viscid liquids 
alone. Pills made with it are generally very hard. It is used for Silver Nitrate, which 
may explode if mixed with vegetable extracts or glucose. 

Soap, — is the best for resinous and fatty substances, increasing the solubility of the 
former. It is more employed in the official pills than any other excipient, but should 
not be used for substances which are decomposed by an alkali, nor for Tartar Emetic. 

Bread-crumb [Mica Panis), — is an excellent excipient for Croton Oil, or other pow- 
erful liquid substances, as volatile oils. 

Confection of Rose, — is too bulky for general use, but is a good excipient for very 
active agents, like Strychnine, which are used in small quantity. 

Althaea, — is good for absorbing and adhesive purposes, but is too bulky for general use. 

Petrolatum, Cacao Butter, and Resin Cerate, — are used for oxidizable substances, 
as Potassium Permanganate. 

Kaolin, — is well adapted for Silver Nitrate, and other substances which are easily de- 
composed. 

Liquorice, — is an old excipient, but not much employed now. In powder it may be 
used for oils. 

Conspergatives, — are absorbent powders which are dusted upon the 
finished pills and put around them in the box or vial in which they are 
dispensed, to keep them from sticking together and losing their shape. 
Powdered Liquorice was formerly much used for this purpose, but the best 



PHARMACEUTICAL PREPARATIONS. 487 

conspergatives are Lycopodium, Talc, Althaea, and Rice Flour, the latter 
especially for white pills. 

Substances Suitable for the pilular form of medicine are — 

Those acting in small doses. Heavy, insoluble substances. 

Those intended to act slowly. Fetid substances. 

Those to act on the lower bowel. Vegetable extracts. 

Gum-resins, Balsams, Turpentine. 

When the basis is an unadhesive substance, one of the other ingredients 
should be an extract or a vegetable powder, which will form a mass by 
moisture alone. Attention to this rule in prescribing pills will often pre- 
vent the increase of their size by inert excipients. 

Substances Difficult to combine, except by peculiar treatment, are 
met with frequently. The following notes will cover most such cases : — 

Aloes, — is best treated on a heated slab with alcohol in very small quantity. Soap 
is the excipient in the official Pilulae Aloes. 

Butyl Chloral Hydrate, — should be treated with a little Confection of Rose and 
thick mucilage. 

Calcium Sulphide, — should be well triturated with an equal quantity of Sugar of 
Milk, and then worked up with a little powdered Liquorice-root and Tragacanth 
Mucilage. 

Camphor, — should be powdered with a little alcohol, and may be worked into a pill- 
mass with Glycerite of Tragacanth after the evaporation of the alcohol. 

Carbolic Acid, — requires nearly an equal part of wheaten flour or bread-crumb, with 
a very minute quantity of Glycerite of Tragacanth. Creosote maybe made into a mass 
by the addition of powdered Liquorice with a very little bees' wax. If made into a pill 
with Silver Oxide it will explode unless the silver salt be first diluted by trituration with 
Liquorice, Gentian, or some other inert powder. 

Iron and Quinine Citrate, — is very deliquescent with most excipients. Canada 
Balsam is the best for it. 

Copaiba, — may be made into pill-mass by the addition of a little Magnesium Car- 
bonate or Wax. 

Croton Oil, — is best worked up with bread-crumb, though powdered Liquorice and 
mucilage may be used. 

Ferrous Iodide, — in pill form requires special manipulation and protection to remain 
unoxidized. The official Pil. Ferri Iodidi is prepared with- Iodine and Reduced Iron, has 
Liquorice, Sugar, and Acacia as excipients, and is protected by a coating of Balsam of 
Tolu. In other formulae, Acacia, Althaea, Cacao-butter, Elm bark, and Liquorice are 
used as excipients. 

Ferrous Sulphate, — is used in Blaud's Pill and in the official Pil. Ferri Composite, 
with Potassium Carbonate, to form by mutual decomposition Ferrous Carbonate, which 
quickly passes into the ferric salt by exposure. Myrrh in powder and Syrup are the ex- 
cipients used for the official pill. 

Gallic Acid, — makes a good pill with a very small quantity of Glycerin. Tannic 
Acid requires about one-fifth its weight of Glycerin and one-tenth of Mucilage. 

Phosphorus, — presents the problem of combining it in pill without letting it oxidize. 
This is believed to be accomplished by the pharmacopceial directions for the Pil. Phos- 
phori, according to which the Phosphorus is dissolved in Chloroform in a test-tube, then 
quickly worked into a mass with Althaea, Acacia, Glycerin and Water, and finally the 
pills are coated by shaking with an Ethereal solution of Balsam of Tolu. Carbon Di- 
sulphide is a better solvent, but when it is used the pill-mass retains its disgusting odor. 

Potassium Acetate, — requires Canada Balsam to secure its stability in pill form 
Potassium Iodide is best manipulated by rubbing it into a smooth paste with a very 



488 



PHARMACEUTICAL PREPARATIONS. 



little water, then adding a small quantity of Liquorice powder. Potassium Perman- 
ganate should be worked up with Kaolin and a very little water. Resin Cerate, Soft 
and Hard Paraffin and Cacao-butter are also used as its excipients. 

Quinine, — requires very clean hands and tools, and a colorless excipient, as Glycerin 
or Glucose, to make a nice-looking pill. If one part of Tartaric Acid is added to four of 
the Quinine salt, the mass will be less likely to crumble and will be of less bulk. Qui- 
nine Sulphate may be made into small and soluble pills by simply triturating it with 
Aromatic Sulphuric Acid TT\iij to each 5 grains of the salt. The moulding into pills 
should be done at the moment when the mass has begun to dry. A drop of syrup or 
honey, added at this time, will prevent the too rapid hardening of the mass. 

Rhubarb, — in powder makes a good mass with one-fifth of its weight of Glycerin ; 
but Soap is the excipient ordered for the official Pilulae Rhei. 



Substances Unsuited to the pilular form are — 
Those requiring large doses, and those which are volatile. 
Emetics, and other agents administered for immediate effect. 
Essential Oils in quantity exceeding half a drop to each pill. 
Oils and other bodies which require much solid matter to make a mass 

except those having a very small dose, as Croton Oil. 
Deliquescent Salts, unless intended to be used immediately. 
Efflorescent Salts, unless deprived of their water of crystallization. 



Deliquescent Salts. 
Ammonii Iodidum. 

Nitras. 

Valerianas. 

Auri Chloridum. 
Calcii Chloridum. 

Chinolin Salts, except the Tartrate, which 

is stable. 
Lithii Citras. 

Bromidum. 

Salicylas. 

Magnesii Citras. 
Potassa. 

cum Calce. 

Potassii Acetas. 

Carbonas. 

Citras. 

Cyanidum. 

Hypophosphis. 

Sulphis. 

Tartras. 

Sodii Hypophosphis. 

Iodidum. 

Zinci Bromidum. 

Chloridum. 

Iodidum. 



Efflorescent Salts. 
Alumen (slightly). 
Ammonii Carbonas. 

Phosphas. 

Antim. et Potassii Tartras (slightly). 
Cupri Acetas. 

Sulphas. 

Magnesii Sulphas (slightly). 
Potassii et Sodii Tartras (slightly). 

Ferrocyanidum (slightly). 

Quininae Bisulphas. 

Sulphas (after a time). 

Soda. 

Sodii Acetas. 

Arsenas (slightly). 

Benzoas. 

Boras (slightly). 

Carbonas. 

Hyposulphis. 

Phosphas. 

Santoninas (slightly). 

Sulphas. 

Sulphis. 

Strychninae Sulphas. 
Zinci Acetas. 

Sulphas. 



Coated Pills are manufactured upon a large scale by the great drug 
houses, extensive machinery being employed for the purpose. The coat- 
ing material used is either Sugar or Gelatin. The U. S. Pharmacopoeia 
directs that two of the official pills shall be coated by being shaken with 
a solution of Balsam of Tolu in Ether, viz. — Pil. Ferri Iodidi and Pil. 
Phosphori. In extemporaneous pharmacy it is rarely practicable to coat 



PHARMACEUTICAL PREPARATIONS. 



489 



pills with anything except gold or silver leaf, and this is sometimes directed 
by the prescriber, the word " Deaur enter — let them he gilded" being 
used in the subscription. To do this neatly the pills should have no trace 
of powder on them, but should be first coated with a trifle of fresh muci- 
lage by rolling between the mucilage-moistened fingers, each pill being 
then dropped directly on to a sheet of gold or silver leaf, until a dozen 
or more are so deposited. The leaf and its pills are then allowed to slide 
into a globular boxwood shaker, or the leaf may be first placed in the 
shaker and the pills dropped on it there. A cautious circular movement 
being given to the shaker the pills are caused to travel around its walls, 
and when the cover is removed they will be found to have each received 
an even coating of the metal used. Gold leaf should always be employed 
for pills of Blue Mass or Asafetida, as silver is amalgamated with the 
former and turned black by the latter. 

Albumen may be used for coating small numbers of pills, which should be of very firm 
consistence before the coating is applied. Each pill is rolled between two fingers with a 
little white of egg, and then revolved in a warm pan. Another method of finishing them 
is, after coating with albumen, to rotate them in a tray with powdered French chalk until 
their surfaces become smooth and shiny. When carefully done this process gives a very 
nice finish. 



Compressed Pills, as now largely manufactured by several reliable 
firms, consist of various medicinal powders pressed into pill or tablet 
shape by machinery. They are extremely convenient preparations for the 
physician's use, as quite a variety can be carried in a pocket-case, and as 
slight pressure is sufficient to reduce them to powder, they can be dispensed 
with facility and accuracy of dosage. The following list includes the 
most important of these preparations, the figures representing the number 
of grains in a pill in each case : — 



Acid, Arsenous, fa ^\, ^\, ^. 
Benzoic, 5. 




Cathartic Comp. and Vegetab. (U. 
Cerium Oxalate, 2. 


S. P 


Gallic, 5. 




Cinchona Alkaloids (Mixed). 




Salicylic, 2*4, 5. 

Salicylic, 2^, and Morphine 

Tannic, 2, 5. 


tV 


Cinchonine Sulphate, 2, 3, 4, 5. 
Cinchonidine Sulphate, 2, 3, 4, 5. 
Codeine, l / t . 




Aconitina, -J^. 




Digitaline, ^. 




Aloes, 2. Aloes et Ferri (U. S. P.). 




Extract of Cannabis Indica, ^. 




Aloes, 2, et Myrrh, 1. 




Extract of Ignatia Amara, %, %. 




Aloes, 2/, et Rhei, i^,et Gentian, 


%' 


Extract of Nux Vomica, ^, l / 2 . 




Aloin, £, X, %. 
Ammonium Bromide, 5, 10. 




Ferrum (Quevenne's), 1, 2. 
Ferrum Arsenate, }i, %• 




Ammonium Chloride, 3, $, 10. 




Proto- carbonate, 3, 5. 




Atropine, £>■ 
Bismuth Subcarb., 5. 
Subnitrate, 5, 10. 




Lactate, 1. 

Pyrophosphate, 2. 

and Quinine Citrate, 2, 3, 5. 




Borax, 5. 
Caffeine Citrate, I. 




Hydrargyrum, 1, 3, 5. 

Chloridum Corros. - s \, -^\, fa 


1 

TO' 


Calcium Sulphide, -jL, ^, }£, I. 
Calomel, %, >£, 1, 2, 3, 5. 
Calomel, 2, Opium, 1. 




Iodidum Rub., fa, y 1 ^-. 

Iodidum Flavum, J^, l /%, l /6, 

Ipecac. et Opii, 2, 3, 5. 


X- 



Camphor, Monobromated, 2, 3, 5. 



Morphine Sulphate, fa, 



490 



PHARMACEUTICAL PREPARATIONS. 



Opium, Deodorized, I. 
Opium, l / z , and Lead Acetate, i)/ 2 . 
Pepsin Saccharated, 2, 5. 
Podophyllin, ^, %, %, %, I, 2. 
Potassium Bromide, 5, io. 

Chlorate, 5. 

Iodide, 5. 

Nitrate, 5. 

Permanganate, %, I, 2. 

Quinine Bisulphate, j^, I, 2, 3, 4, 5. 
Salicylate, 2. 



Quinine Sulphate, y,, 1, 2,3, 4, 5. 

Quinquinine, 2, 3. 

Rhubarb, 3. Rhei Co. (U. S. P.). 

Rhubarb, 2, and Magnesia, 2. 

Salicin, 2^, 5. 

Santonin, I. 

Santonin, I, and Calomel, 1. 

Sodium Bicarbonate, 5. 

Salicylate, 3, 5. 

Strychnine, T ^, ^, up to ^. 
Zinc Phosphide, T ^ up to y. 



The following prescriptions represent the composition of a few unoffi- 
cial pills in general use. A complete pill formulary is easily obtained, 
being published annually by the principal manufacturers. 



Pills of Iron. 

R. Ferri Reducti, gr. 1. 

Mannae, gr. xv. 

Glucosi, q. s. 
Fiat massa, et div. in pil. xxv. 
Sig. — One after each meal. 



R- 



Emmenagogue Pill ( Olio) . 

Ferri Sulph. Exsic. , . . . gr. xlviij 

Pulv. Aloes, gr. xij. 

Terebinthinae, gr. xxvij. 

Ol. Terebinth., ir^x. 

Fiat massa, et div. in pil. xxx. 
Sig. — Two, three times a day. 



Hooper 's Female Pills. 

R. Pulv. Aloes Socot., . . . gr. 

Ferri Sulph. Exsic, . . . gr. 

Ext. Hellebori Nig., 

Pulv. Myrrhae, 

Saponis, aa gr. 

Pulv. Canellae Alb., 

Pulv. Zingiberis, . . . aa gr. 

Aquae vel Syrupi, q. s. 
Fiat massa, et div. in pil.,quisque pondo 
gr. ijss. 

Sig. — One to three at a dose. 



xlviij. 
xxiv. 



xij. 



V J- 



R 



R 



Anaphrodisiac and Sedative. 

Camphorae, gr. xxx. 

Lupulini, gr. xx. 

Fiat massa, et div. in pil. xx. 
Sig. — One thrice daily. 



Astringent Pill. 

. Plumbi Acetatis, . . . . gr. xvj. 

Pulv. Camphorae, . . . . gr. xij. 

Pulv. Opii, gr. iij. 

Bismuthi Subcarb., . . . gr. xij. 

Ext. Gentianae, q. s. 
Fiat massa, et div. in pil. xij. 
Sig. — One thrice daily. 



Astringent Pill. 

R . Argenti Nitratis, . . . 
Pulv. Cretae (Gallicse), . 
■ Petrolati, q. s. 
Fiat massa, et div. in pil. xl. 



. gr. xx. 
. gr. lxxx. 



R. 



Cholagogue Pills {Squibb). 
Resinae Podophylli, . . . gr. vj 



Ext. Belladon. Alcohol, 

Pulv. Capsici, 

Pulv. Sacch. Lactis, . . aa gr. 

Pulv. Acaciae gr 

Glycerini, Syrupi, aa, q. s. 
Fiat massa, et div. in pil. xxiv. 
Sig. — One or two as required. 



r. 
r. nj. 



XXIV. 



Aperient Pills. 

R. Pulv. Aloes Socot., . 

Pulv. Rhei, 

Hydrarg. Chlor. Mitis, 
Antim. et Potas. Tart., 
Fiat massa, et div. in pil. xxiv. 
Sig. — One or two as needed 



gr. xxiv. 
gr. xlviij. 
gr. iv. 
g r - ij- 



R. 



Tonic Pill for Women. 

Strychninae Sulph., 

Acidi Arsenosi, . 

Ext. Belladonnae, 

Quininae Sulph., 

Massae Ferri Carb 
Fiat massa, et. div. in pil. xxxv. 
Sig. — One three times daily. 



aa gr. j. 
• gr- v. 
. gr. xxxv. 
. gr. xc. 



Anti-bilious Pills. 



R . Pulv. Scammonii, 
Pulv. Aloes Socot., 
Pulv. Gambogiae, 
Hydrarg. Chlor. Mitis, 
Potassii Bitart., . . . aa gr. xx. 
Ext. Taraxaci, q. s. 
Fiat massa, et div. in pil. xx. 



PHARMACEUTICAL PREPARATIONS. 49 1 

Potus, A Drink, — is a solution or a mixture intended to be used ad 
libitum, and generally consists of a Potassium or Sodium salt, or a min- 
eral acid, in dilute solution, sweetened and flavored. 

The " Imperial Drink " is made after the following formula : R . Potassii Bitartratis, 
^ij ; Olei Limonis, TT^v ; Aquae Bullientis, q. s. ad ^xx. M. Fiat potus. Sig. — Use as 
a drink. 

Pulveres, Powders, — are usually prepared extemporaneously, but a 
few compound ones have been made official, the ingredients being simply 
directed to be rubbed together until reduced to a fine powder and thor- 
oughly mixed. Special directions are given for the preparation of two, 
— the Compound Effervescing Powder and the Compound Powder of 
Morphine. There are 9 official powders, named as follows, viz. : — 

Pulvis Antimonialis. Pulvis Glycyrrhizae Compositus. 

Pulvis Aromaticus. Pulvis Ipecacuanhas et Opii. 

Pulvis Cretse Compositus. Pulvis Jalapae Compositus. 

Pulvis Effervescens Compositus. Pulvis Morphinae Compositus. 

Pulvis Rhei Compositus. 

The composition of each of these preparations will be found in the section on Materia 
Medica, and under the title from which its name is derived, except that of the Compound 
Effervescing Powder, which is placed under the title Potassium. Pulvis Ipecacuanhae 
et Opii is really a trituration, its ingredients being rubbed together with sugar of milk 
into a very fine powder. 

As prepared extemporaneously Powders are generally compound, and 
may be "mixed on a slab with a spatula, but a much better method of 
mixing them is by trituration in a mortar. The latter should always be 
employed except in the case of substances which may explode if so 
treated, as Potassium Chlorate with oxidizable substances. (See ante, 
page 448.) The diluent best employed in powders is Sugar of Milk, on 
account of its hardness, its density and its comparative insolubility. A 
coloring agent, as Carmine in minute quantity, is a useful ingredient, 
enabling the eye to judge of the degree of mixing and subdivision ob- 
tained. Powders containing soluble salts, extracts, volatile oils, camphor, 
or any other hygroscopic or volatile substances, should be dispensed in 
waxed paper. For ordinary powders the plain white paper of the drug 
stores will answer, but a better paper for small powders is one having a 
high surface finish and made very thin, as the white glazed French demy. 
Powders are often ordered in Wafers {Cachets), to be swallowed without 
unfolding. The division of powders into the number of Papers (C/iar- 
tulce) ordered, and folding them neatly, requires a considerable amount 
of practice. A small machine is used, over which the ends of the papers 
are bent, in order to have them of the proper size for the box in which 
they are usually dispensed. If they are to be put into an envelope, less 
exactness of folding is required, and the mechanical contrivance may be 
dispensed with. 

Substances suitable to administration in the form of powders are those 



492 



PHARMACEUTICAL PREPARATIONS. 



which are insoluble, those which would be chemically incompatible in 
fluid form, and certain pulverizable extracts. Those which are unsuited 
to this form are such as have a very nauseous taste or odor, substances of 
which the dose is large, those which are deliquescent, efflorescent or 
very volatile, and those which liquefy on mixing. A list of deliquescent 
and efflorescent salts is found on page 488, while the following named, 
though dry alone, become moist when triturated together, viz. : — 

Sodium Sulphate and Potassium Carbonate. 
Zinc Sulphate and Lead Acetate. 
Camphor and Chloral Hydrate. 

Many substances cannot be powdered without the intervention of an- 
other body : thus Opium requires a hard substance like Sugar of Milk or 
Potassium Sulphate, Camphor requires a minute quantity of Alcohol, 
Myrrh needs Sugar or Gum, etc. Substances, as the alkaloids and their 
salts, which are very active and are used in very small doses, require some 
inert substance to give them bulk enough for division and handling. 
Sugar of Milk will be found the best agent for this purpose. Prescrip- 
tions may order the ingredients for a single powder, with directions to 
dispense a certain number of the same composition ; or they may give 
the quantities for the whole number of powders ordered, with instructions 
to divide into a certain number. The dispenser should carefully scan the 
prescription in order to avoid the multiplication of quantities where divi- 
sion is intended. The official powders are enumerated above ; and the 
following formulae will serve to illustrate those generally prescribed :— 



Astringent Poivder for Infants. 

R. Plumbi Acetatis gr. ij. 

Pulveris Opii, gr. ss. 

Camphorse, gr. j. 

Sacchari Lactis, . . . . gr. iij. 
Trit., et div. in chartulas xij. 
Sig. — One every 2 or 3 hours in diar- 
rhoea of infants. For an adult the above 
represents one dose. 



Gastric Sedative. 



R 



Bismuthi Subnitratis, . • 

Pulveris Rhei, 

Pulveris Aromat., . . . 
M., et div. in chartulas vj. 
Sig. — One before each meal, 



• 5J- 

aa 3 ss. 



Laxative Powder. 



R 



. Hydrarg. Chlor. Mitis, . 
Sacchari Lactis, .... 
M., et fiant pulv. x. 
Sig. — One powder twice daily, 



gr. x. 
gr. xx. 



R 



Bismuth and Soda. 

Bismuthi Subnitratis, 

Sodii Bicarb., . . . . aa ^ij. 

Pulv. Zingiberis, . . . . gr. xl. 
M., et div. in chartulas xij. 
Sig. — One after each meal. 
Corrective in dyspepsia, acne and eczema. 



Antipruritic Poxvder. 



R 



Pulveris Camphone, . . . gj. 

Zinci Oxidi, % iv. 

Pulv. Amyli, Jj. 

M., et fiat pulvis. 
Sig. — Use locally as a dusting powder to 
relieve itching. 



Catarrh Powder. 



R. Bismuthi Subnitratis, . . 5 iij. 

Pulv. Acaciae, 3J. 

Pulv. Talci, 3^ ij. 

Morphinse Muriatis, ... gr. j. 
M. Sig. — Use by insufflation. 



PHARMACEUTICAL PREPARATIONS. 493 

Compressed Pills are really powders which have been compressed into 
pill shape by machinery. A little pressure from the blade of a spatula 
will restore them to powder form. 

Resinae, Resins, — are solid preparations obtained by precipitating the 

resinous principles of plants from their alcoholic solution by the agency 

of water. They differ from alcoholic extracts in containing only those 

principles which are soluble in alcohol and insoluble in water, while the 

extracts contain all principles which are soluble in alcohol. Besides 

Resina itself, which is the residue left after distilling off the volatile oil 

from Turpentine, there are 4 official Resins, three of which correspond 

to the above description, and one (Resin of Copaiba) is the residue left 

after distilling off the volatile oil from Copaiba. They are named as 

follows : — 

Resina Copaibae. Resina Podophylli. 

Resina Jalapse. Resina Scammonii. 

Spiritus, Spirits, — are alcoholic solutions of volatile substances, which 

may be solids, liquids or gases. They are officially prepared either by 

simple solution, by solution with maceration, by gaseous solution, by 

chemical reaction, or by distillation. The menstruum is Alcohol or 

Deodorized Alcohol in nearly all instances, 4 having Water in addition, 

and 2 being alcoholic liquids of a specified alcoholic strength (Whiskey, 

Brandy). The official Spirits are 25 in number, as follows, viz. : — 

Spiritus iEtheris, 32^. Spiritus Frumenti, 44-50. 

Spiritus yEtheris Compositus, 32^. Spiritus Gaultheriae, 5. 

Spiritus zEtheris Nitrosi, 4. Spiritus Glonoini, I. 

Spiritus Ammoniae, 10. Spiritus Juniperi, 5- 

Spiritus Ammoniae Aromaticus, 9. Spiritus Juniperi Compositus, 63^. 

Spiritus Amygdalae Amarae, 1. Spiritus Lavandulae, 5. 

Spiritus Anisi, 10. Spiritus Limonis, 5. 

Spiritus Aurantii, 5. Spiritus Menthae Piperitae, 10. 

Spiritus Aurantii Compositus, 20. Spiritus Menthae Viridis, 10. 

Spiritus Camphorae, 10. Spiritus Myrciae, 55. 

Spiritus Chloroformi, 6. Spiritus Myristicee, 5. 

Spiritus Cinnamomi, 10. Spiritus Phosphori, 0.12. 
Spiritus Vini Gallici, 39-47. 

The figures placed after Spiritus Frumenti, S. Juniperi Comp., S. Myrciae and S. Vini 
Gallici, represent the percentage of absolute Alcohol by weight in each ; those placed 
after the others indicate the quantity of the principal ingredient in grammes to each 100 
cubic centimeters of the preparation. Absolute Alcohol is the menstruum directed for 
Spiritus Phosphori. 

Suppositoria, Suppositories, — are solid bodies containing medicinal 
substances, and intended for introduction into the vagina, rectum or ure- 
thra. The Pharmacopoeia prescribes a general formula for their prepara- 
tion, according to which the medicinal portion should be incorporated 
with Oil of Theobroma by rubbing them together at a temperature of 



494 PHARMACEUTICAL PREPARATIONS. 

95 F. The mixture should then be poured into suitable moulds, and 
cooled on ice or in ice-cold water. Unless otherwise specified they should 
have the following shapes and weights, corresponding to their several 
uses : — 

Rectal Suppositories, — cone-shaped, about I gramme (15 grains) each. 
Urethral Suppositories, — pencil-shaped, about I gramme (15 grains) each. 
Vaginal Suppositories, — globular, about 3 grammes (45 grains) each. 

The only official Suppositories are those of Glycerin, (Suppositoria 
Glycerini), in which Stearic Acid is employed to give the requisite con- 
sistence. 

In extemporaneous pharmacy Suppositories are usually prepared with 
Cacao-butter as a basis, but for those intended for the uterus or urethra a 
mixture of Gelatin and Glycerin is considered the best excipient, being 
firmer and more plastic than cacao-butter, and more easily handled. 
Hollow cones of cacao-butter, or some composition resembling it, are 
kept in the shops, and will be used by the average druggist in filling pre- 
scriptions for rectal suppositories unless prohibited, as they save him con- 
siderable labor; the active drug being simply placed in the centre of the 
cone, which is then sealed by a plug fitting into its base. These con- 
trivances are by no means so efficient as the regular suppository, in which 
the medicinal agent is thoroughly incorporated with the excipient, for the 
former smear the rectum with a quantity of melted grease before the active 
ingredient is permitted to come in contact with its walls. The agents 
used in suppositories are chiefly extracts and alkaloids; some few powders, 
and a few metallic salts are occasionally employed. Those for the adult 
rectum should contain about 15 grains of the excipient, for the vagina a 
drachm of cacao-butter is the average quantity. Those for the uterus and 
urethra are made of cylindrical instead of conical form, and about the 
diameter of a No. 9 catheter. 

The methods of compounding suppositories are two, viz. : — that by 
the use of moulds (the official method), and that by hand. The former 
process is described above, but many prefer the hand method, which is 
as follows : The medicament is mixed with finely shaved Cacao-butter 
by the aid of a spatula, on a board or tile lightly dusted with Lycopo- 
dium or Starch. After a smooth and uniform mixture is thus obtained, 
the mass may be rolled into cylindrical form, cut into the required sizes 
and with the spatula given the required shape. When dispensed, they 
should be placed in a powder-box, between layers of cotton. 

Bougies or Pencils, as urethral and uterine suppositories are often 
termed, may be prepared by melting together White Gelatin 3, Glycerin 
1, and Distilled Water 1 part by weight, then adding the medicament, 
and drawing the mass into a glass tube previously oiled inside. When 
cold the bougie may be pushed out and cut into suitable lengths. 



PHARMACEUTICAL PREPARATIONS. 



495 



Suppositories and bougies may be prescribed in the manner illustrated 
by the following formulae : — 



R. 



Anodyne Suppository. 
Ext. Opii 



gr- vj. 



Ext. Belladonnas Fol. Al- 

coholicum, gr. ss. 

Ext. Hyoscyami, . . . . gr. ij. 
Olei Theobromae, q. s. 
M. Fiant suppositoria vj. 
Sig. — One into the rectum morning and 
night. 



R 



Anthelmintic. 

. Santonini, 

Olei Theobromae, . . 
M. Fiant suppositoria vj. 
Sig. — One into the rectum as directed. 



gr. xi] . 



Wade's Bougies. 



R. 



Iodoformi, £j. 

Bismuthi Subnitrat., . . %). 

Chloralis Hydratis, . . gr. viij. 

Morphinae Sulphat., . . gr. iij. 

01. Rosae, rr\,x. 

Gelatini, et Glycerini, q. s. 
M. Fiant bougia xij. 
Sig. — One into urethra thrice daily. 



Bougie for Gleet. 




R . Zinci Sulphatis, . . . . 
Ac. Carbolici, 


gr. vj. 

mjij. 


Pulv. Hydrastis, . . . . 
Ext. Belladonnas Fol. Al 


gr. xij. 


coholicum, 


gr. xij. 


Gelatini, et Glycerini, q. s 




M. Fiant bougia xij. 

Sig. — One into urethra night 


and morn 


ing. 





Quinine Suppository. 

R . Quininae Sulphatis, . . . gr. v. 
Olei Theobromae, . . . gr. x. 
Fiat suppositorium unum, mitte tales sex. 

In the British Pharmacopoeia the following 9 suppositories are described, viz. : — 

Suppositoria Acidi Carbolici cum Sapone, Carbolic Acid Suppositories , — Carbolic 
Acid, 12 grains ; Curd Soap, in powder, 180 grains ; Glycerine of Starch, 40 grains ; to 
make 12 suppositories, each containining 1 grain of Carbolic Acid. 

Suppositoria Acidi Tannici, Tannic Acid Suppositories, — Tannic Acid, 36 grains ; 
Oil of Theobroma, 144 grains; to make 12 suppositories, each containing 3 grains of 
Tannic Acid. 

Suppositoria Acidi Tannici cum Sapone, Tannic Acid Suppositories with Soap, — 
Tannic acid, 36 grains ; Glycerine of Starch, 30 grains ; Curd Soap, in powder, 100 grains ; 
Starch, in powder, q. s. ; to make 12 suppositories, each containing 3 grains of Tannic 
Acid. 

Suppositoria Glycerini, Glycerine Suppositories, — Gelatine, cut small, y 2 oz. ; Gly- 
cerine, by weight, 2.)/ z ozs. ; Distilled Water, a sufficiency to make as many suppositories 
as desired, according to size, each containing 70 per cent, by weight of Glycerine. 

Suppositoria Hydrargyri, Mercurial Suppositories, — Mercurial Ointment, 60 grains ; 
Oil of Theobroma, 120 grains ; to make 12 suppositories, each containing 5 grains of Mer- 
curial Ointment. 

Suppositoria Iodoformi, Iodoform Suppositories, — Iodoform, 36 grains ; Oil of Theo- 
broma, 144 grains; to make 12 suppositories, each containing 3 grains of Iodoform. 

Suppositoria, Morphinae, Morphine Suppositories, — Morphine Hydrochlorate, 6 
grains; Oil of Theobroma, 174 grains; to make 12 suppositories, each containing ]/ z grain 
of the Morphine salt. 

Suppositoria Morphinae cum Sapone, Morphine Suppositories with Soap, — Mor- 
phine Hydrochlorate, 6 grains ; Glycerine of Starch, 30 grains ; Curd Soap, in powder, 
100 grains; Starch, q. s. to make 12 suppositories, each containing ]/ 2 grain of the Mor- 
phine salt. 

Suppositoria Plumbi Composita, Compound Lead Suppositories, — Acetate of Lead, 
36 grains ; Opium, in powder, 12 grains ; Oil of Theobroma, 132 grains ; to make 12 sup- 
positories, each containing 3 grains of Lead Acetate and I grain of Opium. 



i 



Syrupi, Syrups, — are concentrated solutions of Sugar in Water or in 
aqueous liquids. They sometimes contain Acetic Acid, and occasionally 
Alcohol; and are termed simple, medicated ox flavored, according as they 
are simple solutions of sugar in water alone, or contain soluble medicinal 



49<5 



PHARMACEUTICAL PREPARATIONS. 



substances, or flavoring ingredients. The Sugar used should be very dry, 
and its official description corresponds with the granulated sugar of com- 
merce. The permanency of these preparations chiefly depends on their 
possessing the proper relative proportions of sugar and water. They are 
prepared either by solution with heat, by agitation without heat, by add- 
ing a medicated liquid to simple syrup, by digestion or maceration, or by 
cold percolation ; these processes being all officially directed except the 
last. They are best preserved by being poured while hot into pint bottles, 
which should be corked securely while full, and the tops dipped into 
melted sealing-wax. Fermented syrups are useless for dispensing pur- 
poses. The number of official syrups is 32, as follows, viz. : — 



Syrupus. 

Syrupus Acaciae. 

Syrupus Acidi Citrici. 

Syrupus Acidi Hydriodici. 

Syrupus Allii. 

Syrupus Altheae. 

Syrupus Amygdalae. 

Syrupus Aurantii. 

Syrupus Aurantii Florum. 

Syrupus Calcii Lactophosphatis. 

Syrupus Calcis. 

Syrupus Ferri Iodidi. 

Syrupus Ferri, Quininae et Strychninae 

Phosphatum. 
Syrupus Hypophosphitum. 
Syrupus Hypophosphitum cum Ferro. 



Syrupus Zingiberis. 



Syrupus Ipecacuanhas. 

Syrupus Krameriae. 

Syrupus Lactucarii. 

Syrupus Picis Liquidae. 

Syrupus Pruni Virginianae. 

Syrupus Rhei. 

Syrupus Rhei Aromaticus. 

Syrupus Rosae. 

Syrupus Rubi. 

Syrupus Rubi Idaei. 

Syrupus Sarsaparillae Compositus. 

Syrupus Scillae. 

Syrupus Scillae Compositus. 

Syrupus Senegae. 

Syrupus Sennae. 

Syrupus Tolutanus. 



Tincturse, Tinctures, — are alcoholic solutions of medicinal substances ; 
and with one official exception (Tincture of Iodine), are made from non- 
volatile bodies. They are prepared by percolation, maceration, solution 
or dilution ; the menstrua employed being chiefly Alcohol, Diluted Alco- 
hol, and Alcohol and Water in various proportions. In one case (Tinc- 
ture of Sanguinaria) Acetic Acid is an ingredient of the menstruum, in 
two the Aromatic Spirit of Ammonia, and in several Glycerin is contained 
therein. 

For Tinctures of Fresh Herbs {Tinctures Herbarum Recentiuni), the Pharmaco- 
poeia prescribes a general formula, according to which, when not otherwise directed, they 
are to be prepared by macerating 50 grammes of the fresh herb, bruised or crushed, in 
100 cubic centimeters of alcohol, for 14 days, then expressing the liquid and filtering. 

The official Tinctures number 71, and are named in the following list, 

the figures placed after each name giving the number of grammes of the 

drug in each 100 cubic centimeters of the tincture. 

Tinctura Aconiti, 35. Tinctura Aurantii Amari, 20. 

Tinctura Aurantii Dulcis, 20. 
Tinctura Belladonnas Foliorum, 15. 
Tinctura Benzoini, 20. 
Tinctura Benzoini Composita, 12. 



Tinctura Aloes, 10. 
Tinctura Aloes et Myrrhae, 10. 
Tinctura Arnicae Florum, 20. 
Tinctura Arnicae Radicis, 10. 



Tinctura Asafoetidae, 20. 



Tinctura Bryoniae, 10. 



PHARMACEUTICAL PREPARATIONS. 



497 



Tinctura Calendulae, 20. 

Tinctura Calumbae, 10. 

Tinctura Cannabis Indicae, 15. 

Tinctura Cantharidis, 5. 

Tinctura Capsici, 5. 

Tinctura Cardamomi, 10. 

Tinctura Cardamomi Composita, 2. 

Tinctura Catechu Composita, 10. 

Tinctura Chiratae, 10. 

Tinctura Cimicifugae, 20. 

Tinctura Cinchonae, 20. 

Tinctura Cinchonae Composita, 10. 

Tinctura Cinnamomi, 10. 

Tinctura Colchici Seminis, 15. 

Tinctura Croci, 10. 

Tinctura Cubebae, 20. 

Tinctura Digitalis, 15. 

Tinctura Ferri Chloridi, 1 3.6. 

Tinctura Gallae, 20. 

Tinctura Gelsemii, 15. 

Tinctura Gentianae Composita, 10. 

Tinctura Guaiaci, 20. 

Tinctura Guaiaci Ammoniata, 20. 

Tinctura Humuli, 20. 

Tinctura Hydrastis, 20. 

Tinctura Hyoscyami, 15. 

Tinctura Iodi, 7. 

Tinctura Ipecacuanha; et Opii, 10. 

Tinctura Kino, 10. 



Tinctura Krameriae, 20. 

Tinctura Lactucarii, 50. 

Tinctura Lavendulae Composita, 0.8. 

Tinctura Lobeliae, 20. 

Tinctura Matico, 10. 

Tinctura Moschi, 5. 

Tinctura Myrrhae, 20. 

Tinctura Nucis Vomicae, 20. 

Tinctura Opii, 10. 

Tinctura Opii Camphorata, 0.4. 

Tinctura Opii Deodorati, 10. 

Tinctura Physostigmatis, 15. 

Tinctura Pyrethri, 20. 

Tinctura Quassiae, 10. 

Tinctura Quillajae, 20. 

Tinctura Rhei, 10. 

Tinctura Rhei Aromatica, 20. 

Tinctura Rhei Dulcis, 10. 

Tinctura Sanguinariae, 15. 

Tinctura Scillae, 15. 

Tinctura Serpentarise, 10. 

Tinctura Stramonii Seminis, 15. 

Tinctura Strophanthi, 5. 

Tinctura Sumbul, 10. 

Tinctura Tolutana, 10. 

Tinctura Valerianae, 20. 

Tinctura Valerianae Ammoniata, 20. 

Tinctura Vanillae, 10. 

Tinctura Veratri Viridis, 40. 



Tinctura Zingiberis, 20. 

Triturationes, Triturations, — form a class of powders having for 
their diluent Sugar of Milk, and possessing a definite relation between the 
active ingredient and the diluent. The Pharmacopoeia prescribes a gen- 
eral formula for these preparations, according to which 10 grammes of the 
Substance and 90 of Sugar of Milk are to be well mixed by a spatula, the 
latter being added in successive quantities, and both triturated in a mortar 
until the substance is intimately mixed with the diluent and finely com- 
minuted. There is but one official Trituration (Trituratio Elaterini), 
though the Pulvis Ipecacuanhas et Opii practically belongs to this class, 
except in respect of the proportions prescribed. Sugar of Milk is. em- 
ployed as the diluent because of its hardness and its comparative insolu- 
bility. The first of these qualities secures the fine comminution of the 
active ingredient, whereby the action of the medicine is increased and 
better distributed. Its insolubility makes it the best diluent for powders 
or triturations administered from a spoon or glass with fluid, as is so often 
done, for unlike cane sugar it is not readily dissolved and does not leave 
the active substance behind on the surface of the utensil. Triturations 
are excellent forms for the administration of powerful alkaloids, which 
may thus be divided with great accuracy into the minute quantities re- 
quired. Mercury and its salts are especially adapted to this method of 
preparation, being more uniformly divided and hence more active than 
when administered in any other form. Triturations of mercury with sugar 
32 



i 



PHARMACEUTICAL PREPARATIONS. 



were commonly used in England a hundred years ago, and triturations of 
many substances were employed by the Arabian physicians of the 13th 
century ; but the subsequent adoption of these preparations by the homce- 
opathists produced such a prejudice against them in the ranks of the regu- 
lar profession, that until recently any one using them stood in danger of 
being stigmatized as a homoeopath. Their recognition by the U. S. 
Pharmacopoeia under their proper title does away with any such implica- 
tion, though it is much to be regretted that the compilers of the last re- 
vision of the British Pharmacopoeia should have shown their fear of a 
name by continuing the title " Pulvis Elaterini Compositus " to designate 
a preparation which in every respect is a trituration. The preparations of 
Pepsin daily prescribed by physicians all over the country are really sugar- 
of-milk triturations of that ferment, and not pure Pepsin as many suppose. 
Prof. H. G. Piffard, Med. Dept. Univ. of the City of New York, in his 
treatise on the Materia Medica and Therapeutics of the Skin (N. Y., 
1 881), after detailing several microscopical examinations of pills and 
triturations, uses the following language : — 

" It is to be expected, therefore, that the protoiodide trituration will prove, ceteris pari- 
bus^ more active than the pill, and such we have found it. Since we have used 
the triturations, however, in preference to the ordinary pills, patients more rarely com- 
plain of disagreeable sensations. We have been enabled to materially reduce the size of 
the dose in order to obtain the desired effect. In other words, a larger proportion of the 
drug is utilized for specific purposes, while but a small amount remains to give rise to local 
irritation I have nothing to add to this, except that I continue to use tritura- 
tions of Mercury and other substances with increasing satisfaction. Beside those men- 
tioned I employ Calomel, Cyanide of Mercury, Black Oxide of Mercury and Corrosive 
Sublimate in this form." 

The following examples will illustrate the mode in which Triturations 
may be prescribed : — 



R . Hydrarg. Oxidi Flavi, . . gr. ss. 

Sacchari Lactis, gr. 1. 

Trit., et div. in chartulas xxiv. 
Sig. — One twice daily. 



R. 



Hydrarg. Chlor. Mitis, . 

Sacchari Lactis, q. s. 
Trit., et div. in chartulas x. 
Sig. — One powder daily. 



gr. x. 



R. 



Morphinse Sulph. 
Sacchari Lactis, . 



Trit., et div in chartulas viij. 
Sig. — One every six hours. 



• g r -J- 
gr. xvj. 



R 



. Acidi Arsenosi, gr. ss. 

Sacch. Lactis, gr. xl. 

Trit.,et div. in chartulas xx. 
Sig. — One powder thrice daily. 



Trochisci,7rarte, — also called Pastilles, Tablets, or Lozenges, — are 
small flattened cakes of medicinal substances, prepared from a mass 
made with a basis of Sugar, some having Mucilage of Tragacanth, others 
Orange-flower Water, Syrup of Tolu, etc., as excipients. They are con- 
venient preparations for the pocket-case, and are especially useful when 
the active ingredients are intended to come into contact with the mucous 
surface of the throat. There are 15 official Troches, named as follows, 
viz. : — 



PHARMACEUTICAL PREPARATIONS. 



499 



Trochisci Acidi Tannici. 

Trochisci Ammonii Chloridi. 

Trochisci Catechu. 

Trochisci Cretae. 

Trochisci Cubebae. 

Trochisci Ferri. 

Trochisci Glycyvrhizae et Opii. 



Trochisci Ipecacuanha. 
Trochisci Krameriae. 
Trochisci Menthse Piperitae. 
Trochisci Morphinae et Ipecacuanhae. 
Trochisci Potassii Chloratis. 
Trochisci Santonini. 
Trochisci Sodii Bicarbonatis. 



Trochisci Zingiberis. 

Troches and Tablets are not readily compounded at the dispensing 
counter, but may be obtained in all first-class shops, being prepared in 
great variety by the manufacturers. Besides the official Troches, those 
named in the following list are generally for sale : — 



Troches {Lozenges). 

Alum, gr. ij. 

Alum, gr. i^, Catechu, gr. ij. 

Ammonium Chloride, gr. ij, and Cubeb, 

Ammon. Chlor., gr. ij, Liquorice, gr. viij. 

Benzoic Acid, gr. l / 2 . 

Borax, gr. iij. 

Bismuth, gr. ij, and Charcoal, gr. v. 

Bronchial, — Oleores. Cubebae, gr. £, Tolu, 

gr. i, 01. Sassafras, gr. -i, and Ext. of 

Liquorice, gr. vij . 
Brown Mixture. 
Carbolic Acid, gr. j. 
Ginger and Sodium Bicarbonate. 
Guaiac, gr. ij. 
Kino, gr. ij. 
Lettuce, gr. j. 
Lime-juice. 
Logwood, gr. ij. 
Magnesia, gr. iij. 
Pellitory, gr. j. 
Pepsin, gr. iij, Charcoal, gr. iij, Magnesia, 

gr. ij, and Ginger, gr.j. 
Potassium Bitartrate, gr. iij. 
Potassium Citrate, gr. iij. 
Santonin, gr. )/ z , and Calomel, gr. y z . 



Cot?ipressed Tablets. 

Ammonium Chloride, gr. iij. 

Charcoal, gr. x. 

Cocaine Hydrochlorate, gr. i, etc. 

Dover's Powder, gr. v. 

Mercury, Yellow Oxide, gr. ^ Tr . 

Pepsin and Pancreatin. 

Potassium Bicarb., gr. v. 

Potassium Chlorate, gr. v. 

Potas. Chlorate and Borax, aa gr. 2^. 

Potas. Chlorate and Ammon. Chloride. 

Spencer's Chloramine Pastilles. 

Sodium Bicarb., gr. iv, Ammon. Carb.,gr. 

X, Ol. Menth. Pip.,gtt. ]/ 6 . 
Sodium Salicylate, gr. iij. 
Antiseptic. Hydrarg. Chlor. Corr.,gr. vijss. 
Fehling's Test for grape-sugar in the urine. 

Hypodermic Tablets. 

Morphine Sulphate, gr. yL- to l / 2 . 
Morph. Sulph. and Atropine Sulph. 
Atropine Sulphate, gr. -^-^\. 
Strychnine Sulphate, gr. yA_. 
Apomorphine Muriate, gr. ^5— fV 
Pilocarpine Muriate, gr. -£$-%. 
(And several others.) 



Unguenta, Ointments, — are soft, fatty mixtures of medicinal agents 
with a basis of lard, petrolatum, or fixed oils with a solid fat such as wax 
or spermaceti. They are intended for application to the skin by inunc- 
tion, and have a melting point which is below the ordinary temperature 
of the human body. Of the 23 official Ointments 1 is prepared by chem- 
ical reaction, (Unguentum Hydrargyri Nitratis) ; 3 by fusion and 1 7 by 
incorporation of the ingredients with each other by mixing them by 
trituration or through the agency of a spatula and a porcelain slab. Un- 
guentum itself is prepared by fusing together 80 of Lard and 20 of 
yellow wax, and is the basis of 3 other ointments, while 14 have Benzo- 
inated Lard as their basis. 




5<DO PHARMACEUTICAL PREPARATIONS. 

Unguentum. Ung. Hydrargyi Oxidi Flavi (10). 

Unguentum Acidi Carbolici (5). Ung. Hydrargyri Oxidi Rubri (10). 

Unguentum Acidi Tannici (20). Unguentum lodi (4). 

Unguentum Aquae Rosse. Unguentum Iodoform] (10). 

Unguentum Belladonnge (10). Unguentum Picis Liquidse (50). 

Unguentum Chrysarobini (5). Ung. Plumbi Carbonatis (10). 

Unguentum Diachylon. Ung. Plumbi Iodidi (10). 

Unguentum Gallae (20). Ung. Potassii Iodidi (12). 

Unguentum Hydrargyri (50). Unguentum Stramonii (10). 

Ung. Hydrargyri Ammoniati (10). Unguentum Sulphuris (30). 

Ung. Hydrargyri Nitratis (7). Unguentum Veratrinse (4). 
Unguentum Zinci Oxidi (20). 

The figures in parentheses show the percentage of extract or other 
active ingredient in the ointment. The composition of each may be 
found in the section on Materia Medica under the title from which the 
preparation is named, except Unguentum, which will be found under the 
title Adeps, and Unguentum Diachylon under Plumbum. 

Ointments and Cerates are frequently ordered on extemporaneous for- 
mulae, though the numerous official preparations of these classes would 
seem to give the physician a sufficiently wide field for selection. The 
basis used is usually either the official Ceratum or Unguentum, but Petro- 
latum, Lard, Lead Plaster with a fixed oil, etc., may be used. Lard is 
probably the best basis for all ointments, as it softens the skin better than 
any other similar substance. Its disadvantage is that it soon becomes 
rancid, so that preparations made with it must be quickly used. Cerates 
only differ from ointments in their firmer consistence, melting at 
temperatures above 104 F., while the latter melt below the ordinary 
temperature of the body. Oleates are described fully on page 78. 

The process of compounding an ointment or a cerate is sufficiently sim- 
ple, being generally a mere matter of triturating the ingredients together 
in a mortar, or of their incorporation on a slab by means of a spatula. 
Rarely will melting be required in the compounding of extemporaneous 
ointments. When extracts, powders or gritty substances are ordered, the 
ingredients should be first pulverized into a fine powder, then triturated 
with a small quantity of the basis into a smooth, impalpable paste ; the 
remainder of the basis being added gradually, until the whole is thor- 
oughly incorporated. A warm mortar may be required for hard extracts. 
Soluble salts should be triturated with a little water before adding the 
excipient. Camphor needs a little alcohol to enable it to be pulverized ; 
and Iodine should be rubbed to a fine powder, then a little alcohol 
added and finally the excipient by degrees. Sulphur Iodide requires 
persevering work with a small portion of olive oil. Borax should be 
triturated with glycerin and Red Mercuric Oxide with distilled water. 
A bone or horn spatula should be used for all ointments, as steel or iron 
blades will injure many substances, particularly alkaloids, free acids, tan- 
nin or iodine, and several of the mercurial salts. Volatile substances 



PHARMACEUTICAL PREPARATIONS. 



501 



should be added last, and quickly worked in, so that their evaporation 
may be as slight as possible. 

Ointments are dispensed usually in amber-colored glass pots o with wooden 
or metallic covers, or in porcelain jars called Gallipots. In hospital and 
dispensary practice the common chip pill-box is used, but soon becomes 
excessively dirty and disagreeable to handle. 



R 



Tnguentum Iodoformi Compositum. 


Unguent 11 m A nti-pru rilicu m . 


. Iodoformi, gj 


R . Camphorse, 


01. Anisi, ..... n^xx. 


Chloralis Hydrat., . . aa £j 


01. Rosse, 


Tere una ad liquorem, dein 


01. Ylang-ylang, . . aa Tt\,v. 


adde cum tritu — 


Ung. Aquse-Rosse, . . . ^j. 


Unguenti Aquae Rosse, . ^j. 


M. Fiat unguentum. 


M. Fiat unguentum. 


Sig. — Ointment. 


Sig. — Ointment for itching. 



Vina, Wines, — when medicated are practically the same as tinctures. 
The menstruum directed to be used is the official White Wine (Vinum 
Album), which should contain from 10 to 14 percent, by weight of abso- 
lute alcohol. It is, however, reinforced by the addition of alcohol to the 
amount of 15 per cent, in all the medicated wines except that of Ipecac, 
which has 10 per cent. In the two Ferric Wines the alcoholic reinforce- 
ment is in the shape of the tincture of sweet orange peel. The official Wines 
are 10 in number, 2 of which are not medicated, and stand first in the 
following list ; four are prepared by solution or admixture, 2 by percola- 
tion and 2 by maceration during seven days. They are named as fol- 
lows : — 



Vinum Album, 10-14. 
Vinum Rubrum, 10-14. 
Vinum Antimonii, 0.4 
Vinum Colchici Radicis, 40. 
Vinum Colchici Seminis, 15. 



Vinum Ergotse, 15. 
Vinum Ferri Amarum, 5. 
Vinum Ferri Citratis, 4. 
Vinum Ipecacuanha?, 10. 
Vinum Opii, 10. 



The figures placed after the first two show the percentage of absolute alcohol by weight 
required in each; those placed after the others indicate the quantity of the principal ingre- 
dient in grammes to each 100 cubic centimeters of the preparation. 



i 



PART III 



SPECIAL THERAPEUTICS. 



Authorities. The principal authorities to whom references are made, 
with their initials, are included in the following list. When a statement 
is not followed by any reference by name or initial, it is to be understood 
as coming from the writer of this book. 

References and Bibliography. 

(A) Aitken. — The Science and Practice of Medicine, by Wm. Aitken. 

(Ag) Agnew. — The Principles and Practice of Surgery, by D. Hayes Agnew. 

(B) Bartholow. — Materia Medica and Therapeutics ; also On the Antagonism between 

Medicines and between Remedies and Diseases, by Roberts Bartholow. 
(Br) Brunton. — Pharmacology, Therapeutics and Materia Medica, by T. Lauder Brunton. 

(C) Carter. — A Practical Treatise on Diseases of the Eye, edited by Green. 
(CI) Clarke. — A Manual of the Practice of Surgery, by W. Fairlie Clarke. 

(DaC) Da Costa. — Notes of Clinical Lectures, delivered by Professor J. B. Da Costa, at 
the Pennsylvania and Jefferson Hospitals. 

(D) Druitt. — A Manual of Modern Surgery, by Robert Druitt. 

(E) Emmet. — Principles and Practice of Gynaecology, by Thos. Addis Emmet. 
(El) Ellis. — A Practical Manual of Diseases of Children, by Edward Ellis. 

(F) Fothergill. — The Practitioner's Handbook of Treatment, by J. M. Fothergill. 

(G) Goodell. — Lessons in Gynaecology, by William Goodell. 

(H) Hamilton. — Nervous Diseases, etc., by Allan McLane Hamilton. 

(L) Leishman. — A System of Midwifery, by William Leishman. 

(M & P) Meigs and Pepper. — Diseases of Children, by J. F. Meigs and Wm. Pepper. 

(N) Niemeyer. — A Text-book of Practical Medicine, by Felix von Niemeyer. 

(O) Osier. — The Principles and Practice of Medicine, by Wm. Osier. 

(P) Phi Hips.— Materia Medica and Therapeutics, by Chas. D. F. Phillips. 

(Pf) Piffard. — Materia Medica and Therapeutics of the Skin, by H. G. Piffard. 

(R). Ringer. — A Handbook of Therapeutics, by Sidney Ringer. 

(Ros) Rosenthal. — Diseases of the Nervous System, by M. Rosenthal. 

(S) Stille. — Therapeutics and Materia Medica, by Alfred Stille. 

(St) Sturgis. — The Student's Manual of Venereal Diseases, by F. R. Sturgis. 

(T) Tanner. — An Index of Diseases and their Treatment, by Thos. H. Tanner. 

(Tr) Trousseau and Pidoux. — On Therapeutics, by Trousseau, Pidoux, and Paul. 

(Tt) Tail. — Diseases of Women, by Lawson Tait. 

( W) Wood. — Therapeutics, its Principles and Practice, by H. C. Wood. 

(Wa) Waring. — Practical Therapeutics, edited by Buxton. 

Besides the above-named, occasional references are made to other works by the same 
authors. References will also be found, with names in full, to Anstie, Brown-Sequard, 
Clymer, Cohen, Flint, Fordyce-Barker, Gross, Hammond, Hilton, Lister, Loomis, Mit- 
chell, Nelaton, Noyes, Nussbaum, Ricord, Roosa, Simpson, A. A. Smith, Thomas, and 
many others. 

502 



ABDOMINAL PLETHORA ABORTION. 



503 



Applied Therapeutics may be studied either with the various thera- 
peutic agents as the objects of chief consideration, as in the first part of 
this work ; or with the different diseases and morbid conditions forming 
the objects of study in respect to their modification and treatment by 
medicines. In the following pages the latter method is followed, the 
therapeutics of each affection being exhibited in the form of an Analyti- 
cal Index to the recognized text-books of the day. Every indication for 
the use of a drug, or statement regarding its value, is followed by the 
initial (in parenthesis) of its author : these references enabling the book 
to be used as an Index to the Authorities, for more strict differentiation 
between indicated remedies, — while the brief analyses given include 
enough to make each section a synopsis of the most advanced therapeutics 
of the disease named bv its title. 



Abdominal Plethora. 

Cathartics. The saline and hydragogue cathartics are of value in congestion of 
the portal circulation (B). Saline Mineral Waters, especially the purgative saline 
waters, as Vichy and Saratoga, in plethora of the abdominal viscera (B). 
Grape-cure has helped many cases, particularly those of hepatic engorgement 
and sluggish portal circulation ; is best used after a preliminary course of power- 
ful mineral waters (P). Aliment is very important. A dry diet is particularly 
indicated in cases of dyspepsia and hepatic enlargement due to excessive 
beer-drinking. Avoid much bread, also salted or twice-cooked meats, rich 
sauces, solid vegetables, especially cucumbers, soups and fruits. Biscuits, 
fresh meat, lemons, fish, fowl and game, may be used. [Compare Hepatic 
Congestion, Obesity.] 

Prescriptions. 



I 



U . Potassii Bicarbonatis, 

Sodii Sulphatis, . . . . aa ^iv. 
Dissolve in 1^ pint of Water, and add 

Acidi Tartarici (cryst.), . . g ij. 
Cork quickly and firmly. y£d to be taken 
thrice daily. 



R. Resinse Podophylli, . . . gr. vj. 
Ext. Colocynthidis Co., . gr. xij. 
Ext. Belladonna? Fol. 

Alcoh., gr iij. 

Fiat massa, et div. in pil. no. xij. 
Sig. — One pill every night. 



Abortion. 

Opium, cautiously in threatened abortion, is often very valuable (Wa) ; — the 
tincture, TtLxx-xxx by rectum (Parvin). Opium to check uterine action and 
Ergot to restrain hemorrhage (B). Ergot, small tonic doses give excellent 
results in threatened abortion (P). Tannin, combined with Opium and Ipecac 
(W). Cimicifuga, to prevent miscarriage when uterus is irritable and prolapsed 
(R). Savine, the dried powder of the leaves, gr. xv-xx, thrice daily, one of the 
most powerful remedies against the hemorrhage indicative of approaching 
abortion (Wa) ; the tincture in doses of 5 to 10 drops, every ^ to 3 hours, 
useful against the hemorrhage (P). Viburnum Prunifolium, in threatened and 
habitual abortion, has a very high reputation. Aurum Chloride, to avert the 
tendency to habitual abortion (B). Iron, with Potassium Chlorate, throughout 
the pregnancy, when fatty degeneration the cause of habitual abortion 
(McLane). Asafcetida, is highly efficient in habitual ^abortion ; given in pills of 
gr. jss each, 2 daily, gradually increased to 10 daily, as soon as a new pregnancy 
occurs, and continued until the labor is over (Turazzo). Tamponade, of the 
cervix uteri, with cotton or sponge, dipped in vinegar or glycerin, when abor- 



504 



ABSCESS ACIDITY. 



tion is inevitable and it is desirable to hasten it and restrain hemorrhage. 
Empty uterus thoroughly with the finger, placenta-forceps liable to do harm 
(Barker). Abortifacients, see pages 48 and 248. Quinine and Ergotin, of each 
gr. ij in pill every 3 hours, the routine abortifacient of many irregular practi- 
tioners. Only by the production of such violent irritation of the abdominal 
and pelvic organs as generally endangers life, can the pregnant uterus be 
stimulated to expel its contents (P). The abortifacient effect of Savine and 
other drugs cannot be obtained unless by the administration of a quantity suffi- 
cient to endanger life (B). 

Prescriptions. 



R. 



Ext. Ergotse Fluidi, . 
Tinct. Opii Deodorat, 
Syrupi Limonis, 



3 V - 



M. Sig. — A teaspoonful thrice daily. 



5t • Acidi Tannici, gr. xv. 

Pulv. Ipecacuanhse, . . . gr. xij. 
Extracti Opii, gr. iij. 

Ft. pil. xij. Sig. — One every six hours. 



Abscess. 

Poultices to check or to assist in maturation, may be smeared with Bella- 
donna or Opium (R). Belladonna, as plaster to subdue (B) ; painted around 
areola (Wa) ; internally often successful in aborting (R). Calcium Sulphide, 
half-grain doses frequently repeated, to abort abscess or to hasten formation of 
pus (B); gr. T V every hour or two, gives striking results in healing large ab- 
scesses (R). Calcium Phosphate, in large abscesses (R). Mercury and Mor- 
phine, the Oleate locally, diminishes induration due to old abscesses and pre- 
vents the formation of new ones (R). Carbolic Acid, a weak solution as 
injection after evacuation, also as a dressing (Lister). Silver Nitrate, a strong 
solution in Nitrous Ether if applied early to adjacent surface will check inflam- 
mation (B). Blisters or Iodine, as counterirritants around or adjacent to seat 
of disease (R). Potassium Permanganate, 3j to the pint of water, to correct 
fetor (B). Iodine, the tincture injected after opening large abscesses (R) ; es- 
pecially in scrofulous abscess (Wa). Salicylic or Boracic Acid, as dressings 
(B). Sarsaparilla, a very useful remedy in chronic abscess with profuse dis- 
charge (P). Cod-liver Oil, improves and lessens discharge from scrofulous 
abscesses (Wa). Surgical. Opening necessary in all deep abscesses, or when 
on face, near anus, mammary, or if danger of its opening into an internal 
cavity. Open with grooved director and forceps ( Hilton). Never open a deep 
abscess with a plunge. Drainage-tube may be required, also irrigation of the 
cavity and pressure (Agnew). Weaning of child necessary in chronic mam- 
mary abscess (Gross). Psoas abscess may result from strain or laceration of 
muscle, as by heavy lifting, effort to recover balance when skating, etc., as well 
as from spinal disease. Symptoms often obscure and simulating those of 
chronic malaria. Early opening by lumbar incision necessary ; then tonics, 
good food, and daily irrigation of the cavity with an antiseptic solution. 
[Compare Suppuration, Carbuncle.] 



Prescriptions. 



R-. Syrupi Ferri, Quininse et 

Strychninae Phosphatum, . ^vj. 
Sig. — A teaspoonful in water thrice daily. 
To repair waste from suppuration. 



R. Syrupi Hypophosphitum, . |jvj. 
Sig. — A dessertspoonful thrice daily. 



R. Quininse Sulph., . . 

Ferri Pyrophosphatis, 

Strychninse Sulph., . 

Ac. Phosphor. Dil., . 

Syrupi Zingiberis, . . 

Aquae, q. s. ad . . . 
M. Fiat mistura. Sig.- 
thrice daily. 



3J- 

A teaspoonful 



Acidity. 

Acids, Hydrochloric or Phosphoric before meals ; acid wine, a genuine Rhine 
wine best ; Sulphurous Acid rr^v-xxx well diluted ; for acid fermentation of 



ACNE. 



505 



starchy foods (R) ; acids after meals for alkaline pyrosis (R). Tannic Acid, 
useful in pill, gr. iv with rr\j of Glycerin (B). Carbolic Acid, often arrests 
eructations (B). Alkalies, after meals for immediate relief, effects only tem- 
porary, Bicarbonates best (R) ; frequent use of alkalies enhances the mischief 
(B). Nux Vomica, gtt. ij-iij of tincture before meals, excellent in small doses 
(B); especially in acidity of pregnancy (R). Pulsatilla, rr\,v of tincture every 
4 hours in acid dyspepsia (P). Silver Oxide, extremely useful (B). Man- 
ganese Oxide, gr. x-xx of the purified black oxide relieves (B). Kino, a favorite 
remedy (B). Ipecacuanha, in acidity of pregnancy (R). Mercury, gr. ss of 
gray powder ter in die, when acidity with clayey stools (R). Atropine, the 
sulphate, thrice daily by mouth, gave excellent results in a case of gastric hy- 
persecretion of acid ; after the third day pain had stopped and vomiting ceased. 
Bismuth, gives excellent results, combined with Opium or Morphine, sometimes 
with Magnesia (R). Diet. Use lemon-juice, aerated or old bread, plain bis- 
cuits. Avoid new bread, pastry, and vegetables. 



Prescriptions. 



R 



Bismuthi Subnitrat., . . giij. 
Acidi Carbolici, . . . gr. ij-v. 
Mucil. Acaciae, .... f ) ). 
Aq. Menth. Pip., . . . giij. 
M. Sig. — A tablespoonful 3 or 4 times 
daily for adults. 



R. Sodii Bicarb., .... 

Spt. Ammonias Aromat., 

Tinct. Zingiberis, . . . 

Infus. Gentianse Co. (U. 

S. P., 1870), q.s. ad, . 



^viij. 



M. Sig. — A tablespoonful or two. 



Acne. 

Alkalies, internally yield the best results in a number of cases (Bulkley) ; 
alkaline lotions for cases with seborrhcea (B). Borax, a weak solution in rose- 
water (5 j-^viij), of great benefit locally in acne simplex (Wa). Potassium 
Bromide, in moderate doses has proved curative in some obstinate cases (R). 
Sulphur, internally and as a lotion. In severe forms an ointment of the Iodide 
or Hypochlorite, 3ij ad %} (R). Belladonna locally, is of some service, 
checking the abundant secretion from the sebaceous follicles (R). Arsenic, in 
old cases, especially in acne indurata, but often disappoints ; given with Brom- 
ides it prevents the bromic acne (R). Arsenic Bromide is adapted to most ot 
the cases of acne vulgaris (Pf). Phosphorus, is an excellent substitute for 
arsenic (B) ; the compound syrup of the Hypophosphites in acne indurata (R). 
Mercury, in lotion is much employed (B) ; a weak lotion of the Bichloride to 
the face two or three times daily (R). The Iodo-chloride (gr. v-xv ad ^) as 
irritant application (Fox) ; or ointments containing the Bichloride or Biniodide 
maybe employed instead of the green soap application (Pf). Glycerin, in- 
ternally, has been used with success (B). Berberis, rr\, v of a fresh tincture 
thrice daily for the acne of girls at puberty. Calcium Sulphide is indicated in 
cases characterized by a tendency to pustulation (Pf ). Bismuth, locally as a 
cosmetic (B). Magnesium Sulphate, as a purgative daily before breakfast, in 
cases of acne vulgaris depending on derangement of stomach and bowels 
(Duhring) ; the salt, finely triturated, is an excellent dusting-powder for cases 
of acne rosacea, and in five-grain doses internally, 3 or 4 times a day, is often 
very efficient in acne vulgaris and other obstinate eruptions due to derange- 
ment of the gastro-intestinal tract. Resorcin, as paste, 50 per cent., with Zinc 
Oxide, applied to the affected part several times a day, to promote peeling of 
the skin in the treatment of acne rosacea. In 3 or 4 days the skin becomes 
like parchment, when the application must be stopped to avoid cracking of the 
skin, and a dressing of gelatin, glycerin, zinc oxide and hot water is applied, 
covered with cotton wool. In a few days the dressing will come off, bringing 
the skin with it. Some few dangerous results have followed this practice, but 
there have been a number of very satisfactory cases (Unna). Sapo Mollis, 
as an active irritant in subacute cases, applied every night as long as bearable, 
then emollients until irritation subsides, when the soap should be re- 



506 



ADDISON S DISEASE ADYNAMIA. 



moved (Pf). Water, hot sponging for 15 or 20 minutes several times a day, 
followed by Glycerite of Starch to allay irritation (R) ; the local use of very hot 
water is of the greatest benefit in all inflammatory forms of acne (Bulkley). 
Puncturing each papule with a lancet point, followed by very hot water, and 
ointments of Sulphur Iodide, Ammoniated Mercury, etc., diluted (Pf ). Ergot 
is well used in acne rosacea and other forms of acne ; a good fluid extract with 
glycerin and water, giving gss internally per diem (B). Diet and Hygiene, 
require careful attention (B) ; powerful tonics are often required (Bulkley). 
[Compare Seborrhcea.] 

Prescriptions. 



R . Potassii Acetatis, . . . . 3j ss-j. 
Tinct. Nucis Vomica, . . ^ij. 
Ext. Rumicis Fluidi, . . :§iv. 
Misce. Sig. — A teaspoonful, largely di- 
luted, half an hour before meals. 



R 



31V- 



I)- 



Potassii Acetatis, . . 
Tinct. Nucis Vom., . 
Infusi Quassiae, vel 
Tinct. Cinchonas Co., . ad ^iv. 
M. Sig. — Teaspoonful in water after 
meals, as an antacid tonic. 



R. Potassii Acetatis, . . . . Jfj. 

Spt. Etheris Nitrosi, . . . sjss. 

Ac. Acetici Dil., . . . . gj. 

Ext. Taraxaci Fl., . . . . § ij. 
Misce. Sig. — A teaspoonful, well 
luted, on an empty stomach. 



di- 



R. 



Magnesii Sulphatis, . . . ^jss. 

Ferri Sulphatis, gr. xvj. 

Acidi Sulphurici, . . . . 3 ij. 

Aquae, q. s. ad ^viij. 

M. Sig. — A tablespoonful in a glass of 
water before breakfast. 



R 



M 



Sulphuris, gj. 

Glycerini, ^j. 

Aquas Rosas, ^ y ij« 

Sig. — Lotion. 



R . Hydrarg. Chlor. Corr., . . gr. x. 

Alcoholis, q. s. 

Aquae Destil., ^ij. 

M. Fiat. sol. Sig. — A teaspoonful in 
% pint of water as a lotion, twice daily. 

R . Liq. Potassae, g j. 

Aquae Rosas, ad g iv. 

M. Sig. — Apply with a soft sponge 
twice daily. 

R. Bismuthi Subnit., . . . . gj. 

Ung. Hydr. Ammoniat., . j^ij. 

Ung. Aq. Rosae, . . . ad %]. 
M. et fiat unguentum. 

R. Hydrarg. Iodo-chlor., . . gr. v-xv. 
Adipis, |j- 

Fiat unguentum. An irritating applica- 
tion, requiring care. 



Addison's Disease. 

Arsenic, with cod-liver oil, gives the best results (Da C). Iron, and other 
tonics are useful, especially a combination of the chloride, glycerin and chloro- 
form (Greenhow). Phosphorus, has seemed to exert a beneficial influence 
(Wilks). Treatment must be symptomatic, and is of little use, the disease be- 
ing always fatal (H). 

Prescriptions. 



R. Tinct. Ferri Chloridi, . . ,^j. 

Spt. Chloroformi, .... %]. 

Glycerini ^vj. 

M. Sig. — A dessertspoonful in water 
thrice daily. 



R. Quininse Sulph., .... gj. 

Ferri Reducti, 3J SS - 

Ac. Arsenosi, 

Strych. Sulph., . . . . aa gr. iij. 

Confect. Rosas, q. s. 

M. et. div. in pilulas lx. 



Adynamia. 

Cinchona or Quinine, with Arsenic, for pale, badly-fed town-dwellers (R) ; 
as a general tonic when flesh flabby, skin perspiring (P). Arsenic, for swelled 
feet of old or weakly persons, and breathlessness from weak heart (R) ; as 
tonic in continued doses of gr. ^ to ^ (Wa). Nux Vomica, in adynamia of 
drunkards. R. Tinct. Capsici £vj ; Tinct. Nucis Vom. 3ij ; gtt. xx in water 



AFTER-PAINS AGALACTIA. 507 

every four hours (B). Lime Salts, the Phosphate, when from prolonged town- 
life or overwork ) gr. j with grain j each of Iron Phosphate and Calcium Car- 
bonate, for a dose (R) ; Hypophosphites, of Lime or Soda, in nervous or gen- 
eral debility (R). Iron, promotes appetite and digestion ; gr. j-iij of the Sul- 
phate, or the official Iron and Aloes pill, or with Manganese (B) ; anaemic 
subjects (R). Hydrastine, as substitute for Quinine, to promote appetite and 
digestion and improve assimilation (B). Digitalis or Eucalyptus, in debility 
with weak heart action (B). Bitters, especially Calumba and Gentian, useful 
for a short time (B). Sanguinaria, when stomach needs stimulation (P). Sar- 
saparilla, broken-down, syphilitic constitutions (P). Alcohol is of great value, 
but has been abused; hurtful when it increases temperature and pulse, dryness 
of tongue, etc. (B) ; a wine with much ether in debility of old age, especially 
where sleeplessness, indigestion and stomach cramps (R). Aliment, sugar 
and saccharine fruits, vegetables, oil, milk, cod-liver oil, wine of good body 
and strength (B). Porter or Rum-and-milk for town-living women (R). Sea- 
bathing, is useful in chronic illness, with much debility (R). Turkish Baths, 
when debility is caused by the tropics, but caution necessary. When town- 
dwellers become stout and flabby, are easily tired, suffer from a lack of energy 
and from mental depression, a course of baths is beneficial (R). [Compare 
Anemia, Convalescence.] 

Tonic Prescriptions. 



R. Quininae Sulph., gr. xxx. 

Ac. Sulphurici Dil., . . . q.s. 
Tinct. Ferri Chlor., . . . £ij. 

Aquas, ad J ij. 

M. Sig. — A teaspooriful thrice daily. 



R. Tinct. Ferri Chlor., . . . giv. 

Ac. Phosphor. Dil., . . . gvj. 

Sp. Limonis, 5pj. 

Syrupi, q. s. ad %y\. 

M. Sig — A dessertspoonful in water 
after each meal. 



R . Quininae Sulph., ^j. 

Strychninae Sulph., . . . gr.j. 

Tr. Ferri Chloridi, . . . 3 v. 

Ac. Phosph. Dil., . . . . }§ij. 

Syr. Limonis, . . . . ad J vj. 
M. Sig. — A teaspoonful in water thrice 
daily, in nervous debility. 



R . Ac. Arsenosi, gr. j. 

Quininae Sulph., .... gr.xl. 

Ferri et Potass. Tart., . . gr.lxxx. 
M. Fiant pil. no. xl. 
Sig. — One after each meal. 



After-pains. 

Opium, more certain in action than any other remedy (Wa) ; Morphine and 
Atropine (gr.^and gr. T ^o), combined (B), hypodermically (Wa). Belladonna, 
as ointment, much used in France (L). Camphor, gr. x with gr. y% of Mor- 
phine, an effective remedy (B) ; ^j in ^vj of mucilage, tablespoonful doses 
every hour or two (Wa). Chloral, will stop the pains, but large doses, gr. 
xx-xl, are necessary (R). Chloroform, the Linimentum Chloroformi, ^j with 
Linim. Saponis gvj, applied on flannel to the abdomen (Barker). Quinine, gr. 
v-x night and morning, with the above chloroform liniment locally, in neuralgic 
after-pains which do not yield to opiates, the uterus being tender on pressure 
(Barker). Gelsemium, suspends them, large doses (TTLxx) necessary (B). Cimi- 
cifuga, relieves the pains, and allays general nervous excitement (P). Ergot, 
is better than cimicifuga (R). Poultices, warm, over the hypogastrium, with 
soothing injections into the vagina (L). 

Agalactia. 

Ricinis Communis, gr. v of extract, or gj-ij of strong decoction, daily in 
water; also the leaves, or an infusion, locally to mammae (T). Gossypium, an 
emulsion of the seeds has repute in India, as a galactagogue. A wineglass of 
the decoction every 20 or 30 minutes (P). Pilocarpus, remarkably increases 
the secretions (B). Tea, a good black tea promotes the milk-supply. [Com- 
pare Lactation.] 



508 



ALBUMINURIA ALCOHOLISM. 



Albuminuria. 

Aconite, in incipient albuminuria with high body temperature (R). Lead, 
diminishes the albumen (R). Turpentine, gtt. ss-j, every 2 to 4 hours, or one to 
two drop doses night and morning, of great value in chronic albuminuria with- 
out marked symptoms of Bright's disease (P). Gallic Acid, the most efficient 
agent in the acute form to restrain loss of albumen (P). [See Aitken's formula 
below.] Cannabis Indica is indicated when bloody urine (R). Chimaphila, has 
unquestioned power over albuminuria (P). Cantharis, rr\j every three hours, of 
the tincture, after the subsidence of acute symptoms, especially when bloody 
urine (R). Fuchsin, in doses of gr. j-iij, completely arrested albuminuria in 
many cases with oedema (Bouchut). Alkalies, the citrates and acetates as 
diuretics (R) ; the Buffalo Lithia Water of Virginia is highly recommended. 
Strontium Lactate, has been used with benefit, but should not be given when 
scanty urine or symptoms of uraemia are present. Nitro-glycerin, n\j of a one 
per cent, solution to dilate the peripheral vessels, relieving the heart and les- 
sening the renal congestion (B). Turkish Baths, benefit by relieving the 
kidneys of work (R). Milk-cure, with buttermilk, has proved very efficient in 
many cases (B). Chalybeate Waters, especially those having purgative quali- 
ties, are beneficial (B). [Compare Bright's Disease.] 

Prescriptions. 



R . Acidi Gallici, 3J-ij- 

Ac. Sulphurici Dil„ . . gss. 

Tinct. Lupuli, gj. 

Infusi Lupuli, .... ad ^vj. 
M. Sig.— Tablesp. thrice daily. 

[Aitken.) 



R- . Liq. Ferri et Ammonii Ace- 

tatis(U. S. P.),. ... 3vj. 
Sig. — Teasp. to a tablesp. according to 
age, well diluted, thrice daily. 

(Basham.) 



Alcoholism. 

Arsenic, for distressing vomiting, one drop of Liquor Arsenicalis (Fowler's 
solution), before breakfast (R). Capsicum, in dyspepsia of chronic alcoholism, 
and to induce sleep ; also as a substitute for the alcohol. With Bromides or 
Arsenic and bitters to assist in overcoming habit, by removing the distress at 
pit of the stomach. The tinct. in 10-minim doses should be taken shortly 
before meals, or whenever there is depression or craving for alcohol. It obvi- 
ates the morning vomiting, and promotes appetite and digestion (R). Ammo- 
nia, a full dose (£ss) of the spirit will often sober a drunkard speedily (R) ; — 
a few drops of Liquor Ammoniae, diluted, have prompt action (S) ; — Z] of the 
aromatic spirit with Capsicum (see formula below). Ammonium Chloride, is 
remarkably efficient in straightening up a subject of acute alcoholism : gss in 
yi pint of water, swallowed at one draught, by a patient on the verge of deli- 
rium tremens, said to quickly restore the faculties. Cinchona, especially Cin- 
chona Rubra, for gastric catarrh of drunkards (B) ; Quinine, gr. ij-vj daily to 
raise the nervous tone (P). Nux Vomica, for after stomachal disorders (B) ; 
in tremor of chronic alcoholism, of much value (P) ; the tinct. in 5-minim 
doses with 15 of Tinct. Capsici, in water every 4 hours, is exceedingly effective 
in diminishing the craving for spirits and sustaining the nervous system. 
Strychnine, the Nitrate, gr. -^5-^ hypodermically thrice daily for ten days, is 
an absolute cure for dipsomania (Luton) ; a very valuable remedy for chronic 
alcoholism and dipsomania, not merely curing the attacks, but abolishing the 
desire for drink, the patients abstaining from spirits of their own accord (Pom- 
brak). [See ante, page 309, for extract from letter of Dr. Portugalofif, of 
Samara, Russia, regarding his use of strychnine in chronic alcoholism.] Gly- 
cozone, is one of the best remedies for the gastric catarrh of chronic alcohol- 
ism (Edson). Potassium Bromide, Z) every 4-6 hours in the "horrors " (B). 
Phosphorus, in chronic alcoholism, recommended by Anstie (R). Opium, 
cautiously, if at all (B) ; — Morphine with tonics before meals for pain, nausea, 



ALOPECIA. 



509 



and want of appetite (R). Cocaine, has been pronounced of great benefit, 
restoring appetite, inducing sleep and promoting digestion, while it soothes the 
brain and induces a feeling of contentment and calm (R). Cimicifuga, is said 
to be useful in the treatment of the drunkard's stomach (R). Chloral, is very 
successful, gr. xv-xx, but must be cautiously used with old worn-out drunkards 
(B). [See ante, page 182.] Picrotoxin, small doses for the tremor, gr. 2V 
repeated (B). Lupulin, is the best substitute for alcoholic stimulants, and 
extremely serviceable in delirium tremens (B). Zinc Oxide, is very useful in 
chronic alcoholism, to diminish the craving, to relieve the gastric catarrh and 
lessen the tremor (B). The Keeley Injection contains Strychnine and Atropine, 
also Codeine and Cocaine for subjects of the opium-habit. (TV. Y. Med. 
Record.) [See under Patent Medicines.] Acute Alcoholic Poisoning requires 
an emetic or the stomach-pump, cold douche to the head and breast, warmth 
to the feet and limbs. Artificial respiration may be required. Milk, mucila- 
ginous drinks, and black coffee, are the principal remedies. A milk diet often 
creates a disgust for alcohol. [Compare Delirium Tremens, Vomiting, and 
Neuritis ; also page 101, ante.~\ 

Prescriptions. 

R. Zinci Oxidi, gj. 



R 



Tinct. Capsici, .... ^ss. 
Potass. Bromidi, .... ^ss. 
Vel Liq. Potass. Arsenit., TT\^1. 
Vel Tinct. Nucis Vom., . pjij. 
Spt. Ammonias Aromat., ,^iij. 
Syr. Tolutani .... ad Jvj. 
M. Fiat mistura. Sig. — A dessertspoon 
ful in water four or five times daily. 



R. 



Tinct. Nucis Vom., 
Tinct. Gentianae Co. 
Spt. Limonis, . . . 
Spt. Chloroformi, . 
Aquae, q. 



s. ad 



"ivj. 



M. Sig. — One-sixth to be taken 3 or 4 
times daily, for insomnia. 



Piperini, 
M. Fiant pil. 
thrice daily. 

R . Tinct. Gentianae Co., 
Tinct. Calumbae Co., 
Tinct. Nucis Vom., . 
M. Sig. — A dessertsp. 

meal, for rum-stomachs. 



B. 



Sig. 



gr. xx. 

— One pill 



.VJ- 

rnjxxx. 
before each 
(Loomis.) 



Ext. Lupulini Fl., .... ^j. 
Ext. Aromatici FL, "| 
Tinct. Capsici, . . L . aa ^vj. 
Mucil. Acacias, . . J 
Aquae Menth. Viridis, . ad % iv. 
Fiat emulsio. Sig. — A teaspoonful or 
two as required. 



Alopecia. 

Cantharides tincture, 1 part to 8 of castor oil, well rubbed into roots of hair, 
night and morning (Wa). Arsenic, r^v of Liq. Arsenicalis ter die, exercises a 
more or less powerful influence (Wa). Nitric Acid, with olive oil, makes a 
serviceable liniment (Wa). Pilocarpine, has a decided influence on the growth 
of the hair (B). Glycerin in combination with the above remedies (Wa). Sul- 
phur Iodide, has been found very effectual, used internally and externally 
(Wa). Frequent Shaving may often save the hair in alopecia after illness. 
Use clean brushes with long bristles, and brush against the natural lay of the 
hair. [Compare Tinea.] 

Prescriptions. 
R. 01. Amygdalae Expres., R. Tinct. Cantharidis, . . . . ,gjss. 



M 



01. Amygdalae Expres., 
Aq. Ammoniae, .... 

01. Rosmarini, 

Alcoholis, 

Aq. Destillat 

Mellis Despumat., . . ad 
Sig. — Lotion for the hair. 




( Wilson.) 



R. 



M 



Tinct. Macis, g jss. 

Olei Olivae, ad gij. 

Sig. — Lotion for baldness. 

(Hebra. 



Tinct. Capsici, ir^xx. 

Glycerini, ;fss. 

Spt. Odorat., ad ^vj. 



M. Sig. — Hair tonic. 



[Gross.) 



R. 



Pilocarpin. Hydrochlorat., gr. j. 

Aquae Destillat., :f j. 

M. Sig. — Ten to thirty drops twice daily, 
according to age, to improve the growth of 
the hair. {Bartholow.) 



5io 



AMAUROSIS AND AMBYLOPIA AMENORRHEA. 



, Amaurosis and Amblyopia. 

Arnica, has long been a popular remedy for amaurosis in Germany. Man- 
noir employed it with much success (P. Wa). Rue, in minim doses night and 
morning, for dimness of vision from functional amaurotic condition. Elgajaki 
says it produces dimness of vision, and in smaller doses improves the eyesight 
(P). Strychnine, may cure functional amaurosis from lead, tobacco and alco- 
hol (B) : gr. ¥ X q hypodermically (Nagel) ; hypodermically in tobacco and 
traumatic amaurosis, and in progressive nerve atrophy not dependent on inter- 
cranial disease (R). Guaiac, is advised for cases of amaurosis occurring in 
persons of rheumatic diathesis (Wa). Santonin, has given very satisfactory 
results in amaurosis (Wa). Veratrine, as lotion brushed over eyelids, brows 
and temples, once a day, is often useful, but should not be permitted to touch 
the conjunctiva, or great pain will result (Wa). [See formula below.] Potas- 
sium Iodide, in amblyopia from lead-poisoning (Wa). Seton, a small seton in 
the temple kept open for a long period, has been found effectual when other 
remedies failed (Wa). Amaurosis and Amblyopia are names formerly much 
used to denote the various conditions of blindness, before ocular diagnosis 
became as exact as it now is. Amblyopia is still used to designate certain im- 
pairments of vision not accounted for by any organic changes visible {Roosa). 



Prescriptions. 



R 



Veratrinae, gr. x. 

vEtheris, gij. 

Alcoholis, Jj. 

M. Sig. — Use with a brush once a day 
over eyelids, eyebrows and temples. 



R. Strychnine Sulphatis, . . gr.j 

Alcoholis, 3J. 

Aquae Destillatae, . . . ad ^ iv. 
M. Fiat solutio. Sig. — A teaspoonful 

thrice daily before meals, when not used 

hypodermically. 



Amenorrhoea. 

Aconite, sudden suppression from cold or wet feet (R. P). Pulsatilla, in 
sudden suppression (B) ; often of the greatest value in functional form (P). 
Iron, when from anaemia, the most frequent cause ; small doses preferred. 
Solution of Acetate, or Ferri et Ammonii Citras (gr. ij), or Ferri et Strychninae 
Citras (gr. j), also chalybeate waters. Caution, careful diagnosis before giv- 
ing iron (B). Aloes, when dependent on anaemia (B) ; at the periods, with hot 
pediluvia, friction, etc. (R. P). Potassium Permanganate, gr. j thrice daily in- 
creased to gr. ij is the best of all remedies for bringing back the menses, having 
specific action on the uterine tissue (R) ; excellent in amenorrhoea from cold 
feet, and is by far the best emmenagogue, in pill it may explode ; best in 
capsule with powdered elm or licorice (Parvin). Manganese Binoxide, in pill, 
gr. ij thrice daily, is a very efficient emmenagogue. Mercury, the Biniodide is 
a certain and safe emmenagogue, gr. yi in pill, four times daily. Oxalic Acid, 
is highly praised, gr. Yz-}( in mixture, every hour (Poulet). Apiol, when from 
functional inactivity. First give Iron for the blood ; next aloetic purgatives, 
then apiol (gr. xv) just preceding the period; or a daily dose for a week, or 
several days before (B) ; the best emmenagogue next to Potass. Permang. 
(Parvin). Senega, a saturated decoction of the root, to extent of a pint in 24 
hours, during preceding two weeks, advantageous (P). Polygonum, has given 
excellent results when used in £>ss doses four times daily for a week (B). 
Cimicifuga, has been recommended (R) ; is of very great value (P). Arsenic, 
combined with Iron, when from functional inactivity of ovaries (B). Aurum 
Salts, from torpor of ovaries (B). Ignatia, in suppression of hysteria (P). 
Cinnamon, causes a flow of blood to the womb (Goodell). Indigo, is consid- 
ered very efficient, in doses of from Z) to 3iv. Larger doses produce nausea 
and vomiting. Nux Vomica, small doses of the extract, of benefit in some 
obstinate cases (Wa). Silver Nitrate, in substance lightly to the os uteri, at 
time of expected discharge (Wa). Colocynth, in chlorotic amenorrhoea (P). 



ANAEMIA. 



511 



Ergot, has cured when due to plethora (B) ; when anaemia after use of iron 
(R) ; in chlorotic (P) ; mj every % hour for 5 or 6 hours the day before and 
that of the expected flow, is very efficient when the cessation is not due to 
anaemia (A. A. Smith). Senecio Aureus, seems to have a well-founded reputa- 
tion. Rue, in functional inactivity. Ol. rutae, n\j-v (B. P). Sanguinaria, func- 
tional amenorrhcea, in absence of plethora (B. P). Savine, general atony : 
rr\,v-x of the fluid extract (B. R. P). Serpentaria, with anaemia or chlorosis 
(B). Ammonium Chloride, for headache (R). Sitz-baths, hot, for six days 
before period ; mustard may be added at period ; often effectual in sudden sup- 
pression (B). Spinal-ice-bag, to lower dorsal and lumbar vertebrae ; or cold 
sponging useful (R). Electricity, in atony of uterus and ovaries (B). [Com- 
pare Anaemia, Chlorosis.] 

Prescriptions. 



R. Olei Sabinae, gj. 

Olei Rutae, £j. 

Tinct. Polygon. Hydropip., 3J. 

01. Amygdalae Expres., 

Mucil. Acaciae, 

Aquae Menthae Pip., . . aa gij. 
Fiat mistura. Sig. — A teaspoonful two 
or three times daily. (Bartholozv.) 



R. Ext. Aloes, 3J. 

Ferri Sulph. Exsic, . . . gij. 

Asafoetidse, giv. 

Fiant pilulae 100. Sig. — One pill after 
each meal, gradually increased to three. 

{GoodelL) 



3 u i- 
jiss. 



R . Tinct. Ferri Chloridi, 
Tinct. Cantharidis, . 
Tinct. Guaiaci Ammon. 

Tinct. Aloes, % 

Syrupi, q. s. ad % vj. 

Fiat mistura. Sig. — A tablespoonful 

thrice daily, in simple atonic amenorrhea. 

[H. C. Wood. Dewees.) 

R . Quininae Sulphat., . . . . g iss. 

Extr. Nucis Vom., . . . . gr. xij. 

Olei Sabinae, 3 ss. 

Aloes Socotrin, gr. viij. 

Cantharidis, gr. xxiv. 

Fiant pilulae xlviij. Sig. — One pill thrice 
daily. 



Anaemia. 

Nux Vomica, stimulates blood-making organs, and is used as an adjunct to 
restorative remedies (B). Iron, its chief value is to improve digestion ; also 
furnishes haematin to the blood. The most astringent preparation is the best, 
and should be used after meals. Also chalybeate waters (B). Some stomachs, 
with irritable mucous membrane, require bland preparations. A pale, flabby 
tongue indicates large doses of the perchloride or sulphate (R). Arsenic, as 
adjunct to Iron, and where iron cannot be borne, or fails (B). Quinine, for 
badly-fed town dwellers (R). Hypophosphites, are useful, but should not be 
given with iron, cod-liver oil, or stimulants (R). Calcium Phosphate, in 
anaemia of growing persons, and of women weakened by rapid child-bearing 
or excessive menstruation (R). Calcium Lacto-phosphate, for nursing mothers, 
or in waste from suppuration (B). Acids, added to purgative salts as tonics to 
the mucous membrane (R). Pepsin, is recommended by Hollmann. Manga- 
nese, alone not of much use ; is best combined with iron (B) ; is not, like iron, 
found in the faeces, nor does it cause constipation (Wa). Galvanization, as aid 
to remedies (B). Cold Sponging, needs great caution, or may lower tone by 
minute degrees (R). Diet and Hygiene, of prime importance. Nourishing, 
digestible food, in as large quantities as can be assimilated — milk, eggs, ani- 
mal broths ; afterwards, fish, poultry, game, mutton, etc. Moderate daily out- 
of-door exercise, in pure air, is indispensable. Bathing, especially sea-bathing, 
aids restoration. Wines, often useful. Red wines are the best. 



Tonic Prescriptions. 



R. Pil. Ferri. Carb. (U. S.). . xlviij. 
Sig. — One to three after meals. 

R. Pil. Ferri Iodidi (U. S.), . xlviij. 
Sig. — One to three after meals. 



R. Massae Ferri Carbonat., . gj. 

Acidi Arsenosi, gr. j. 

Quininae Sulphatis, . . . gr. xl 
Fiat massa, et. div. in pilulas xl. 
Sig. — One or two thrice daily. 



512 



ANESTHESIA ANEURISM. 



]&. Tinct. Ferri Chloridi, . . ^iv. 

Ac. Phosphorici Dil., . . £vj. 

Spt. Limonis, gij. 

Syrupi, q. s. ad gvj. 

Misce. Sig. — A dessertspoonful in water 
after meals. To the above may be added 
3 ij of the Liquor Strychninae Hydrochlo- 
ratis of the B. P. {GoodelL) 

IJ. Hydrarg. Chlor. Corr., . . gr.j-ij. 

Liq. Acidi Arsenosi, . . . 5 j. 

Tinct. Ferri Chlor., ..." 

Ac. Hydrochlor. Dil., . aa %iv. 

Syrupi, ^iij. 

Aquse, q. s. ad %v]. 

Misce. Sig. — A dessertspoonful in a 
wineglassful of water after each meal, as 
an alterative tonic. (A. H. Smith.) 



R . Acidi Arsenosi, gr. j. 

Quininse Sulphat., .... ^j. 

Ferri et Potass. Tart., . . £ij. 
M. Ft. pil. no. xxx. Sig. — One pill 
after each meal. 



R. Tinct. Ferri Chloridi, . . giij. 

Potassii Chloratis, . . . . ^j. 

Liq. Strychninse (B. P.), . gj. 

Syr. Simplicis, giv. 

Aquse Cinnamomi, . . ad ?iv. 
Misce. Sig. — One or two teaspoonfuls 
after each meal. 



R 



gr. xx. 
gr. xl. 



Quininae Sulphatis, . 
Ferri Sulph. Exsic, . 
Strychninae Sulph., . . gr. ss. 
Fiant pilulae xx. Sig. — One pill thrice 
daily. {Bartkolow.) 

R. Tinct. Nucis Vom., . . . ^ijss. 
Tinct. Cinchona;, . . . ad |pv. 
M. Sig. — A teaspoonful after each meal. 



R. Ferri Sulph. Exsiccat., 

Potass. Carbonatis, . aa . ^ij. 

Syrupi, q. s. 

Fiant pilulae no. xlviij. Sig. — One pill 
after each meal, gradually increased to 
three.- (B/aud.) 



Anaesthesia. 

Morphine, subcutaneously before inhalation, diminishes the danger, and les- 
sens the after-pain if an operation is to be performed (Nussbaum) ; Morphine 
gr. -fa and Atropine gr. j^, hypodermically, after emergence from anaesthesia, 
will relieve the nausea and vomiting. A preliminary injection of Morphine 
lessens the stage of rigidity and spasm, enables a smaller quantity of the 
anaesthetic to be used with full effect, prolongs the stage of insensibility, pre- 
vents shock, and antagonizes the cardiac and respiratory depression (B). 
Atropine, is decidedly the best antagonist to the respiratory paralysis of Ether, 
and should be given hypodermically (gr. g 1 ^) as soon as alarming symptoms 
manifest themselves (Amidon). The writer of this book has saved at least four 
subjects of chloroform-narcosis by the hypodermic use of Atropine after both 
heart and respiration had apparently failed. Alcohol, jfj-ij of whiskey or 
brandy, before inhalation, to sustain the heart and prolong narcosis (B). 
[Compare pages 88 and 187 for the general subject of Anesthesia, and page 
25 for a list of Local Anesthetics. See also the article Coca, page 203, for 
the use of Cocaine as a local anaesthetic] 



Aneurism. 

Potassium Iodide, in large doses (gr. xv-^ss), 3 or 4 times a day, gives great 
relief and has cured (B) ; combined with recumbent position and restricted 
diet (R). Veratrum Viride, aids surgical expedients ; also in large internal 
aneurisms, with absolute recumbence and a little Opium to relieve pain, vomit- 
ing to be avoided (B). Ergot, with recumbent position ; favors coagulation of 
the blood in sac (B) ; Ergotin (P). Gallic Acid and Iron, internally, have cured 
cases of aortic aneurism (Speer). Chloroform inhalation, great dyspnoea (R). 
Lead Acetate, a valuable auxiliary to the more important items of rest, diet and 
mechanical appliances, gr. iij-v ter die (Wa) ; its use limited to the sacculated 
form (S). Electrolysis, galvano-puncture in deep aneurisms ; not very success- 
ful (B). The object sought is the coagulation of blood within the aneurismal 
sac. Cures have not been attained by this treatment, but in many it has pro- 
duced great amelioration of the most distressing symptoms (Petit). Aliment 



ANGINA PECTORIS ANTRUM. 



513 



milk regimen, for denutrition (B) ; a low diet, with absolute rest ; Ergotin and 
Potassium Iodide for deep aneurisms beyond reach of surgical treatment (B). 
Rest, in recumbent posture, and light, unstimulating diet, are primary and es- 
sential elements in treatment of aneurisms. Surgical Treatment includes liga- 
tion of the vessels, also pressure by a tourniquet or bags of shot, the operator's 
fingers., etc., applied to the main artery above the tumor, and the introduction 
of fine wire into the sac to favor coagulation. 



Prescript 



R. 



Potassii Iodidi, . . . 
Tinct. Veratri Viridis, 
Tr. Cinchonae Co., 
Tr. Cardamomi Co., . 
Tr. Gentianae Co., . . 
Syrupi Simplicis, 

Alcoholis, aa!§iv. 

Aquae, ...... q.s. ad Jxvj. 

Misce. Sig. — ^ss thrice daily. Each 
dose has gr. xv of Pot. Iod. 



3Jss. 

3jss. 

^ss. 



'ions. 
Px 



R. 



Acidi Gallici, ?j 

Ext. Ergotae, gr. 

Digitalis, ... • . . . gr. 
Fiat, massa, et div. in pil. xx. 
Sig. — One every two hours. 



Plumbi Acetatis, . . . . gr. xxxvj. 

Extracti Opii, gr. iv. 

Confectionis Rosa?, . . . q. s. 
Ft. pil. xij. One every four hours. 



Angina Pectoris. 

Aconite, believed by Gubler to be appropriate, and by Fleming to have been 
curative in many severe cases resisting other remedies (P). In cardiac disease 
its action is uncertain (Br). Arsenic, lessens or prevents paroxysms, if used in 
the intervals (B. R. Anstie). Amyl Nitrite, as inhalation, affords signal relief 
(R) ; unsafe in advanced degeneration of cerebral vessels and fatty degenera- 
tion of heart (B) ; gives great relief during paroxysms (Br). Sodium Nitrite, is 
less rapid in action than Amyl Nitrite, but is more efficient in preventing re- 
turn of symptoms (Br). Laurocerasus, as anodyne (P). Strychnine, in the 
milder forms ; very small doses, gr. T ^ to ^ (P). Glonoinum, doses of iilxiyo 
have been used with success (Pf. R). Chamomile, in pseudo-spasms of hysteri- 
cal persons (P). Ether, aborts a mild attack (B) ; Sulphuric Ether, in nervous 
form ; a spoonful immediately on commencement of attack will greatly miti- 
gate it (Anstie). Phosphorus, often serviceable (R). Morphine, hypodermically, 
especially in cardiac dyspnoea ; strengthens the heart (R). Turpentine, appli- 
cations, hot, over chest, to mitigate severity of the paroxysms, especially in the 
aged (Wa). Quinine, when intermittent (Wa) or when any malarial taint (Br). 
Brandy, in frequent small doses, with hot bran poultice over heart, and warmth 
to extremities. Cocaine, in doses of gr. % to %, thrice daily for two days, 
proved curative in four very severe cases (Laskevitch). 



Antrum, Disease of. 

Hydrogen Dioxide, the solution 1, to 12 of water, injected through the ostium 
for diagnosis of empyema of the antrum. If pus be present it is driven out, 
and fills the nose as a white foam (Brown). Chloroform, by inhalation, small 
quantities frequently, for treatment of acute catarrh extending to the antrum, 
extremely efficient, both as a remedy therefor and as a preventive of suppuration 
therein (Potter). Operative Measures. That in most favor is to enter the 
antrum through the alveolus of the second molar tooth (Garretson) ; to give 
free drainage and enable medication of the diseased mucous membrane, best 
to enter the antrum in its most dependent portion, through the upper part of 
the alveolus or immediately above it, between the roots of the 2d bicuspid 
and 1st molar. A gold tube then fitted to the opening, so as to project beyond 
the mucous membrane, will give free drainage, without sacrificing a sound or 
even diseased tooth (Brown). Boric Acid, in saturated solution, as wash to 
cavity twice a day, the after treatment ; and occasionally injecting Iodine, Zinc 
Sulphate, or Bismuth Subnitrate (Idem). 
33 



514 ANUS APHONIA APHTHA. 

Anus, Fissured. 

Hydrastis, locally, promotes healing (B). Rhatany, as injection, night and 
morning, after enema in the morning to move the bowels (Pf. Tr). Iodoform, 
improves and relieves pain (B). Iodo-tannin, well applied, effective (B). 
Belladonna, locally of great service for painful spasms of sphincter (P). 
Opium, with gall-ointment for fissures of anus ; mild purgatives should be 
simultaneously employed (R). Sulphur, as a mild purgative, to cause soft 
motions (R). Tannin, 3] in Glycerin ^ij, introduced on a tent, night and 
morning, with great advantage (Wa). Collodion, as protective covering (P). 
Potassium Bromide, with 5 parts of Glycerin, as local application (R). Castor 
Oil, as a mild purgative (R) ; to keep motions soft (Br). Surgical Means, the 
most efficient ; forcible dilatation of sphincter, or partial division in severe 
cases, through the mucous membrane, and a few fibres of sphincter. 

Prescriptions. 



R. Tinct. Krameriae, .... gj. 

Ext. Kramerise, .... 31J. 

Aquae, ad £ viij. 

M. Sig. — One-fourth as injection, night 
and morning, after using enema. 



R. Sulphuris, !|j. 

Pulveris Aromat, 

Confec. Rosse, . . . . aa £ij. 
Misce. Sig. — One-third to be taken at 
bedtime as a laxative. 



Aphonia. 

Ignatia, in that of hysterical women (P). Atropine, in hysterical aphonia, 
and for fatigue of vocal cords, gr. T |-^ to g 1 ^, morning and evening (B). Nitric 
Acid, n\v-x of the dilute acid, for hoarseness of singers, in fatigue of vocal 
cords, and when stomachal (B). Benzoin, the tincture by inhalation in laryn- 
geal catarrh (Br). Oil of Rue, as inhalation in chronic catarrh (Br). Uranium 
Nitrate, as spray in very chronic catarrh (Br). Alum, gr. X-3J aquas, as spray, 
in chronic coughs and hoarseness (R). Borax, a piece the size of a pea 
allowed to dissolve in the mouth (R). Glycerite of Tannin, locally in chronic 
inflammation of the throat (R). Sulphurous Acid, by inhalation, spray, or 
fumigation, in clergyman's aphonia (R). Ipecacuanha, wine, as spray, when 
congestion of vocal cords (R) ; in laryngeal catarrh (Br). Ammonium 
Chloride, vapor inhaled, of great value in catarrhal aphonia (Wa). Turkish 
Bath, at commencement of a feverish cold (R) ; in acute laryngeal catarrh 
(Br). Galvanism, localized, the best means for hysterical aphonia. 



R . Liq. Ammoniae, 

Aquae, aa J;j. 

M. Sig. — A teaspoonful in a pint of hot 
water for each inhalation. 



Prescriptions. 

R. Acidi Nitrici Dil., . . . . £ij. 

Tinct. Calumbae, . . . . j^j. 

Aquae, ad £ iv. 

M. Sig. — A dessertsp. in a winegl. of 
water thrice daily. 



Aphthae. 

Potassium Chlorate, the best remedy ; a solution of gr. x to the Sj, as wash, 
alone or with Borax (Br) ; and gr. x to xx by the stomach (B). Borax, with 
honey, or as glycerite of borax, frequently used (R) ; crystals allowed to dis- 
solve in the mouth (W). Sulphurous Acid, as solution, strong or diluted, 
locally (R), dilute as spray (B). Mineral Acids, formerly much used (B). 
Mercury, Hydr. cum Creta in small doses to remove the indigestion on which 
aphthae often depends (B) ; Borax being used locally, when aphthae exist in 
the mouth (Wa). Copper Sulphate, a weak solution painted over mucous 
membrane (R). Potassium Iodide, gr. j-v-^j aquae, locally (B). Salicylic 
Acid, one part (dissolved in alcohol) to 250 of water (R). Quinine, gr. j every 



APOPLEXY APPETITE ARTHRITIS. 515 

2 or 3 hours, in infants (B), especially when consequent on diarrhoea (Br). 
Coptis, the infusion has repute in New England (B). Bismuth, freely to parts 
(B) ; as a local application (Br). Glycerin, will sometimes cure (R). Rhubarb, 
the compound powder to remove indigestion (Br) ; — is highly useful in small 
doses (Wa). 

Prescriptions. 



R. Ac. Sulphurosi, . . . . gij. 

Aquae, ad % ij. 

M. Sig. — Mouth-wash, or use as 
spray. 



R. Pulv. Rhei Co., 3 ij. 

Sacch. Lactis, q. s. 

Triturat. et div. in pulv. xij. Sig. 
One thrice daily. 



Apoplexy. 

Aconite, when full strong pulse, hot, dry skin, plethoric cases. The best 
remedy (P) ; to lower blood-pressure and prevent further hemorrhage, where 
the pulse is strong and arterial tension high (Br). Elaterium, as a purgative ; 
a large dose (gr. ij) in suppository with soap ; or as an injection into large bowel 
(P). Croton Oil, as purgative, a drop may be put on the back of the tongue 
(Br) ; rt\,^ or l / z each hour (R). Colocynth, as a derivative purgative (Br) ; 
appears to act well (P). Cold Water, often harmful, though frequently used. 
Injurious when face pale, surface cool, circulation depressed (B). Electricity. 
Very mild galvanic currents to promote absorption. Caution necessary, espe- 
cially if much headache and vertigo (B). Diet and Hygiene, of great import- 
ance in patients subject to apoplexy. Avoid stimulating food and drink 
{especially beer), over-eating, excitement, haste, exposure to hot sun, heated 
rooms, etc. At no subsequent period should a full animal diet or the use of 
undiluted wines be indulged in (A). Diagnosis. Should be carefully differ- 
entiated from alcoholism, with which it is often confounded. [Compare Cere- 
bral Congestion, also page 100, ante.~] 



R . Tinct. Aconiti, ..... TT^x. 
Aquae Cinnamomi, . . ad %i]. 
M. Sig. — A teasp. every % hour for 2 
hours, then every half-hour. 



Prescriptions. 

R . Ext. Colocynthidis Co. , . . gr. xx. 

Olei Tiglii, TT\^ij. 

Fiat massa, et div. in pil. iv. 
Sig. — One pill as required, until free 
purgation ensues. 



Appetite. 

Ignatia, will correct diseased appetite (P) ; especially in hysterical subjects 
(Br). Anthemis, will stimulate the appetite. Cannabis Indica, produces a 
ravenous appetite. Bitters, to stimulate the appetite (R). Food should be 
savory and well cooked. Habits require examining into, when lost appetite 
complained of. Fluoride of Sodium or Potassium will produce almost total 
anorexia, and may be employed with advantage in bulimia (Da C). [Com- 
pare Dyspepsia.] 

Prescriptions. 



R. Gentianae, Quassiae, 

Cinnamomi, aa gij. 

Sig. — Put into a pint of boiling water, 
and when cold, strain ; take a winegl. thrice 
daily as an appetizer. 



R . Anthemidis, 

Quassiae, aa ^j. 

Sig. — Put in a pint of boiling water, and 
when cold, strain : take a winegl. thrice 
daily before meals as an appetizer. 



Arthritis, Rheumatoid. 

Aconite, highly spoken of; as liniment, conjoined with internal use (Wa). 
Cimicifuga, when joints enlarged and much stiffened, and when traceable to 
uterine derangement, is very useful (R) ; when pains worse at night (Wa). 



5i" 



ASCITES. 



Viburnum Prunifolium, the fl. ext. with that of Cimicifuga, 20 drops of each 
thrice daily, gradually increased to 30, produced steady improvement in a well- 
marked case of eight years' standing, involving nearly all the articulations. 
Iodine, tinct. internally, said to be better than potassium iodide (R). Iodoform, 
10 parts to 20 of Ether and 20 of Alcohol, as liniment to the joint, applied by 
a pencil, and covered with oiled silk (Gubler). Iodides, often signally benefit, 
especially when due to syphilitic, mercurial, or mineral poisoning (B). Large 
doses of Potassium Iodide sometimes required (R) ; combined with Guaiac, or 
Corrosive Sublimate, often curative in cases resisting these remedies given sep- 
arately (Wa) ; Potassium Iodide should always be fairly tried (Da C). Guaiac, 
the ammoniated tincture, in doses of 3j-ij in milk, often gives excellent results 
(Da C). Colchicum, with alkalies, extremely useful (B). [See Gout, for for- 
mulae.] Arsenic, when referable to nervous affections (B) ; as a bath contain- 
ing ^iv washing soda andgr.xx. of Sodium Arsenate ; — in large doses, continued 
for some time, sometimes of great benefit, but action is capricious (R) ; in small 
doses is of great benefit (Da C). Aurum. The Bromide of Gold and Arsenic 
has proved curative in arthritis deformans, characterized by great pain, stiff- 
ness and swelling of the joints (E. A. Wood). Lithium Salicylate, very effi- 
cient in acute and progressive subacute articular rheumatism, and has some 
effect also in chronic cases, where some of the joints are deformed, swollen and 
painful ; Z) may be given daily, in doses of gr. vij to x, in water (Vulpian). 
Lithium Bromide, of great value in acute and chronic (B). Phenocoll with 
Piperazin, 15 grains of each daily, in a pint or more of carbonated water, has 
rendered good service in gouty and rheumatic affections. Piperazin, should be 
used in all cases of difficult diagnostic differentiation, from its remarkable power 
over uric acid and urate concretions. Potassium Bromide, sometimes allays 
the severe pain (R). Arnica, the tincture and infusion are said to be of great 
value (P). Cod-liver Oil, internally and locally, of much value (R). Baths, 
Turkish or sulphur. The cold douche, which may be slightly warmed in 
winter ; use for one or two minutes and rub dry (R). Adhesions may be broken 
up under anaesthetics (Da C). Massage may be used with benefit to ameliorate 
the condition in chronic cases, where a cure cannot be obtained (Da C). 



Prescriptions. 



R. 



Vini Colchici Sem., . . . ^iij. 
Spt. Ammon. Aromat., . . gxiij. 
M. Sig. — A teasp. every 3 hours, until 
some physiological effect is produced. (B.) 



R . Lithii Bromidi, giij. 

Syr. Zingiberis, . . . . t ^ ss. 

Aquas, ^J ss - 

M. Sig. — A teasp. thrice daily, con- 
jointly with a lotion of the same. (B.) 



Ascites. 

Digitalis, when ascites is part of a general dropsy due to cardiac or renal 
disease ; is of the greatest service, except where there is aortic regurgitation and 
cardiac hypertrophy (P) ; afresh infusion the best preparation (R) ; its action 
increased by combination with Squill and Mercury (Br). [See formula below.] 
Jalap, the most generally approved hydragogue purgative is the compound 
powder, with Podophyllum (B) ; with Potassium Bitartrate, combined in form 
of electuary, may be persevered with daily, though apt in some cases to cause 
gastric derangement (Saundby). Stillingia, in ascites due to hepatic changes 
(B). Elaterium, as hydragogue cathartic, gr. l /e, with a grain of Ext. Hyoscy- 
ami, and a drop of some aromatic oil, is the most efficient of its class in ascites, 
but its action is very exhausting (W) ; cautiously in debilitated subjects, and is 
contraindicated where gastro-intestinal irritation or inflammation is present 
(B). Arsenic, when ascites is due to feeble heart, and in that of old age (B) ; 
did excellent service after tapping in a woman aged 82, from whom the writer 
removed 6 l /i gallons of ascitic fluid at one tapping, when almost moribund, 
with the result that she lived ten years longer. Diuretin, is often of very marked 
benefit, especially in cases of cardiac and renal origin. [See under Dropsy.] 



ASPHYXIA AND APNCEA. 



17 



Diuretics are of little use when the accumulation is excessive ; the venous pres- 
sure seems to be too great for them to act (Saundby). Copaiba, is an excellent 
remedy in hepatic dropsy (Br) ; the resin in doses of 10 to 15 grains is often 
serviceable in cases of moderate effusion (Saundby). Milk-diet is an ancient 
remedy for ascites, and often successful, causing profuse alvine and urinary 
discharges (B) ; is sometimes very serviceable when the renal action is inade- 
quate (Br). Surgical. Paracentesis abdominis should be done in all cases 
where excessive effusion. Laparotomy, and washing out of the peritoneal 
cavity, in cases of tubercular peritonitis with effusion, which has recently been 
treated successfully thereby (Saundby). [Compare Dropsy.] 



Prescriptions. 



B. 



Potassii Bitart., ^ ss. 

Mellis, ^j. 

Sig. — Ateasp. every 2 hours until bowels 
are freely moved. 



B 



M. 



Resinse Copaibae, . . . . % iij. 

Alcoholis, 3 v. 

Spt. Chloroformi, . . . . £j. 

Mucil. Acacise, % ij. 

Aquae q. s.ad Jjxij. 

Sig. — A tablesp. thrice daily. 



R. Potassii Bitart., Jss. 

Pulv. Jalapae, 3J SS - 

Mellis, . i|j. 

Sig. — A teasp. every 2 hours, until bowels 

are freely moved. 



B • Hydrarg. Chlor. Mitis, 
Pulv. Digitalis, 

Pulv. Scillae, aa gr. vj. 

Fiat massa, et div. in pil. vj. 
Sig. — One pill thrice daily, in ascites 
from hepatic changes. 



Asphyxia and Apncea. 

Of the New-Born. — Clean the mucus out of nostrils and throat ; catheterize 
the trachea, and suck up the mucus. Marshall Hall's method, — by placing 
child on abdomen, then bringing into lateral posture, repeating slowly and 
deliberately. Schultze's method, — by placing the thumbs upon the anterior sur- 
face of thorax, the indices in the axillae, and the other fingers along the back, 
the face of the child being from you ; rotate the child, by swinging upward, so 
that the inferior extremities turn over toward you. In a moment re-rotate to 
the original position. Do not support head or legs in the forward rotation ; 
their bending upon or toward the abdomen gives a forced expiration. 

From Foreign Bodies in Air Passages. — If the foreign bodies are round and 
smooth, invert the patient head downwards and strike upon the back. The 
bristle-probang is a good instrument for the removal of fish-bones, coins, etc., 
from the gullet ; or a pair of curved forceps will often render good service. 
The writer removed a gold plate with three teeth attached, from the oesophagus 
of an insane woman, by passing down a curved piece of stout wire, having the 
end bent upon itself to form a hook. After the hook was passed to one side of 
and below the obstruction, the wire was half rotated, so as to engage the plate, 
which came up on the second trial of the improvised instrument. Tracheot- 
omy or Laryngotomy may be necessary, as a final resort. 

From Drowning. — Remove the person from the water as rapidly and gently 
as possible, turn the face downwards for a moment, and depress the tongue, in 
order that water, mucus, etc., may be removed from immediately over the en- 
trance of the windpipe. Give the patient plenty of fresh air, fully exposing 
neck and chest to the breeze, unless that be inclement. Turn gently on the 
face, one forearm being under the forehead, and raise the body up that the 
water may have free discharge from the mouth. Place the patient upon the 
side and apply stimulants (Ammonia, etc.) near to the nostrils ; or the cold 
douche to the face and chest, in order to excite respiration. 

The above measures being ineffectual, convey the body to the nearest con- 
venient spot, strip it carefully and dry it, and place it on a warm bed, with 
head and shoulders slightly raised, and at once employ one of the following 
methods. 



5 l8 ASPHYXIA AND APNOEA. 

Silvester's Method. — Pull the tongue forward, to prevent obstruction to en- 
trance of air into the windpipe ; produce expansion of the chest by drawing 
the arms from the sides of the body and upwards until they almost meet over 
the head. Then bring the arms down to the sides again, causing the elbows 
almost to meet over the pit of the stomach, and thus producing contraction of 
the chest. This imitation of the act of respiration should be continued at the 
rate of fifteen or sixteen times a minute, as in health. 

Marshall Hall's Method. — The person should be placed flat on the face, 
gentle intermittent pressure being made with the hands on the back, the body 
turned on the side, or a little beyond, then on the face, and the same pressure, 
etc., continued as at first. The whole body must be worked simultaneously. 
The same number and frequency of these artificial processes of respiration 
should be employed as in the other method. 

The Michigan Method. — Lay the body face down, the head upon the arm, 
and stand astride it ; grasp it then about the shoulders and armpits, and raise 
the chest as high as you can without lifting the head quite off the arm, and 
hold it about three seconds ; then replace the body upon the ground, and press 
the lower limbs downward and upward, with slowly-increasing force, for ten 
seconds ; then suddenly let go, to perform the lifting process again. 

Whichever process be employed, the effort to restore the temperature of the 
body must be maintained, the body being well rubbed in an upward direction 
with the hands, with warm flannels, etc. ; bottles of hot water, hot bricks, etc., 
being applied to the stomach, the axillae, the soles of the feet, etc., stimulants 
and beef tea being judiciously administered when restoration is about taking 
place. The attempts at resuscitation must be persevered in for several hours, 
if necessary. 

. Laryngotomy or Tracheotomy, with or without catheterization, or forced in- 
sufflations of air or oxygen, have proved successful, as also electro-puncture 
(Garratt). 

In artificial inflation, always press the larynx and trachea against the verte- 
bral column, so as to close the oesophagus and thus prevent the air entering 
the stomach. 

After Long Submersion is Recovery Possible ? — According to Harley, dogs 
kept under water \yi minutes always died, if water had entered the lungs. If 
it had not, the trachea being plugged, they survived a submersion of 4 minutes. 
When persons rise after sinking they usually get some air, and less speedily 
come into a state from which recovery is impossible. The greatest period be- 
tween the last inspiration and the stoppage of the heart is 4 minutes. Some 
think that no recovery has been made after complete cessation of the heart's 
action. We infer that after complete submersion for 5 minutes recovery is im- 
probable, unless the person had been previously choked, or in a fainting state, 
so that no water entered the lungs. But in Anderson's case, the patient had 
been under water at least 15 minutes, and in Garratt's the time was variously 
estimated at from 15 to 60 minutes. 

When is a Case Hopeless ? — Harley says, " If the eyes are open, the pupils 
dilated, the conjunctiva insensible, the countenance placid, the skin cold, 
frothy mucus round the nostrils and mouth, no attempt at respiration, and the 
heart's action inaudible (when the ear is applied to the chest), the case is 
hopeless." 

Signs of Death. — The following have been suggested as methods of deciding 
whether death has occurred : — 

Tie a string firmly about the finger. If the end of the finger becomes 
swollen and red, life is not extinct. 

Insert a bright steel needle into the flesh. If it tarnishes by oxidation in the 
course of half an hour, life may be considered not extinct. 

Inject a few drops of Liquor Ammoniae under the skin. During life a deep 
red or purple spot is formed. 

Moisten the eye with Atropine. During life the pupil will dilate. 

Look at a bright light or at the sun, through the fingers held closely side by 
side. During life the color is pink ; after death a dead white. 



ASTHENOPIA ASTHMA. 519 

After death a dark spot is said to form gradually on the outer side of the 
white of the eye, from drying- of the sclerotic, so that the dark choroid shows 
through. 

Putrefaction is an absolute sign of death. Better delay for it than run any 
risk of burying alive. 

Asthenopia. 

The proper glasses ; cold douche ; rest of eyes. Atropine, systematically 
instilled, to prevent strain, and control spasm of the accommodation (C). 
[Compare Myopia.] 

Asthma. 

Nux Vomica, in nervous subjects (B) ; often of great benefit in spasmodic 
asthma (P) ; the tincture, in one-drop doses every five minutes has rendered 
extraordinary results in both cardiac and bronchial asthma, and in asthma of 
peripheral reflex origin, as from phimosis (Macfarlan). Antipyrin, is success- 
fully employed in bronchial asthma. Aconite, in spasmodic (P) ; often averts 
the attack, if given at commencement ; useful also in the asthma following 
coryza and sneezing in children (R). Ipecacuanha, the wine as spray to the 
fauces, sometimes useful in severe bronchial asthma, but not of much servi.ee 
in genuine asthma (R) ; nauseant and emetic doses in the spasmodic form (B). 
Lobelia, gtt. x of the tincture every % hour during paroxysm ; rrpc ter die, with 
additional doses at night, in bronchitic asthma when worse at night, — cau- 
tiously if heart disease (R) ; often gives permanent relief (B). Arsenic, as 
cigarettes, as well as by internal administration (B) ; try of liquor arsenicalis. 
ter die, in attacks from bronchitis, local irritation, etc., allied to hay fever (R). 
Belladonna, relieves paroxysm when expectoration abundant, skin cool and 
moist (B) ; internally in large doses, also in cigarettes (Br). Atropine hypoder- 
mically is more efficient, gr. ^ at bedtime to abort morning paroxysm (B). 
Large doses required, but very satisfactory (R). Was much valued by Dr. 
Salter and M. See (P). Potassium Iodide, when from acute bronchial catarrh, 
gr. xv-xx each 2, 3, or 4 hours (B. R) : the best medicament to suppress the 
asthmatic attack, in bronchial asthma, is Potassium Iodide and Chloral (Laz- 
arus). Is the specific in asthma, if any drug can be so called ; should be given 
with Lactucarium (See). Cocaine, hypodermically, is used with the best results, 
even where other remedies failed to relieve (Mosler). The leaves of the coca- 
plant make the best cigarettes for asthma (Nachtigal). Pilocarpine Hydro- 
chlorate, gr. l /e in water, at bedtime, promptly and effectively relieves, in cases 
of bronchitic asthma with hypertrophic rhinitis. In some of nine years' stand- 
ing it gave permanent relief apparently (Wyss). Chloral, may arrest paroxysm 
(R). Chloroform, inhaled from warm water. Anaesthetics relieve, but increas- 
ing doses required, leading to habit (R). Ether, in full dose, may avert a mild 
attack (B). Amyl Nitrite, inhaled, quickly checks spasmodic asthma (R). 
Antimony, in an affection of children like asthma. Dissolve a grain of tartar 
emetic in half a pint of water, and give a teaspoonful of this every ]i hour for 
the first hour, then hourly. If vomiting induced, lessen the dose (R). Coffee, 
a small cup of very strong coffee often useful ii^a paroxysm (R). Asthmatics 
should not use it as a beverage (P). Stramonium, twenty grains of the dried 
leaves or ten of the powdered root may be smoked. Datura tatula sometimes 
better. Stramonium preparations are often of bad quality ; — asthmatics ad- 
vised to grow the drug themselves (R). Grindelia, gives relief in spasmodic 
form (B) ; three grains of extract thrice daily, to prevent attacks, or rr^xx-xxx 
of fluid extract every half-hour or hourly from onset of paroxysm (R). Ethyl 
Iodide, very valuable in spasmodic form, and lessens liability to subsequent 
attacks ; rt^v-xx thrice daily by inhalation (B). Cannabis Indica, has been 
useful (R). Sulphurous Acid, by inhalation, spray, or fumigation (R). Mor- 
phine, hypodermically, quickly cuts short a paroxysm (B) ; in some cases mor- 
phine will induce a paroxysm (R). Apomorphine, gr. ^ hypodermically, has 



5 2 ° 



ASTIGMATISM. 



been found effective ; or gr. -^ every 3 or 4 hours in camphor water, with or 
without Morphine or Ipecacuanha. Tobacco, smoking, sometimes relieves 
(R. P). Asafoetida, has been recommended (R) ; palliative only (P). Col- 
chicum, in gouty subjects (R). Bromides, relieve but soon lose effect (B. R). 
Eucalyptus, smoked with Stramonium, Belladonna, Tobacco (B). Quinine, 
after acute symptoms subside, as antipyretic to succeeding fever and restora- 
tive tonic (B). Potassium Nitrate, the inhalation of fumes of burnt nitre paper 
will sometimes avert a paroxysm. Different methods of preparation useful for 
different cases (R). Oxygen, when no heart disease (R). Silver Nitrate, 
sometimes injected into trachea (R). Chamomile Oil, has been found very ser- 
viceable (P). Sanguinaria, is very useful in humid asthma, and occasionally 
so in the spasmodic form (R). Galvanism, of pneumogastric often relieves ; + 
pole beneath mastoid process ; — pole to epigastrium. Faradism of no use (B). 
Prophylaxis, avoidance of exciting causes, especially indigestible food, wet, 
damp, and sudden changes of temperature. Attention to the stomach will do 
most for many asthmatic patients. An important point is to take the heaviest 
meal early in the day, and very little solid food after 2 p.m. Shower-bath and 
out-of-door exercise, not, however, to a fatiguing extent (R). In special cases 
of reflex origin from exposed nerve-filaments, operative treatment of the nose 
and naso-pharynx, by galvanic cautery or otherwise is required (Lazarus). 

Prescriptions. 



Arsenical Cigarettes. 

R. Sodii Arsenatis, ..... ^ss-j. 
Aquae Destillatae, . . . . :§ j. 
Moisten unsized white paper, and roll 
into cigarettes, each containing gr. j^ to 
gr. j. of the salt. Two or three of these to 
be inhaled daily. {Bartholow.) 



R 



. Ext. Grindelias Fluidi, . . !| ss. 

Ext. Lobelias Fl., . . . . gij. 

Ext. Belladonnse Fl., . . gj. 

Potassii Iodidi, 5 iij . 

Glycerini, ^iij. 

M. Sig. — A dessertspoonful as required. 



R. Chart. Potass. Nitratis, . . j. 

Burn in a close room and inhale the 
fumes. 



R. Ammonii Bromidi, . . . . gr. clx. 
Ammonii Chloridi, . . . gr. xc. 

Tinct. Lobelias 3 iij. 

Spt. Etheris Comp., . . . %]. 
Syrupi Acacise, . . . . ad £ iv. 
M. Sig. — A dessertspoonful in water, 
every hour or two, for the paroxysm. 

{Pepper.) 

R- . Potassii Bromidi, .... t ^j. 

Potassii Iodidi, % ss. 

Aquae Cinnamomi, . . . . g iv. 
M. Sig. — A teaspoonful in water every 
half-hour or hour. (B.) 



R. 



Belladonnas Fol., .... sjj. 
Stramonii Fol., 

Hyoscyami, aa gss. 

Extracti Opii, gr. iij . 

Aquae Laurocerasi, . . . q. s. 

Dissolve the opium in the water, and 

moisten the leaves therewith. When dry, 

roll into twelve cigarettes. Smoke two to 

four daily. [Trousseau.) 

R. Tinct. Sanguinarias, 

Tinct. Lobelias, 

Ammonii Iodidi, . . . aa gj. 

Syr. Tolutani, g vj. 

M. Sig. — A teaspoonful every 2, 3, or 4 
hours, in humid asthma. (B.) 



R. Tinct. Lobeliae, gj. 

Ammonii Iodidi, . . . . 5jij~. 

Ammonii Bromidi, . . . . 3 iij. 

Syrupi Tolutani, .... 3jij. 
M. Sig. — A teaspoonful every I, 
or 4 hours. 



2,3, 



R. 



Spt. Etheris Compos., 
Liq. Morph. Sulph. 

(g r -j ad 3J)> • • • aa gj. 
M. Sig. — A teaspoonful every half-hour 
or hour in the paroxysm. 



R. 



Spt. Etheris Comp., . . . j|j. 
Tinct. Belladonnas, . . . £j. 
M. Sig. — A teaspoonful ter in die. 



Astigmatism. 

Atropine, a weak solution to aid examination of eye by dilating pupil, and 
paralyzing accommodation (B). Duboisine, as substitute for atropine, has more 
rapid action, with shorter duration of effects, and less conjunctival irritation. 



ATHEROMA BILIOUSNESS. 521 

Glasses, of suitable form, cylindrical in simple astigmatism, bi-cylindrical in 
mixed astigmatism. Pray's Test Letters, to determine degree and direction of 
the defect (C). 

Atheroma. 

Phosphorus, in minute doses, for atheroma, with cod-liver oil (B). Arsenic 
often of great value in atheroma, especially where imperfect action of kidneys 
(Br) ; indicated when there are puffy eyes, drowsiness, intellectual torpor (B). 
Quinine, gr. iij-x daily, in atheroma, with advantage (B). Ammonium Bro- 
mide, in atheroma, to promote absorption of deposit (Wa). Digitalis, may be 
useful in general capillary atheroma ; cautiously ! (W). Cod-liver Oil, with 
Phosphates, Hypophosphites, or Calcium Lactophosphate, in combination (B). 
[Compare Aneurism.] 

Atrophy. 

Cod-liver Oil, has proved beneficial (Wa). Olive Oil, by inunction, every 
12, 6, or 4 hours, successfully employed (Wa). Arsenic, has had remarkable 
success in muscular atrophy (Tr). Electricity, in progressive muscular atrophy, 
the induced current very strong at first, then weaker as improvement ; inter- 
rupted currents from vertebral column and plexuses to nerves of affected mus- 
cles ; in more extended forms, the constant current to the nerves, the induced 
to the muscles (Ros). Massage, removes the waste products and restores the 
muscular power (Br). [Compare Emaciation, Locomotor Ataxia.] 



Balanitis. 

Mercury, Hydr. Chlor. Corr, gr. j to ^jss aquae calcis, as lotion, if not much 
inflammation (Br). Oil, on linen, to inflamed part, beneath foreskin, which 
must be again drawn forward ; strict cleanliness. Astringent Lotions, Alum, 
Zinc Sulphate, with warm water injections (Br). Lime-water, the best lotion 
if much inflammation (D). Tannin, in alcohol, equal parts, as dressing after 
washing with a weak solution of common salt. Carbolic Acid, a 5 per cent, 
solution, on cotton rag after washing, thrice daily, is generally sufficient. [Com- 
pare Phimosis, Gonorrhoea.] 

Bed-sores. 

Alcohol, Brandy, or Eau-de-cologne, to harden skin of parts exposed to 
pressure (R) ; as wash to parts threatened (B). Glycerin, or glycerin cream, 
rubbed over the parts exposed to pressure, after washing, morning and evening, 
is one of the best preventives (R). Alum, ^ ss, whites of four eggs, Tinct. 
Camphorse, §ij, an excellent application (B). Charcoal, sprinkled over the 
black slough, which is then covered with a poultice (R). Galvanic Couplet, of 
zinc and silver, connected by a copper wire ; one element on sore, the other on 
adjacent part (B). Silver Nitrate, a solution (gr. xx-^j) to be painted on the 
threatened but unbroken skin, as soon as it becomes red, will prevent sores ; if 
Nitrous Ether solution be used, gr. v to the ^ is enough (R). Iodoform, dusted 
over sores (R). Linen, air-dried better than that which is ironed or mangled, 
by reason of its greater softness. Aristol, is an excellent application. 



Biliousness. 

Podophyllum, acts as a cathartic (B) ; corrects deficient secretion of bile, espe- 
cially in children and infants ; gr. -^ to ^, every six hours, to correct white or 
clayey stools ; also in general hepatic derangement (P). Aconite, in occa- 
sional doses, improves the effect of Podophyllum (R). Mercurial Cathartics, 
act only as purgatives ; Calomel gr. j-x, or Pil. Hydrarg. gr. v-x ; Mercury 



522 



BLADDER, IRRITABLE. 



as purgative restricted to cases where there is excess or deficiency of bile (B) ; 
frequent small doses of gray powder for deficiency (R) ; Calomel, gr. iij, fol- 
lowed by 3ij each of Rochelle and Epsom Salts, when the tongue is heavily 
coated and furred (Gross). Mercury, Yellow Oxide, in doses of gr. -^ to -£$, 
in trituration with sugar of milk, exceedingly efficient in many disordered con- 
ditions of the alimentary canal and its appendages (Schaffer). Bryonia, is 
worthy of commendation in the ordinary bilious headache with vomiting, and 
in general hepatic derangement known as sluggish liver (P). Hydrastis, gtt. 
v-xv of fluid extr. daily before meals, for biliousness with chronic gastric 
catarrh and dyspepsia (B). Mineral Acids, before meals, Hydrochloric Acid 
and Pepsin after meals, in atonic dyspepsia (B). Stillingia, when deficient 
biliary secretion (B); may be used in place of Mercury (Br). Ammonium 
Iodide, gr. j — iij in water each 2, 3, or 4 hours, when catarrh of duodenum and 
biliary ducts (B). Ammonium Chloride, is much employed in Germany for 
hepatic derangements, and with good success. Euonymus, is considered very 
efficient by many practitioners in cases of hepatic dyspepsia, or "bilious 
attacks," so-called. Manganese, for gouty subjects. Rhubarb, as a chola- 
gogue. Aloes, in biliousness with constipation. Angostura, is suitable to 
worst forms of bilious fevers (P). Calumba, is of benefit in many forms (P). 
Alkalies, and their laxative salts, in bilious state, with uric acid diathesis (B). 
Milk-cure, in obstinate cases ; buttermilk or skimmed milk often agrees best 
(B). [Compare Dyspepsia, Hepatic Congestion, Duodenal Catarrh.] 



Prescriptions. 



R. Ext. Stillingise FL, . . . gv. 

Tinct. Aloes, ^ij. 

Tinct. Nucis Vom., . . . gj. 
M. Sig.— Twenty drops in water thrice 
daily. (B.) 

R. Ext. Euonymi, gss. 

Ext. Hyoscyami, . . . . gr. xv. 

Ext. Gentianae, gr. vj. 

Fiat massa, et div. in pil. xij. 
Sig. — One pill every other day. 



Ijt . Hydrarg. Oxidi Flavi., . . gr. j. 
Sacch. Lactis, . . . . . q. s. 

Triturat. et div. in chart, xlviij. 

Sig. — One powder dry on the tongue 
twice daily. « 

R . Massae Hydrargyri, 

Ext. Colocynthidis Co., aa gr. iij. 

M. et div: in pil. ij. 

Sig. — Take at once, and follow in a few 
hours with a saline cathartic. 



Bladder, Irritable. 

Belladonna, in nocturnal incontinence, due to relaxation of sphincter, or irri- 
table mucous membrane (B) ; gtt. v-xx of tinct. every 3 or 4 hours give gradual 
but sure relief (P). Cantharis, in women, without acute inflammation (B) ; in- 
continence on coughing (R). Benzoic Acid, when from enlarged prostate, 
removes fetor of urine ; also renders phosphatic or alkaline urine acid (P). 
Ammonium Benzoate, may be used instead of Benzoic Acid (Br). Gelsemium, 
the best remedy for irritable bladder of women of hysterical type, with constant 
desire to urinate (B). Cubeb, is often successful in women, but Cantharis gen- 
erally better (B) ; is of especial value when vesical catarrh present (P). Aqua- 
puncture, strange to say, has been used with considerable success (B). Canna- 
bis Indica, in spasm of the bladder, and in irritable conditions of that organ 
is generally useful. Eucalyptol, is often very efficient, but frequently fails, 
mjj on sugar two or three times a day. [Compare Cystitis, Dysuria, Enur- 
esis, Lithiasis, Calculi, Urinary Disorders.] 



Tinct. Gelsemii, 
Sodii Bromidi, . . 
Ext. Tritici Fluidi, 



Prescription. 



3 SS - 
3iij- 
giss. 



Sig. — A teaspoonful in water every four 
hours, for irritable bladder. 



BLADDER, PARALYSIS BLEPHARITIS BOILS. 523 

Bladder, Paralysis of. 

Cannabis Indica, in retention from spinal disease (R). Ergot, in paralytic 
dysuria, especially when sensation of bladder being only partially emptied 
(P); when incontinence from paralytic sphincter, and in paralysis from over 
distention (Wa.). Arnica, has proved curative (P). Strychnine, gr. -^ to ■£$ 
useful (B). Cantharis, often given with excellent effect, when bladder atonic 
(Wa). Galvanism, may greatly benefit (B) ; electro-magnetic current from 
the bladder to the spine, of great use (Wa). 

Blepharitis. 

Pulsatilla, internally and externally (P). Mercury, after detaching crusts, 
rub in brown citrine ointment (B) ; should be diluted with vaseline or simple 
ointment (Br). Tannin, powdered, or tannic acid solution, gr. j-x to the ^ 
(B). Alum, after acute symptoms subside (B) ; a solution, gr. viij-^j aquae, 
every % or l A hour, an excellent application (R). Hydrastis, as lotion, very 
serviceable (P). Bismuth, equal parts of the subnitrate and glycerin to the 
inflamed surface, in ciliary and glandular blepharitis (Wa). Ergot, the fluid 
extract locally, gives excellent results (B). 

Prescriptions. 



R . Aluminis, gr. x. 

Aquae Rosse, !|ij. 

M. Sig. — Lotion for the eyelids. (B.) 



R. Unguent. Hydrarg. Nitrat., gj. 

Petrolati Molli, giij. 

M. Sig. — Ointment for the margins of 
the eyelids. 



Boils. 

Belladonna, as plaster, to subdue inflammation, or use lint wetted with Atro- 
pine, gr. iv, Rose-water, if j (B) ; with Glycerin locally, to allay pain ; inter- 
nally often successful (R. Wa). Sulphides, in small doses (gr. ^ to ]/ 2 of Calx 
Sulphurata) every hour or two, or Sulphurous Mineral Waters will abort or 
mature, and aid to expel pus (R) ; of no use in the boils of diabetes (R). 
Aromatic Sulphuric Acid, for the tendency, gtt. x-xv, in plenty of water thrice 
daily. Silver Nitrate, gr. v-xx to ^j of nitrous ether, painted over adjacent 
part, to abort ; specific if used early (R). Boric Acid, gr. xij daily, in 2 wafers ; 
also a 4 per cent, aqueous solution, warm, externally by gentle friction, 4 or 5 
times a day, and on compresses to the parts — will abort furuncles yet in the 
commencement of development, rapidly cure those matured, and prevent new 
ones (Alison). Arsenic, long-continued, for succession of boils (B) ; to lessen 
tendency to recurrence (Br). Opium, a thick extract locally (R). Camphor- 
ated Alcohol, smeared over boils in the earliest stage, then, when skin dry, 
smear with camphorated oil, to abort (R). Sodium Phosphate, the best remedy 
for the systemic condition which produces boils (R). Carbolic Acid, undiluted, 
on a thread passed through centre of boil while recent, will abort it. A 
carbolized solution of 5 per cent, strength, on dressings after opening a boil, 
will prevent a second crop, due, as is often the case, to the migration of cocci 
into the skin from the original boil. Counter-irritation, by blisters or Iodine 
around the boil (R). Collodion, at papular or -pustular stage (R). Salicylic 
Acid, locally to destroy the parasitic organism (staphylococcus pyogenes), on 
which boils depend. [See formula below.] Hydrarg. Biniodide, the oint. 
locally, with Calcium Sulphide, gr. j daily in divided doses internally, leaves 
little to be desired so far as treatment is concerned. Corrosive Sublimate, the 
B. P. solution (1 in 875), dropped into the ear twice daily, in furunculosis of 
the ear, also on cotton wool in the canal, gives satisfactory results and prevents 
return. Aluminum Acetate, a solution in water, 1 to 4, causes the speedy 
abortion of boils in the external auditory canal (Grosch). Poultices to assist 
maturation and allay pain, may be smeared over with Belladonna or Opium 
(R). [Compare Acne, Carbuncle.] 



524 BONE BREATH BRIGHT's DISEASE. 



Prescriptions. 

R. Calcis Sulphurat., . . . gr. iij. 
Sacch. Lactis, .... q. s. 
Triturat. et div. in chartas xxx. 
Sig. — One powder every 2 hours. 



R. Acidi Salicylici, .... gij. 
Emplast. Saponat., . . . 2;ij. 
Emplast. Diachyl., ... ^j. 
Sig. — Ointment for boils. (Heitzmann. 



Bone Diseases. 

Iodine, in scrofulous affections of bones, should be used locally, with Fer- 
rous Iodide or Cod-liver Oil internally, nutritious diet, wine, out-door exercise 
(Wa). Cod-liver Oil, in scrofulous affections, may be relied on if perseveringly 
used, and accompanied by good hygienic conditions (Wa). [Compare Caries, 
Exostosis, Nodes, Periostitis, Rachitis, Spina Bifida, etc.] 



Breath, Fetid. 

Potassium Permang., gr. j to ^j aquse rosae, as a wash for the mouth (B). 
Chlorine, as solution of chlorinated lime, to remove fetor (B). Carbolic Acid, 
a dilute solution, as wash for mouth (W). Camphor, is used as a corrective (R). 
Look for bad teeth, disordered digestion, and in very offensive cases for gan- 
grenous lungs ; cleanliness of teeth and mouth are essential. Thymol, in 
solution, as a mouth-wash is very efficient in removing the odor of tobacco 
from the breath. 

Prescriptions. 

R-. Calcis Chlorat, 5 iij. 

Aquae Destillatse, 

Alcoholis, aagij. 

Olei Rosae, rr^iv. 

M. Sig. — A teaspoonful in a glassful of 
water as a lotion for the mouth. (B.) 



R. Acidi Salicylici, £j. 

Liq. Ammonii Acet., . . 5 iij. 

Glycerini, ^j. 

Aquse, q. s. ad^v). 

M. Sig. — A tablespoonful every six 
hours. {Robinson.) 



Bright's Disease, Acute. 

Aconite, should be given immediately on the appearance of the nephritis in 
scarlatina (R) ; as a diuretic, advocated (P). Cantharis, after subsidence of 
the acute stage, one-minim dose every 3 hours will stop the hematuria (R). 
Digitalis, (infusion ^ss) the best remedy in renal dropsy from acute desquama- 
tive nephritis (B) ; only diuretic as long as dropsy lasts (R). Cannabis 
Indica, as diuretic ; is especially useful when bloody urine (R). Eucalyptus, 
sometimes effective ; cautiously, or it will aggravate symptoms (B). Hyoscya- 
mus, in irritable kidneys (P) ; may be substituted for Belladonna (Wa). 
Jaborandi, is much used (Da C) ; large doses very depressant to the heart, but 
tt\,v-x of the fluid extract every half-hour or hour will produce sweating ; may 
be combined with tinct. of Digitalis (Smith) ; or Pilocarpine Nitrate, to excite 
skin when symptoms urgent, gr. -^ to x /% for adult (B). Turpentine, in drop or 
half-drop doses every 2 to 4 hours, controls the dropsy in a remarkable man- 
ner (P) ; hot turpentine epithems are serviceable, but may increase the action 
of the kidneys ( Wa). Belladonna, has often proved useful (P) ; may be used 
with benefit (Wa). Jalap, the compound powder is the most generally useful 
purgative, used in the early morning, to produce free watery evacuations, when 
uremic symptoms supervene (B). Gallic Acid, checks albuminuria (B). [See 
Albuminuria, for formula.] Juniper, as diuretic ; often aggravates (P). 
Poultices, large, of linseed meal, made light and soft as possible, beneficial 
(Wa). Cupping, in lumbar region, ameliorates acute desq. nephritis, and con- 
gestion of the kidney (B) ; cupping or leeches over the loins, with opiates freely, 
diluents, and demulcents, with rest and antiphlogistic regimen, often suffice 
(Wa). A Vapor-bath or Warm Pack, to increase the action of the skin (B). 



BRIGHT S DISEASE, CHRONIC. 525 

Diluents, as milk, and Potassium Bitartrate in solution, should be used freely to 
relieve the congestion and remove obstructions from the tubules (B). Iron, 
after the acute symptoms have subsided, as a tonic, the most suitable prepara- 
tion being Basham's mixture (the now official Liquor Ferri et Ammonii Ace- 
tatis) in ^ss doses thrice daily (Da C). [Compare Albuminuria, Hematuria, 
Uraemia. J 

Prescriptions. 



$ . Ext. Pilocarpi Fl., . . . . % ss. 

Vini Ipecac, 3J SS - 

Mucil. Acacise, gj. 

Aq. Cinnamomi, . . . ad^'i). 
M. Sig. — A teasp. every four hours 

until free diaphoresis. 

R. Pulv. Jalapae Comp., . . . 31 v. 
Div. in chartulas no. iv. 
Sig. — One in water before breakfast. 



R . Potassii Acetatis, .... 3 ijss. 

Infusi Digitalis, ^iij. 

Infusi Juniperi, ..... Sjiij. 
M. Sig. — A tablesp. every 2 to 4 hours 
as a diuretic. 



R- . Liq. Ferri et Ammonii Ace- 
tatis (U. S. P.), . . . . 3 viij. 
Sig. — A tablesp. thrice daily, as soon as 
hematuria disappears. 



Bright's Disease, Chronic. 

Lead, diminishes the albumen (R). Gallic Acid, to lessen the albuminuria 
(A). [See under Albuminuria for formula.] Hydrastis, lessens excretion of 
albumen (B). Potassium Bitartrate, to prevent dangerous accumulations in 
cellular tissue or important cavities, also to draw off effete matters ; care must 
be used as it is a brisk purgative, and is weakening (R) ; in form of " cream-of- 
tartar lemonade," an agreeble diuretic (B). Jalap, the compound powder 
occasionally, as derivative cathartic, to relieve the kidneys (Da C). Nitro- 
glycerin, fflxiyo to dilate peripheral vessels, relieves the heart and the renal 
congestion, and diminishes albumen (B). Fuchsin, in doses of gr. vij-xv 
daily, used with considerable success in different stages of the disorder, and 
was well borne (Riess). Oleum Erigerontis, lessens albumen, lowers vas- 
cular tension, improves general condition, and favorably influences the head- 
ache, nausea, and other uraemic symptoms (B). Cod-liver Oil, is very useful 
(R). Cannabis Indica, as diuretic when bloody urine (R). Turpentine, some- 
times given in very small doses as a diuretic, and to check hematuria (R) ; 
half-drop or drop doses every 2 to 4 hours very successful in dropsy with albu- 
minous urine depending on non-desquamative disease of the kidneys. Jabor- 
andi, in uraemia is very satisfactory (B) ; large doses very depressant to the 
heart (Smith) ; rrv, xx of the fluid extract ter in die if the urine decreases much 
(Da C). Iron, to improve digestion and correct anaemia ; the tinct. of the chloride 
or tinct. ferri acetatis preferred (B) ; in chronic tubular nephritis with cardiac 
hypertrophy the liq. ferri et ammonii acetatis, |[ ss ter in die, with an occasional 
vapor-bath (Da C). Chimaphila, has power over various forms of nephriticdis- 
ease, especially when albuminuria present (P). Eucalyptus, in chronic desqua- 
mative nephritis, cautiously used, will cause improvement (B). Elaterium, for 
the dropsy, as a derivative cathartic ; must be cautiously used (R). Bromides, 
are useful in the convulsions (R). [See Uraemia.] Potassium Iodide, has 
improved some cases, which were possibly due to syphilis (R). Aurum, the 
chloride in pill gr. -£$ to -£$ ter in die, persistently, in chronic interstitial neph- 
ritis, to arrest hyperplasia of the connective tissue ; may be combined with 
Arsenic, which has a similar influence (B). Mercuric Chloride, acts in the same 
manner, gr. ^ bis die (Da C). Milk-cure, has been very successful ; skim-milk 
alone for some time, then gradual addition of other diet (B). Water, in large 
draughts, as diuretic, when excretion of solids is deficient (Br) ; hot fomenta- 
tions to lumbar region (B). Baths, warm and Turkish, when uraemic symp- 
toms and dropsy ; discretion needful, as baths may weaken (R). Mineral 
Waters, especially the Buffalo Lithia Water, of Virginia, which has many 
advocates. Food should be nourishing ; milk, eggs and rare beef are particu- 



526 BRONCHIECTASIS BRONCHITIS. 

larly suitable (Da C). Peanuts are an excellent article of food for subjects of 
kidney disease, by whom foods rich in animal albumen are to be avoided 
(Furbringer). [Compare Dropsy, Uremia.] 

Prescriptions. 
(Compare those under Bright's Disease, Acute.) 



R. Strychninae Sulphatis, . . gr. ^4. 

Tinct. Ferri Chloridi, . . t ^ss. 

Acidi Acetici, 3J SS - 

Curacoae, !f j. 

Liq. Ammonii Acctat., ad ^vj. 
M. Sig. - A tablesp. every 6 hours, fol- 
lowed by a glass of water. For the anaemia. 



Be. Tinct. Nitro-glycerini, I percent. 

Sig. — One drop, gradually increased to 
five, four times daily, on sugar. (B.) 

& . Auri et Sodii Chloridi, . . gr. jss. 
Aquae Destillatae, . . J iv. 

Solve. Sig. — A teasp. ter in die. 



Bronchiectasis. 

Quinine, the most useful remedy as a tonic (B). Phosphates, are undoubt- 
edly useful, so also are the Hypophosphites (B). Chlorine, in solution as a 
stimulant and deodorizer, or as inhalation to lessen fetor (Br). Palliation of 
the cough and expectoration, with care of the general health of the patient, is 
all that can be accomplished. [Compare Emphysema.] 

Bronchitis, Acute. 

Acetanilid, in dose of gr. iv every two hours, has often arrested the attack 
within 24 hours. Aconite, gtt. ss-j every hour (B) ; in catarrh and bronchitis 
of measles (R). Tartar Emetic, first stage, gr. -^ to ^%, especially if cough 
is violent (B) ; gr. j to a quart of water, a teasp. of this every hour for the 
wheezing and cough of slight bronchitis in children (Smith) ; — gr. % to }4 every 
2 or 3 hours (R). Ipecacuanha, as wine, when expectoration profuse and diffi- 
cult to expel (R); in dry stage (P); Ipecac, when secretion is scanty and dry, 
— Squill, when the secretion, though copious, is difficult to expel (Br). Lobelia, 
as expectorant (B) ; for paroxysmal dyspnoea (R). Sanguinaria, after subsid- 
ence of acute symptoms, as expectorant (B) ; very successful (P). Quinine, to 
reduce temperature (R). Colchicum, useful when gouty diathesis (P). Opium. 
Morphine and Quinine combined, or Dover's powder, to abort an attack ; also 
with expectorants to allay cough (B) ; in frequent and violent coughs, without 
obstructed oxidation ; also to check excessive secretion (R) ; as sudorific very 
useful, gr. x of Dover's powder (P). Carbolic Acid, as spray, a 5 per cent, so- 
lution with steam atomizer, prompt and efficient. Apomorphine, the hydro- 
chlorate in doses of gr. ^ every three hours, the best of all expectorants. 
Cimicifuga, an excellent expectorant, and useful when acute symptoms have 
subsided (B). Nitric Acid, rt^x of dilute acid relieves (B). Asafcetida or Am- 
moniacum, the last best, in bronchitis with wheezing of old people (R). Asa- 
fcetida, is an excellent stimulant of respiration, especially when the capillaries 
have become clogged with the products of inflammation, and suffocation seems 
imminent. Here also the Cold Bath is a means of enabling the patient to 
expel the mucus, the equal of which has not been yet advanced. The cold 
bath may be used for even very young infants, and should be but momentary 
(W). Ammonium Carbonate, when the expectoration is profuse, and the con- 
dition low (R). Ammonium Acetate, from its sudorific action is always indi- 
cated, especially in children (Dessau). [See formula below.] Cubeb, very 
useful, especially when secretion copious and system relaxed (P). Copaiba, 
after subsidence of the fever, the most serviceable expectorant, but nauseous 
(B). Counter-irritants, mustard as large poultice, with linseed or oatmeal, or 
both, very useful (R). Iron, Lead, Zinc Oxide, to check profuse secretion (R). 
Heat to chest by linseed poultices, of great service. Diet, should be light and 
in liquid form. Temperature of atmosphere in room should be about 8o° F., 
and the air moistened by steam. [Compare Cough.] 



BRONCHITIS, CAPILLARY. 



527 



Prescriptions. 



R 



M. 
hours 



Antira. et Pot. Tart., . . . gr. ij. 
Liq. Ammonii Acet., . . . ^iv. 
Spt. Etheris Nitrosi, . . . 3J. 

Tinct. Aconiti, ^ss. 

Syr. Simplicis, . . q. s. ad Jyj. 

Sig. — A teaspoonful every 2 or 

In first stage. 



R. Liq. Amraon. Acetat., . . sjiv. 

Spt. Etheris Nitrosi, 

Syr. Ipecac, aa ^jss. 

Syr. Senegae, %]. 

Syr. Limonis, ^j. 

M. Sig. — A teaspoonful every 3 hours 
for children. [Dessau.) 

R. Tinct. Aconiti, tt\viij. 

Aquae Cinnamomi, . . . 25 j. 
M. Sig. — A teaspoonful every )4 hour 
for 2 hours, then every hour. In acute in- 
flammatory form. 



R 



. Ext. Cimicifugae Fl., . . . ^ ss. 

Tinct. Opii Deodorat., . . 'gj. 

Syr. Tolutani, ad Jij. 

M. Sig. — A teaspoonful every 4 hours. 

(B.) 



R 



Tinct. Sanguinariae, 

Tinct. Lobeliae, . . . aa sjj. 

Vini Ipecac, 3 ij. 

Syrupi Tolutani, . q. s. ad 5 iv. 
M. Sig. — A teasp. every 3 hours. (B.) 



R. Apomorph. Hydrochlor., . gr. }( . 

Ac. Hydrochlor. Dil., . . mjij. 

Syrupi Senegae, zv. 

Aquae Destillat, *]. 

M. Sig. — A teaspoonful every 2 hours, 
for a child of 3 years as expectorant. 
Should be put up in a blue bottle. 



R. Vini Ipecac, gij'. 

Liq. Potassii Citratis, . . . g iv. 
Tinct. Opii Camphorat., 
Syr. Acaciae, . . . . . aa t ^j. 
M. Sig. — Tablesp. ter die. In first stage 

of ordinary acute bronchitis. (Da Costa.) 



R. Ext. Eriodyctii Fl., . . . ^vj. 
Ext. Senegae Fl., . . . . ^iv. 
Syr. Pruni Virginianse, . . Jij. 

Aquae, q. s. ad g iv. 

M. Sig. — Teaspoonful every 3 hours. 



Bronchitis, Capillary. 

Ipecacuanha, as emetic, preferred to tartar emetic in capillary bronchitis of 
very young or very old (B) ; as wine, when expectoration profuse and difficult 
to expel (R). In very young infants should be used in place of antimony 
(M & P). Squill, as expectorant, may be used with benefit (Wa). Antimony, 
sulphurated, gr. T ^ in combination with Dover's powder, every 2 or 3 hours, 
when the temperature very high, and pulse full and strong ; must be stopped as 
soon as nausea and vomiting begin (M & P). Lobelia, for paroxysmal dysp- 
noea (R). Ammonium Carbonate, when expectoration profuse and strength 
diminishing ; in severe bronchitis or broncho-pneumonia of children, especially 
when prostrate and livid (R) ; has probably a specific action on the diseased 
tissue and its products (Clymer). Ammonium Iodide, in small, rapid doses, 
often gives great relief to the catarrhal process (Da C) ; often gives the most 
astonishing relief (B). Ammonium Muriate, gr. ij every 2 hours, either alone 
or with Potassium Chlorate (Clymer). Serpentaria, in capillary bronchitis of 
children gives excellent results (B). Turpentine, one of the best stimulants when 
vital powers are depressed and peripheral circulation feeble (B). Camphor; 
to allay cough and promote expectoration (B). Hydrocyanic Acid, for cough 
and tendency to spasm. Hydrarg. Subsulph. effective as emetic (B). Mus- 
tard, as poultice or bath, useful (R) ; the most important part of the treatment 
(M & P). Poultices, to encircle the whole chest in children (R). A jacket of 
cotton-wool around the chest. Steam, by inhalation, may be impregnated 
with sedatives, or with Carbolic acid ; is of great importance (M & P). Qui- 
nine, in that form of capillary bronchitis occurring in tropical climates, and 
where marked debility (M & P). Stimulants, are often necessary, especially 
in the suffocative form, and where marked prostration (M & P). Emetics, 
are necessary when suffocative symptoms become prominent. [Compare 

COUGH.1 



528 



BRONCHITIS, CHRONIC. 



Prescriptions. 






&. Ammonii Iodidi, . . 
Ammonii Carbonat., . 
Syr. Glycyrrhizae, 
Syr. Tolutani, . . . . aa ^ij. 
M. Sig. — A teasp. every 2 or 3 hours. 



R. Quininag Sulph., .... gr. vj. 

Ac. Sulphurici Dil., . . . TT^xij. 

Syr. Simplicis, . . . . . ^ ss. 

Aquae, % ijss. . 

M. Sig. — A teasp. every 2 hours to 
child of 2 or 3 years ; older children re- 
quire more quinine. (M. & P.) 



B . Liq. Ammonii Acet., . . . J ss. 

Syr. Ipecac, gj. 

Liq. Morph. Sulph. 

(§ r - J a d 3 J), "1*1. 

Syr. Acacias, -|j. 

Aquae, Ijss. 

M. Sig. — A teasp. every 2 hours for a 
child 2 years old. When surface pale and 
expression languid, skin cool. (M. & P.). 

R. Ext. Serpentaria FL, . . . ^ss. 
Ammonii Carbonat., . . . £ij. 

Syr. Tolutani, Jj ss - 

M. Sig. — A teasp. every 2, 3 or 4 hours. 



Bronchitis, Chronic. 

Antimony, when expectoration copious and difficult to expel (R). Arsenic, 
where emphysema, in cigarettes (B). [See ante, Asthma, for formula.] Sul- 
phur, gr. v-x, in severe cases, with abundant discharge, especially where con- 
stitutional debility (R). Sulphurous Acid Gas, inhalations, or the acid in form 
of spray, sometimes beneficial (R). Hydrogen Dioxide, the solution internally, 
doses of 3j-iij, diluted with 3 to 4 of water, gives great relief in chronic 
bronchitis with dyspnoea. Lobelia, for paroxysmal dyspnoea (R). Ammo- 
nium Chloride, combined with stimulating expectorants, such as Serpen- 
taria, Sanguinaria, or Eucalyptus (B) ; when secretion is thick and abundant, 
may be applied by an atomizer (R). Carbolic Acid as inhalation of spray, 
1 part to 100 of water ; may be combined with tincture of Iodine (R) ; a 5 per 
cent, solution in steam atomizer as inhalation. Hydrastis, fluid extract, locally 
and internally (B) ; of great value internally and externally in chronic coryza 
(P). Senega, especially in the aged (R). Iodine, by inhalation, sometimes 
used (R) ; the Iodides, especially Ammonium Iodide, are very serviceable in 
combination with expectorants (B). Colchicum, in gouty subjects (R). Bal- 
sam of Peru, and of Tolu, when copious secretion of pus (R). Ammonia, as 
inhalation, to lessen expectoration (R). Oleum Anthemidis, in pulmonary 
catarrh with excessive secretion and difficult expectoration, a very useful 
remedy, wuj-iv (P). Ammoniacum, the mistura, with Ammonium Chloride or 
Carbonate, efficient in the bronchitis of old people, with wheezing and abund- 
ant secretion (R). [See Bronchorrhgea, for formula.] Benzoin, 3j of the 
compound tincture to boiling water, as inhalation; eases cough and lessens 
expectoration (R). Sometimes used by atomization (B). Phosphates, for the 
resulting cachexia (B) ; the Calcium Phosphate (R). Serpentaria, as stimulant. 
Alum, powdered, dusted over surface (B). Silver Nitrate, locally (gr. v-xx to 
the %) on sponge probang (B). Camphor, to allay cough and promote expectora- 
tion (B). Sumbul, has decided efficacy (P). Opium, with expectorants, to 
allay cough (B) ; when cough frequent and violent, without any signs of ob- 
structed oxidation ; also to check excessive secretion (R). Codeine, gr. x /e 
every 3 to 6 hours, when other opiates are not well borne (P). Ethyl Iodide, 
by inhalation, is very valuable by reason of its local influence, rr^v-xx thrice 
daily (B). Grindelia, an excellent expectorant, and especially when cough is 
troublesome (B). Strychnine, as a respiratory stimulant and to check the re- 
flex vomiting (B). The Syrup of the Phosphates of Iron, Quinine and Strych- 
nine. Squill, in chronic forms with tenacious sputa, but not when fever or 
acute inflammation (R). The Pil. Ipecac, cum Scilla, of the Br. Ph. in 10- 
grain doses night and morning, is a most useful remedy (Br). Tar, diminishes 
the secretion and allays the cough (P) ; gr. ij in pill every 3 or 4 hours in 
chronic paroxysmal winter cough (R). Digitalis, when interstitial pneumonia 
and general anasarca (B). Eucalyptus, valuable in chronic cases of broncho- 






BRONCHORRHCEA. 



529 



pulmonary catarrh (B). Gallic Acid, useful in some forms of chronic broncho- 
pulmonary catarrh (B). Iron, with free expectoration, Mistura Ferri Compos- 
ita ; or better, the Phosphate of Iron, Quinine, and Strychnine (B) ; to check 
profuse bronchial secretion (R). Myrtol, in fetid bronchitis, of great value 
(Gubler). Copaiba, when purulent secretion (R) ; for profuse secretion, the 
best of all expectorants, but nauseous (B). Cubeb, when profuse expectora- 
tion, has similar remedial influence (B). [See Bronchorrhcea, for formula.] 
Terpin Hydrate, gave immediate and curative results in cases of long-stand- 
ing and obstinate bronchitis, which had resisted all other treatment ; gr. xlviij, 
in Glycerin, q. s. ut. ft. solutio, Syr. Lactucarii, q. s. ad jfij, of which a teasp. 
every three hours (Boyland). Terebene, is proving very valuable; requires an 
equal weight of light magnesium carbonate to suspend it. Koomiss-cure, 
possesses great value (B). Cod-liver Oil, a teaspoonful ter die, after meals, of 
great service, if continued (B) ; to control expectoration (R). Poultices, made 
large, of hot linseed meal to cover the chest, when congestion of lungs. Olive 
Oil, inunctions to chest, has soothing and strengthening effects. Diet, nutri- 
tious, and stimulants necessary when great prostration. Koomiss is an excel- 
lent article of diet. [Compare Cough, Emphysema.] 



Prescriptions . 



R. Ext. Eucalypti Fl., . . . . %]. 

Ammonii Chloridi, . . . gj. 

Ext. Glycyrrhizae, . . . . gij. 

Syrupi Tolutani, . . . . 5j iij. 

M. Sig. — A teasp. 4 to 6 times daily. 



R. 



M 



Tinct. Sanguinariae, . . 
Ammonii Chloridi, . . 
Syrupi Tolutani, . . . 
Spt. Etheris Nitrosi, . . 

Aquae, 

Sig. — Tablesp. p. r. n. 



3J- 

§ ^ss. 



R . Syrupi Scillae, ^ ss. 

Tinct. Opii. Camph., . . . ^ij. 

Ammoniaci, gss. 

Syrupi Tolutani, ^x. 

M. Sig. — A teasp. p. r. n. 



R. Ammonii Chloridi, . . . 3 iij. 
Syrupi Picis Liquidse, . . ^vj. 
M. Sig. — Tablesp. 4 times daily. 



R 



. Ammonii Carbonat., . . . gr. xl. 

Infusi Serpentariae, . . . 3 iv. 
M. Sig. — A tablesp. every 3 hours. 



Bronchorrhcea. 

Ammonium Iodide, often improves the condition, especially if used with 
Arsenic (B). Eucalyptus, the oil of great utility (B) ; TT\jj ter die on sugar, or 
•see formula above. Sulphurous Acid Gas, as inhalations, or in solution as 
spray, sometimes improves (B). Lead Acetate, as astringent to restrain secre- 
tion (B) ; gr. j-ij every 2 hours. Petroleum, crude, in capsules, has been ad- 
ministered with rapid amelioration as the result (Blache). Grindelia, an 
efficient remedy (B). Iodine, as liniment, over front and back of chest (R). 
Spinal Ice-bag, to restrain excessive secretion (R). Quinine, and the Phos- 
phates, also Cod-liver Oil, as restoratives (Wa). Copaiba, the most serviceable 
expectorant, but nauseous (B) ; when copious secretion of pus (R). Cubeb, 
has remedial effect in chronic bronchial affections with profuse expectoration 
(B). Asafetida, is of great benefit (B). Turpentine, an excellent remedy when 
fetid expectoration ; may be used internally (n\,v) or by inhalation from ato- 
mizer. Terpin Hydrate, seems to be even more efficient than turpentine, in 
doses of gr. x-xx daily. Carbolic Acid, internally ("1 j), and by spray (gr. v. 
ad Sjj aquas), often of great utility (Da C). Benzoin, by inhalation, for its local 
influence. Myrtol, is largely eliminated by the lungs, and is a most valuable 
agent in bronchorrhcea and fetid bronchitis, acting as a stimulant and antisep- 
tic (Gubler) ; dose, rr\jj in capsules (Br). [Compare Cough.] 



R . Copaibae, 

Syrupi Tolutani, . . . aa £ ss. 
Spt. Etheris Nitrosi, . . . %). 
Aquas Menth. Pip., . . . Jij. 
M. Sig. — A teasp. every 4 hours. 

34 



Prescriptions. 



R. Ammonii Chloridi, . . . 3jj. 
Emulsi Asafoetidae, • - • % > v - 
Misce. Sig. — Tablesp. as required. 



530 BRUISES BUBO BUNION BURNS. 

R. Potassi Iodidi, gj. 

K . Copaibae, Ac. Nitrici Dil., .... giij. 

Bals. Tolutan., Tinct. Belladonnae, . . . gj. 

Pulv. Acaciae, . . . . aa^ss. Ac. Salicylici, gj. 

Ac. Sulph. Aromat., . . . 3 ss. Aquae Camphorae, q. s. ad % iv. 

Aquae Destillat., . . . . Jvj. M. Sig. — Dessertsp. in water 3 or 

M. Sig. — Tablesp. bis vel ter in die. times daily, for fetid bronchitis. 



Bruises. 

Arnica, the infusion very useful as an external application for bruises and 
cuts ; also an excellent internal remedy for internal bruises, shake, falls, blows, 
or shock ; rrvv-x every 2 or three hours (P) ; in bruises, sprains, etc. (Wa). 
Aconite, the liniment locally to painful sprains and bruises (Wa). Capsicum, 
a strong tinct. applied with gum, said to act like a charm on discolored bruises 
( R). Sulphurous Acid, a solution constantly applied (R). Oil of Bay, as stimu- 
lating liniment (P). Opium, the tincture with Linimentum Saponis (gj to 5jj) 
diligently rubbed in two or three times a day, affords great relief (Wa). 



Bubo. 

Mercury, necessary in the indurated buboes diagnostic of syphilis (Ricord) ; 
Calomel locally applied for indolent buboes refusing to heal after opening (H). 
Nitric Acid, indolent and broken bubo (R). Sulphides, are less useful in ma- 
turating buboes than in the case of ordinary boils or abscesses (R) ; to check 
suppuration (St). Iodoform, locally, has proved useful (Wa). Iodine, applied 
to produce vesication around a bubo, relieves inflammation (R) ; freely every 
day, with rest and compression, to cause absorption (St). Silver Nitrate, lightly 
to surface, to stimulate indolent buboes (Wa). Potassio-tartrate of Iron, 30 
parts to 250 aquse destil., three tablesp. daily, also as lotion to sore (Ricord) ; 
phagedena (St). Tartar Emetic, gr. j every two hours reduces inflammation in 
many cases (Wa). Ice, greatly relieves (B). Surgical. — Open freely with a 
bistoury when suppurating ; if pus is virulent, the open bubo is a chancroid, 
and must be treated as such (Keyes). Pressure, by compressed sponge under 
a spica bandage, or a shot bag, the best local treatment for indolent bubo 
(Keyes) ; in all cases cleanliness, rest in recumbent posture, emollient poultices. - 
Diet, should be generous, with cod-liver oil, in phagedenic bubo. The treat- 
ment of Syphilitic Bubo is that of general syphilis ; local measures are useless, 
and no treatment called for until the general eruption appears (Keyes). [Com- 
pare Chancroid, Syphilis.] 

Bunion. 

Iodine, as paint, or Emplastrum Hydrargyri, for indolent form, thick but not 
tender (D). Rest, fomentations, and anti-arthritic remedies for thickened 
bunion ; burst it by pressure if recent and sac thin (D). [Compare Bursitis.] 



Burns and Scalds. 

Carbolic Acid, 1 part to 30 of Linim. Calcis, or 1 part to 6 of Olive Oil ; the 
latter speedily relieves pain, and promotes healing without suppuration (Wa) ; 
1 part to 10 of Olive Oil, applied on layers of cotton batting, the best applica- 
tion for burns of all degrees. Boracic Acid, a saturated watery solution, used 
with great success (Lister). Lead Carbonate, white lead paint, an excellent 
application to burns of small extent (B). Salicylic Acid, 3j to ^viij 01. Olivae, 
is an efficient local application (B). Collodion, flexible, to burns of first degree 
(R. P). Phytolacca, relieves pain (B). Lime, as Lime-water and Oil, equal 
parts (R) ; or Lime-water with Linseed Oil, a favorite application (P). Rhus 



BURSITIS CACHEXIA. 



531 



Toxicoden., the tinct. externally, Z) to the pint of water in superficial but ex- 
tensive burns (P). Cantharis, the tincture diluted with 40 of water and applied 
on rags, is a most excellent application. Sodium Carbonate in solution as 
lotion, immediately relieves pain and promotes rapid healing. Turpentine, in 
dangerous cases, where great constitutional depression (P) ; as wash to severe 
burns, then locally Basilicon Ointment mixed with Turpentine (B). Cotton- 
wool, to allay pain and exclude air (P). Warm Bath, immerse for some days 
(R) ; exclusion of air the main indication (H). Pinus Canadensis, the con- 
centrated extract, painted on freely, relieves the pain effectually. 

Prescriptions. 



Lime and Linseed. 

R . Olei Lini, £ vij. 

Aquas Calcis, ,i vu J' 

M. Sig. — Apply on sheet lint, and 
cover with oiled silk. 



R. Sodii Carbonatis, . . . . ^yj. 

Aquse, Oiij. 

M. Sig. — Apply freely for 3 days on 
old cloths or lint. 



R. Iodoformi, ^j. 

Cetacei, ^j. 

Ext. Conii Alcohol, . . . gr. xl. 

Acidi Carbolici, .... gtt. x. 
M. Sig. — Spread on lint and cover the 
parts therewith. 



R. Pulv. Carbonis Ligni, . . ^viij. 

Sig. — To be dusted thickly over the 
burned parts. 



Bursitis. 

Iodine, painted on outside, after removal of fluid from aspirator (D) ; after 
blistering (Wa). Blisters, in rheumatic enlargement of bursas, are almost 
indispensable for a rapid cure (Wa). Fomentations, with rest, to relieve pain 
and swelling ; if unavailing, a crucial incision into the bursa, care being taken 
not to open the capsule of the knee (D). Excision, when chronic, tumor hard, 
resisting other measures (C). 

Cachexise. 

Calcium Phosphate, in scrofulous affections and anaemia (Wa) ; in phthisis, 
and affections marked by mal-nutrition (B). Iron, in splenic, syphilitic, and 
strumous, and especially in all anaemic states ; also in the malarial and phthis- 
ical ; chalybeate waters (B). The Ammonio-citrate the best tonic in the 
cachexia of gastric ulcers, especially in chlorotic females (Wa). Arsenic, a 
prompt remedy in the malarial cachexia ; also in the cancerous of real value 
(Wa). Hydrastine, in paludal and splenic cachexias, stands in high esteem 
(B). Nitric Acid, is adapted to the cachexia following acute diseases or intem- 
perance ; also as alterative after long course of Mercury (Wa). Potassium 
Iodide, in constitutional syphilis, and resulting affections of bones and skin 
(Wa). Mercury, in the syphilitic, but its utility much questioned (Wa). 
Aurum, in cancerous, mercurial, and syphilitic cachexias, especially when 
bones, glands, and oculo-nasal mucous membrane affected. Phosphates, in 
bone diseases, wasting, bronchitic, leucorrhceic, etc. (B). Arnica, in very 
developed cachexias, has excitant action on the nervous system (Wa). Euca- 
lyptus, a serviceable tonic and stimulant in cachectic states generally (B). 
Manganese, the Syrup of Ferrous and Manganese Iodide in anasmic, syphi- 
litic, strumous, malarial, cancerous, etc. (B). Grape-cure, often modifies most 
happily many conditions (P). Air, in good condition, an important element 
(B). Water, the Turkish bath and wet pack as aids to remedial action, in 
plumbic, mercurial and paludal (B). Oils and Fats, to promote constructive 
metamorphosis in many cachexias, especially cod-liver oil (B) ; the latter a 
most valuable remedy in scrofula, phthisis, atrophy, tubercular and jail ca- 
chexias, anaemia, etc. (Wa). Massage, has been productive of remarkable 
results in many forms of cachexias (B). Aliment, of prime importance (B). 
[Compare the titles Anaemia, Scrofula, Syphilis, etc., and the Formulas for 
Tonics, on pages 507 and 511, ante.~] 



532 



CALCULI. 



Calculi, Biliary. 

Chloroform, is supposed by some to act as a solvent in 20 to 60-drop doses 
every 3 or 4 hours ; it cannot act as a solvent, but undoubtedly affords some 
relief (B) ; as an inhalation it may be used to relieve the pain of the paroxysm 
(Br). Ether and Turpentine, equal parts of each, Z] once daily for a year, is 
Durande's solvent remedy ; is not solvent, and as an anodyne inferior to mor- 
phine or chloral (B). Morphine, gr. % with Atropine, gr. t |q, hypodermically, 
the best anodyne for the pain and vomiting during the paroxysm (Br). Chloral, 
sometimes relieves the pain (R). Counter-irritants, as mustard poultices to 
relieve the pain during the paroxysm (Br). Olive Oil, jfij at night, followed 
next morning by 3 or 4 seidlitz powders an hour apart, efficient in facilitating 
the expulsion of accumulated gall-stones. Nitro-muriatic Acid, as bath, found 
useful in India to relieve the pain and promote expulsion of the calculus, ^iij 
of the acid to a gallon of water (Scott). Sodium Phosphate, in 3-dose before 
each meal for several months, to prevent recurrence (B) ; should be given in 
plenty of water (Br). Sodium Salicylate, increases the secretion of bile and 
renders it more watery ; it is therefore indicated in cases where there is a 
tendency to the formation of gall-stones (Br). Succinate of the Peroxide of 
Iron, hydrated, contains a large proportion of nascent oxygen, and is given in 
teaspoonful doses after meals for several months, and resumed at intervals 
afterwards to prevent reformation of the calculi (Buckler). Diet, is import- 
ant ; withhold all starches, sugars and fats, also malt liquors and spirits ; mod- 
erate exercise out of doors, lean meats, eggs, fish, fruits and succulent 
vegetables to be used freely. Mineral Waters, the alkaline are useful, especi- 
ally Vichy, which is deemed of great benefit. [Compare Colic, Jaundice.] 



Prescriptions. 



R . Succinat. Hydrat. Ferri Per- 

oxidi, ,1J SS - 

Aquae, ^ vjss. 

M. Sig. — Teasp. after each meal for 
several months. 



R. Spt. Etheris Comp., . . . £ij. 

Liq. Magendie, rrLxxx. 

Syr. Zingiberis, ... ad Jj. 
M. Sig — Teasp. doses, an hour apart, 
until pain is relieved. 



Calculi, Renal and Vesical. 

Alkalies, especially Potassium salts, if long continued will effect solution of 
uric acid calculi (R) ; Sodium salts should not be used (B). Potassium 
Citrate, in large doses for bloody urine containing uric acid crystals (R) ; the 
Citrate and Carbonate are the most desirable solvents for uric acid gravel (Sir 
H. Thompson). Potassium Tartra-borate, if long used is very efficient as a 
solvent for uric acid calculi (B). Potassium Salts, are much more efficient 
than those of Lithium as solvents for uric acid (Rogers). Alkaline Mineral 
Waters, those rich in Potassium preferred, especially Vichy (B). Ammonium 
Benzoate, long-continued, will dissolve phosphatic calculi (B). Ammonium 
Biborate, will prevent attacks of colic where uric-acid calculi, in 20 grain doses 
every two hours until free urination, then gr. xv thrice daily in a glass of flax- 
seed tea. Magnesium Boro-citrate, is a good solvent of uric acid calculi 
(Madsen). Lithium Citrate, to promote oxidation (Da C). Hydrangea, in de- 
coction, used by the Cherokees in all calculous affections with uniform success 
(Butler). Lead Acetate, gr. yi to the ^ of distilled water, injected into the 
bladder to prevent formation of phosphatic calculi, or a solution of Dilute HC1 
Acid, rrL ij-iij to the ^ (Sir H. Thompson). Nitric Acid, very dilute, as injec- 
tion for phosphatic calculi (R) ; gtt. j to the %, as injection into the bladder in 
chronic cystitis and phosphatic deposits (B). Cotton-root, in decoction, as a 
demulcent for strangury and gravel (P). Castor Oil, of value as a purgative 
(P). Calumba, to relieve the vomiting (P). Counter-irritants, as mustard- 
poultices, or turpentine stupes, to relieve the pain of the paroxysm (R). Anaes- 
thetics, for the same purpose (B). Morphine, hypodermically, as an anodyne 



CANCER. 533 

and. to relieve the vomiting (B). Hot Fomentations, to alleviate spasm and 
pain while calculus is passing. Diet. Restrict the use of sugar in any form or 
combination, also fats and alcoholic beverages. Fresh, green vegetables may 
be used freely, also skimmed milk or buttermilk. Mineral waters, preferably 
Vichy, Friedrichshall and Carlsbad. Frequent abstinence from animal food. 
Lemon-juice and soft water in large draughts, are useful. Surgical Measures. 
Lithotomy or Lithotrity for removal of a stone from bladder. Solvents are of 
no use except for a very small calculus, and even then a considerable time 
must be occupied in the process. No operation in surgery more certainly 
safe, rapid and successful than lithotrity (Sir H. Thompson). [Compare Colic, 

LlTHIASIS, OXALURIA, etc.] 

Prescriptions. 



Magnesium B or o- citrate. 

R . Magnesii Carbonat., . . . gj. 
Sodii Biborat, 

Acidi Citrici, .... . aa ^ij. 

Aquae Bullientis, . . . . ^ viij. 

M. Sig. — Tablespoonful 3 or 4 times 
daily. (B.) 



Potassium Tartra-borate. 
R . Potassii Bitartratis, . . . partes iv. 

Ac. Borici, partem j. 

Aquae, partes x. 

By heating the above together, the salt is 
obtained as a white powder, of which gr. 
xx in a large draught of water 3 or 4 times 
daily. 



Cancer. 

Arsenic, in cancer of the stomach, diminishes pain and checks vomiting ; also 
in scirrhus of stomach and epithelioma ; is believed to retard the growth of 
uterine cancer (Br). Arsenous acid, pure or with starch, as a caustic ; enough 
should be used to set up active inflammation (R) ; may cause arsenical poison- 
ing by absorption. Belladonna, locally and internally (ttlv-x), of great benefit 
as palliative in severe pains of cancer (P). Conium, as poultice, and internally 
to relieve pain (R) ; is particularly applicable to pain of cancer (P) ; as palliative 
(Wa). Hydrastis, has a renewed interest (Pf ). Carbolic Acid, undiluted, to 
sore, and injected beneath it, limits and retards (B) ; pure, as anaesthetic, be- 
fore applying caustics ; with glycerin, as application to fetid cancers (R). Mer- 
curic Chloride, in small doses, long-continued, will retard the growth of gastric 
cancer (DaC). Citric Acid, Z) to ^viij aquae, useful in allayingpain of cancer- 
ous ulcerations (Wa). Acetic Acid, 1 to 3 aquae ; rr\,xxx injected into the tumor, 
has been used with varying success (Wa). Chloral, in 10 gr. doses, 3 times a 
day, has relieved the most severe pain of cancer (R). Chloroform, as vapor 
to raw surface (R). Pyoctanin (Methyl Violet) in solution, by injection into 
the neoplasm, to bring about the shrivelling up and final disappearance of 
carcinoma (Mosetig). Hyoscyamus, bruised leaves, locally (P). Bismuth, 
relieves pain and vomiting of gastric cancer (B). Glycerite of Tannin, with 
Glycerite of Carbolic Acid, checks discharge and stench of uterine cancer (R). 
Carbonic Acid, injected up vagina in cancer of uterus, to relieve pain (R). 
Iodoform, applied to diseased surface, relieves pain and removes fetid odor 
(P). Resorcin, 15 parts to 20 of Vaselin as an ointment twice daily after 
washing with a solution of Pot. Permanganate, has successfully stopped epithe- 
lioma (Antonio). Potassium Chlorate, in impalpable powder, dusted on epi- 
thelioma, said to be curative (B). Pepsin, injections into tumor (B). Salicylic 
Acid, pure, applied in powder (B). Zinc Chloride, the most efficient and safe 
escharotic ; parts j-ij to v of flour, as "caustic arrows" inserted at base of 
tumor (B). Potassa Fusa, as escharotic (B). Opium, to cancerous sores. 
Morphine, dissolved in glycerin, and spread on lint, very useful where there is 
much pain. Opium is also used in cancer of the stomach (R). Codeine 
(g r - T5 t0 to). a good hypnotic (P). Zinc Sulphate, dusted over, dry ; an 
excellent caustic. Remove the eschar by poultice (B). Bromine, for destruc- 
tion of uterine cancer, is preferred by some (B). Chromic Acid, a powerful 
escharotic (B). Calcium Carbonate, as calcined oyster-shell, very efficient 
in arresting growth of cancerous tumors, and in alleviating the pain thereof 



534 CANCRUM ORIS CARBUNCLE. 

(Hood). Rumex Acetosa, an excellent local application ; has a popular 
reputation. Iron and Manganese, the Syrup of the Iodide, for resulting cachectic 
state (B). Poultices, of starch, applied cold (R) ; or poultices of bread, sprinkled 
with charcoal or freshly ground coffee, as deodorizers to open cancers. Water 
Enemata, to relieve pain and straining in intestinal cancer (R). Electrolysis, 
has been of great service in many cases, relieving the pain, and diminishing 
the tumor. In a case of sarcoma of the thigh, in which amputation was the 
only possible resource, after one application of the needles by Mr. Annandale, 
the pain was relieved and the tumor diminished (Duncan). It seems proved 
that there is a less frequent return of cancerous growths removed by electro- 
lysis than by the ordinary procedures ; the evidence in its favor has recently 
accumulated (Tibbits). In any case in which operative interference is neces- 
sary, electrolysis is the preferable method, and in others is advisable (Butler). 
In 18 cases of epithelioma treated by electrolysis, 13 were cured, 2 improved, 
in 2 there were no results, and 1 ended fatally (Groh). 



Cancrum Oris. 

Arsenic, in medicinal doses (R). Nitric Acid, to surface (R) ; strong Nitric 
Acid the best caustic for worst forms of the disease (Wa). Potassium Chlorate, 
gr. xx-xl in 24 hours, has been strongly recommended (D). Quinine, made 
into a syrup, or as enema, to support the strength (Wa). [Compare Aphthae, 
Stomatitis.] 

Carbuncle. 

Boric Acid, administered internally and externally as for Boils (which see) ; 
equally efficacious in carbuncle, diminishing pain, redness and hardness ; nu- 
merous apertures rapidly form for the elimination of the core ; the fever falls, 
excitation and insomnia abate, and the carbuncle heals, in the majority of 
cases, without surgical interference (Alison). Mercury, Corrosive Sublimate, 
injected into tumor at several points, in doses of 2 drachms of a -^ per cent, 
solution dividedly, has produced good results. The injections were often 
repeated, in broken doses likewise, on the following days (Casson). Bella- 
donna, with Glycerin, as local application to relieve pain (R. P. Wa). 
Ammonium Acetate, to support the system (Cezard). Carbolic Acid, on lint, 
with Glycerin or Oil, into discharging sinuses (R) ; or hypodermically into the 
sloughing tissues. Iodine, to produce vesication around carbuncle ; reduces 
inflammation (R) ; part j of the tincture to iij aquas, locally, has most striking 
effect (Wa) ; may be used with benefit internally or hypodermically (Cezard). 
Calcium Sulphide, gr. y 1 ^ hourly, or every two hours, of great service (R). 
Opium, a thick extract, locally (R). Potassium Chlorate, highly recommended, 
also Quinine and Iron, freely to support the system and counteract the carbun- 
cular poison. Poultices, the inflamed surface having been previously smeared 
with Belladonna and Glycerin (R). Long-continued poulticing thought to 
create tendency to a fresh crop. Strapping, with plaster, concentrically from 
border inwards, leaving the centre free, will sometimes arrest extension (R). 
Collodion, as protective covering (P) ; as zone around base, leaving the centre 
exposed (Wa). Collodium cum Cantharide in a broad zone painted around 
the carbuncle, to relieve the tension (Ag). Ice, or Ice-bags or iced water on 
cloths in early stage, changing to warm fomentations as soon as suppuration has 
begun (Hebra). Galbanum and Opium as plaster to relieve pain, the separa- 
tion of the core then proceeding painlessly (Hill). Crucial Incisions are not 
so frequently made now as formerly ; they relieve tension but often give rise 
to severe hemorrhage. Diet should be very supporting, and stimulants may 
be used freely when the patient is debilitated. Saline purges occasionally 
(Hill). Cauterization, with fuming Nitric or Carbolic Acid, on top of a free 
crucial incision, followed by dressing with Carbolized Oil, is the course to pursue 
in malignant pustule. Caustic Potash, applied before an opening occurs, or 



CARIES CATALEPSY CATARACT. 



535 



small pieces inserted into openings made by scalpel, to cause the rapid separ- 
ation of the slough. The resulting ulcer should be treated on general prin- 
ciples. [Compare Boils, Pustule Malignant.] 



Prescriptions. 



R. 



nj. 



Calcis Sulphurat., . . . . gr. 
Sacchari Lactis, . . . . q. s. 
Triturat. et div. in chart, xxx. 
Sig. — One powder every 2 hours, to be 
taken dry on the tongue. 



R. Tinct. Ferri Chloridi, . . gj. 

Potass. Chlorat., . . . . 3 iij. 

Liq. Ammonii Acetat., . . ^iij. 

Syrupi et Aquae, . q. s. ad ,^viij. 
M. Sig. — Dessertsp. every 2 hours. 



Caries. 

Aurum, in syphiloma of bones (B). Calcium Chloride, where strumous 
cachexia (B). Phosphoric Acid, with 8 parts water, locally applied, has been 
of benefit (Wa). Phosphates, best is Syrup of Calcium Lacto-phosphate, or 
Parrish's phosphates (R). Villate's Solution, to dissolve the carious bone, has 
cured many cases (B). [See formula below]. Sarsaparilla, a very useful med- 
icine (P). Iodine, locally, with Iron or Cod-liver Oil internally (Wa). [See 
Bone.] Potassium Iodide, in syphilitic caries, holds the first place (Wa). 
Cod-liver Oil, to promote constructive metamorphosis (R). Mechanical Con- 
trivances, necessary in most cases ; Sayre's plaster jacket, Agnew's jacket of 
leather and steel, Taylor's apparatus, etc., are used in spinal caries to separate 
the diseased bones, and extend the spinal column. [Compare Necrosis.] 



Prescriptions. 



Villate's Sohition. 
R . Cupri Sulphat., 

Zinci Sulphat., aa partes xv. 
Liq. Plumbi Subacetat, p. xxx. 

Aceti, p. cc. 

To be injected through the sinuses. 



$ . Syrupi Calcii Lacto-phos- 

phatis(U. S. P.), . . . !f viij. 
Sig. — A dessertsp. to a tablesp. 3 or 4 
times daily. 



Catalepsy. 

Turpentine, in enemas, and embrocations along the spine, affords the best 
chance of stopping the paroxysms (Wa). Treatment must be essentially tonic 
and restorative (H). No constant line can be stated (A) ; external stimulation 
to arouse consciousness, by Ammonia, cold douches, Faradism, etc. Apomor- 
phine, gr. -£$ to ■£%., in the paroxysm ; with the onset of nausea, consciousness 
returns and spasm ceases ; in the intervals between the attacks the treatment 
should be that of hysteria (Gowers). 



Cataract. 

Phosphorus, with Oil, by frictions to the forehead, and instillation of the same 
into the eye, may cause absorption of the lens or. capsule (Wa). Codeine, in 
diabetic cases (Br). Sodium Sulphate, a solution suggested as injection into 
anterior chamber, in hope to dissolve the nebula (Wa). Galvanism, has been 
successfully employed in incipient stage (Wa). Mydriatics, Atropine, Duboi- 
sine, etc., to secure full dilatation of pupil, as a means of ascertaining when 
the operation should be made, which is when the cataract is mature, there be- 
ing no vision even with dilated pupil (Wa). Diet and Regimen, may do much 
to retard degeneration of the lens, in cases due to diabetes, or malassimilation 
in gouty or rheumatic persons (C). Iridectomy, made early and effectually 
may postpone the progress of lenticular opacity, if due to increased intraocular 
tension (C). In partial cataracts, which have become stationary, iridectomy 
for artificial pupil may be done to expose clear portion of lens (Roosa). Medi- 



536 CATARRH, ACUTE NASAL. 

cine, accomplishes nothing except to improve general health and so delay the 
progress of the opacity. Removal may be performed by one of several opera- 
tions (Roosa). 

Catarrh, Acute Nasal. 

Sodium Salicylate, to abort a cold (see ante, page 373). Aconite, in severe 
coryza with much chilliness, aching limbs, hot and dry skin, and quick pulse ; 
also in catarrhs of children and that accompanying measles (R) ; in acute 
coryza (P) ; with Belladonna in ordinary colds with sore throat and high fever 
(B) ; in doses of tt\, y z every % hour, very useful for a commencing cold in 
the head (Smith). Belladonna, in acute nasal catarrh with profuse watery 
secretion, rr\, v of tincture, then rr^ j each hour (B). Nux Vomica, has great 
effect upon a dry cold in the head (P). Euphrasia, is of decided utility in 
coryza (P). Pulsatilla, a warm lotion, o\j _ ij i n S lv aquae, syringed into the 
nasal passages in subacute coryza with muco-purulent secretion (P) ; acts simi- 
larly to Aconite, but is contraindicated if much gastric or intestinal irritation 
exists (B). Iodine, by inhalation in daily attacks with itching nose (R) : gij 
of the tincture with 3j of Carbolic Acid inhaled from sponge in the bottom of a 
wide mouthed bottle placed in hot water (B). Iodides, are unquestionably 
serviceable, their action being local and substitutive ; Ammonium Iodide, gr. j 
every two hours, the best mode of using them (B). Sodium Iodide, gr. x ter 
die, with Pil Ferri Iodidi, in catarrhs of specific origin (B). Potassium Iodide, 
gr. x at bedtime at the onset, to cut short an acute cold in the head ; also use- 
ful in chronic colds (R). Arsenic Iodide is very efficient as a remedy for an 
acute cold, coryza, and similar affections, especially when accompanied by a 
sore throat resembling that of diphtheria ; gr. iij triturated with gr. xx of sugar 
of milk, one-half of which may be dissolved in ^iv of water, and a teasp. 
given every hour or so. Arsenic, when sneezing, itching of nostrils and 
frontal headache (R) ; as cigarettes (B). [See under Asthma, for formula.] 
Veratrum Viride, if Arsenic fails (R). Quinine, gr. x, with Morphine, gr. l /e, 
at incipiency, will often abort an acute coryza (B). Opium, at night, if taken 
early in the case, will often abort an attack of coryza ; a glass of hot grog 
assists its action (R) ; Dover's powder in a full dose at the onset may abort 
(B). Codeine, is useful in common colds, as a palliative (B). Ammonia, may 
be inhaled in the early stage (R). Potassium Chlorate, 8 or 10 lozenges a day 
will abort many a cold (R). Camphor, as inhalation, the spirit in form of 
vapor (R) ; with Opium and Ammonium Carbonate as powder (see formula 
below), to break up or modify a cold (Beard). Tartar Emetic, gr. -^ to y\- in 
the first stage (B) ; in acute catarrh of children often accompanied by vomiting 
and diarrhoea (R). Ipecacuanha, for acute nasal and bronchial catarrh, and 
ordinary colds in children (B). Cimicifuga, when headache, stiff muscles, 
dull aches, bone-pains, etc. (R) ; an excellent expectorant (B) ; rheumatic 
colds ; neuralgic pains in jaw (P). Jaborandi, the fluid extract in doses of 
ttlx to xxx, every half hour until profuse diaphoresis sets in, is one of the best 
modes of aborting a cold ; or Pilocarpine Hydrochlorate, gr. Ye in water at 
bed-time, will give prompt relief, and cure in a few days (Wyss). Cocaine, a 
4 or 5 per cent solution locally as spray, to empty the engorged venous sinuses 
of the nasal mucous membrane, by their contraction, which it induces. The 
fluid extract of Coca diluted with water is equally efficient if enough be used 
(Cohen). Resorcin, the best of all applications. (See Catarrh, Chronic.) 
Cubeb, or Ammonium Chloride, in the dry, congestive stage of a cold in the 
head ; Cubeb cigarettes may be smoked as a temporary palliative with great 
relief. Sulphurous Acid, in coryza, by inhalation, spray or fumigation, is very 
efficient (R). Oil Inunctions, daily to the whole body, in cases of undue sus- 
ceptibility to taking cold, will prevent the frequency of the attack (B). Baths, 
a warm foot-bath before going to bed ; Turkish bath, at onset in coryza, may 
prove abortive ; also useful later on. Cold sponge-bath in cases of extreme 
susceptibility, supplemented by occasional Turkish baths (R). [Compare 
Cough, Hay-Fever, Influenza.] 



CATARRH, CHRONIC NASAL. 



537 



Prescriptions. 



}&. Quininse Sulph., . . . 

Liq. Arsenicalis (B. P.), 

Liq. Atropinse (B. P.), . 

Ext. Gentianae, .... 

Pulv. Acacia, .... 
Ft. pil. no. xij. Sig. — One every 3, 4 or 
six hours, for acute colds. ( Whalen.) 



gr. xvuj. 

gr. xx. 
q. s. 



R- . Camphorse, gr. 1. 

Athens, q. s. 

Dissolve to creamy consistence, 
then add — 

Ammonii Carbonat., . . . gr. xl. 

Pulv. Opii, gr. x. 

Divide into thirty papers. 
One or two powders, according to age, 
twice or thrice daily. [Beard.) 



R. Acidi Carbolici, gr. lxxx. 

Alcoholis, ,1 ss - 

Aq. Ammonia?, X\ lxxx. 

Aquae, 3 ijss. 

M. Sig. — A few drops as an inhalation 

from a cone of blotting paper. [Brand.) 



. . gr. iv. 
aa 3J. 



&. Morph. Acetat, . 
Bism. Subnitrat, 
Pulv. Talci, . . . 
Ft. Chartulas no. xxx. 
Sig. — Use as snuff in acute rhinitis. 

(Sajous.) 

]& . Codeine, gr. ij. 

Syrupi Tolutani, 
Syr. Scillse Comp., . . . aa 3 j. 
M. Sig. — Teaspoonful occasionally for 
a common cold. (B.) 



1$ . Tinct. Aconiti, ir^ x. 

Tinct. Belladonna, . . . z ss. 

Syrupi Zingiberis, . . . ad 3 ij. 
M. Sig. — Half to one teasp. according 
to age, every hour. 



R 



Ferrier 's Snuff. 
Morph. Hydrochlor., . . . gr. ij. 
Bismuthi Subnit, .'.'.. 2J vj. 

Pulv. Acacise, 3 ij. 

M. Sig. — Use as snuff, % to ]/ 2 
above in 24 hours. 



th ( 



Catarrh, Chronic Nasal. 

Sanguinaria, the tincture in 10-drop doses thrice daily, or gr. -^ of the alka- 
loid, internally, and the powder in small quantity locally to the mucous mem- 
brane, is successful treatment for chronic nasal catarrh (B). Glycozone,, fre- 
quently applied, is of benefit in chronic coryza (Edson). Hydrastis, is of 
value in chronic coryza, also in ulceration of the septum or any other part of 
the nasal fossae, gtt. v of the tincture thrice daily internally, and Z) to 3 viij of 
water locally with syringe (P). Pulsatilla, is excellent in subacute inflamma- 
tion of nasal passages, with offensive muco-purulent discharge, 3>j-ij ad £iv 
of water, as wash (P). Potassium Bichromate, is an excellent local application 
in a solution of gr. j-x to ^iv water (B). Iodoform and Tannin, 1 of the former 
to 2 or 3 of the latter, carefully triturated, and applied by an insufflator every 
other day only, is the very best of all applications (B). Sodium Chloride or 
Phosphate, a teasp. to the pint of warm water as cleansing solution, or the 
Bicarbonate, in the same proportion. A sea-water gargle in the nasopharyn- 
geal space, has been used with success (Mosler). Wei de Meyer's Catarrh 
Cure is simple Sodium Bicarbonate and a little pink coloring matter (Robin- 
son). Potassium Permanganate, gr. j-x to the pint of warm water, as a deodo- 
rant solution when necessary. Ammonia, by inhalation, when painful inflam- 
mation of nasal mucous membrane and frontal bones (R). Carbolic Acid, a 
1 per cent, solution as spray, or inhalations of the vapor with that of Iodine 
from a bottle in hot water, or vaporized by the warmth of the hand (B). Sali- 
cylic Acid, in weak solution, 1 to 500 of water, as a disinfectant and astringent 
injection, used with a retro-pharyngeal syringe, and followed by applications 
of powdered Calomel, through a speculum, upon the ulcerated parts of the 
mucous membrane (Massei). Cubeb, finely powdered and blown into the 
nares by an insufflator (B), has proven very useful (P); may be smoked, and 
administered internally in teasp. doses (Wa) ; in freshly ground powder as 
a confection, (see below for formula), very efficient in follicular disease of the 
naso-pharyngeal space (Robinson). Ammoniacum, in the same condition, very 
small doses, gr. j-iij, with Ipecac or Ammonium Carbonate, will greatly lessen 
the amount of secretion (Robinson). Bismuth, in powder, with Acacia, as 



538 



CATARRH, CHRONIC NASAL. 



in Ferrier's snuff (see above for formula), or with Tannin, Calomel, Iodoform, 
etc., used by insufflation, daily (Robinson). Aurum Chloride, in mercurialized 
and syphilitic subjects, with offensive discharge, depressed spirits and soreness 
of the nasal bones. Iodides, of Iron and Sodium, in catarrh of specific origin 
(B). Silver Nitrate, in powder, as alterative application, gr. x-xv to the § of 
menstruum, is often a useful adjunct to treatment, used once every 4 or 5 days 
(Robinson). Cod-liver Oil, should be used in strumous subjects (R). Alum, 
in powder, dusted over the affected surface, is a useful application (B). Resor- 
cin, the best of all applications, in acute and chronic catarrh. After cleansing 
the nose with a Boracic Acid solution, or Dobell's, use a 2 to 10 per cent, oint- 
ment (in Vaselin), also a spray every other day, of a 2 to 4 per cent, solution. 
It gives the same results as Cocaine, but is slower in action and more lasting, 
and does not suppress the normal function of the mucous membrane, as the 
latter does. Eucalyptus, has been employed with benefit (Wa). Bromine, the 
vapor may greatly benefit, but must be used with caution (B). Senega has 
been found serviceable (Wa). Douche is dangerous, being likely to cause 
extension of the catarrh to the Eustachian tube and the middle ear. It has 
been very generally abandoned. Sprays by hand-ball atomizers, or com- 
pressed air apparatus, of warm watery solutions, Vaselin, etc., are used with 
considerable success (Cohen). The Hank's atomizing tubes, with a 2-ball 
rubber syringe, are very serviceable for office use, and for the application of 
Rumbold's hot Vaselin spray. [See formula below.] Sulphur Waters, inter- 
nally, of great benefit in follicular disease (Robinson). [Compare OzjENA.] 

Prescriptions. 



R . Acidi Carbolici, tl\, x. 

Glycerini, 3 ij. 

Vaselini 3" ij. 

M. Sig. — Warm and use as a spray 
every 4 hours. (Rumbold.) 

R . Pulv. Argenti Nitrat., . . gr. vij. 

Pulv. Acacias, gj. 

Bismuthi Subnitrat, . . . 3 iij. 
Triturat. Sig. — Apply with insufflator 
once in 4 or 5 days. (Robinson.) 



Be. 



M 



Acidi Carbolici, Tt\, xl. 

Sodii Boratis, 

Sodii Bicarbonat, . . . aa 3 ij. 

Glycerini, 3 vij. 

Aquas, q. s. ad £ viij. 

Sig. — Use daily as spray. 

' (Dobell.) 



M 



Bismuthi Subcarb., 

Pulv. Acaciae, . . . . aa gss. 

Zinci Sulphat., gr. x. 

Morph. Sulphat., . . . . gr. ij. 
Sig. — Snuff, to be used thrice daily. 
(Sajous. ) 



I£ 



Pulv. Cubebae, 3* ij. 

Syr. Aurantii, % iij. 

Aq Menth. Pip., . . . . 3*ij. 

Aquae, q. s. ad ^vii]. 

Ft. mistura. Sig. — A teaspoonful every 
3 or 4 hours. (Robinson.) 

R. Bismuthi Subcarb., . . . gvj. 

Morph. Muriatis, . . . . gr. ij. 

Pulv. Amyli, gij. 

Triturat. Sig. — Burness' modification 
of Ferrier's snuff. 



R • Sodii Iodidi, ^ ss. 

Syrupi Picis Liq., .... ^vj. 
M. Sig. — Dessertsp. thrice daily with 
Pil. Ferri Iodidi (U. S.) one thrice daily, in 
chronic nasal catarrh of specific origin. 

. (B.) 

R. Sodii Boro-benzoatis, . . S|j. 
Ext. Hydrastis Fl., . . . *|j. 

Glycerini, 3J. 

Ac. Carbolici, rr\,xx. 

Aquae Camphorae, . . . . 3*yj. 

Aquae, q. s. ad J xij. 

M. Sig. — Use with syringe or atomizer 



thrice daily. 



R. 



( Chamberlain.) 



gtt. xv. 



Acidi Carbol., . . . 

Extr. Hydrastis Fl., . 

Sodii Bicarb., 

Sodii Biborat., . . . . aa 3J. 

Glycerini, Sjj. 

Aquae Camphorae, . . ad 3 viij. 
M. Sig. — Use with posterior nasal 
sprayer. 

R. Sodii Salicylatis, . . . . £ij. 

Sodii Boratis, 3" iij. 

Glycerini, % ss. 

Aquae, q.s.ad^v], 

M. Sig. — Of this put a dessertspoonful 
into a pint of warm water, and snuff it from 
the hollow of the hand thrice daily. 

(Sajous.) 

R. Ext. Pini Canad., .... tt\xx. 

Glycerini, tt^xxx. 

Aquae, Oj. 

M. Sig. — Use with post-nasal syringe. 



CEREBRAL ANEMIA CHANCRE. 530 

Cerebral Anaemia. 

Iron, the Tincture of the Chloride, or mild chalybeate waters, in chronic 
cases from general anaemia (B). Amyl Nitrite, in vaso-motor spasm ; affords 
relief in sudden attack (B). Chloral, in small doses with stimulants, warm 
baths (Ros). Camphor, or other cerebral excitants, as Asafcetida, Valerian, 
Serpentaria (B). The Mono-bromide in one to five-grain doses (Hammond)! 
Glonoinum, n\J of a 1 per cent, solution (P). Phosphorus, supplies the needed 
material for healthy brain action (B). Strychnine, stimulates the circulation 
generally; with Iron preparations as a tonic. Galvanism, a mild current 
transversely through the head, gives excellent results in the confusion of mind, 
vertigo, etc., due to imperfect nutrition of the brain from atheroma of the cere- 
bral vessels (B). Arsenic, is highly efficient in some hypochondriacal cases 
(B). Aurum, is of great utility in vertigo, melancholia, etc., when due to or 
accompanied by cerebral anaemia (B). [Compare Insomnia.] 



Cerebral Concussion. 

Arnica, when from a fall, cannot be too highly spoken of (P). Warmth, to 
extremities, rest, expectant treatment, will suffice in mild cases (Ag). The 
indications are : (1) to recover from insensibility and collapse ; (2) to prevent 
inflammation; (3) to restore impaired faculties (D). Stimulants or Venesec- 
tion, cannot be too strongly reprobated (Ag). 



Cerebral Congestion. 

Aconite, in active form, renders important service (B) ; is much the best 
remedy in this condition (P). Belladonna one of the best remedies in all 
hyperaemic conditions of the brain or spinal cord (P). Gelsemium, n^v of the 
fluid extract every two hours, very useful (B). Bromides, are very useful (B) ; 
must be used in full doses. Colocynth, as counter-irritant, appears to act well 
(P). Cathartics, lessen blood-pressure (B). Colchicum, in plethoric subjects 
(B). Galvanism, of brain and cervical sympathetics (B). Chloral, when tem- 
perature high (B). Arsenic, sluggish venous circulation, torpor (B). Hydro- 
cyanic Acid, rrLij-v of Scheele's dilute acid (B). Venesection, will prevent 
injury to brain. Not to be adopted as a matter of course ; is contraindicted 
when anaemia, aortic valvular disease, or in cases commencing with syncope 
(A). Water, cold douche to head, feet in warm water; ice and hot water 
alternately to head and nape of neck, often more effective than ice alone (B). 
Hot water to head on flannels ; mustard and hot water packing for 20 to 30 
minutes, around legs, when active congestion ; protect bowels well (R). Diet, 
should be low, but not too low, until all fear of relapse past ; full animal diet 
should be avoided, also undiluted wines (A). [Compare Apoplexy, Coma.] 



Cerebral Softening. 

Venesection, and antiphlogistic treatment generally, most beneficial in red 
softening, result of inflammation ; require wise discretion, and should be used 
early. Not to be thought of in the yellow form, from want of nutrition ; where 
restoratives and food are needed, perhaps wine (A). Phosphorus, in threatened 
softening of the brain; is the only drug which affects the nerve centers (W). 



Chancre. 

Mercury, small doses steadily, but ptyalism must not be induced. Black- 
wash (Calomel gr. viij, Aq. Calcis ^j), or yellow-wash (Hydr. Chlor. Corr. gr. j, 
Aq. Calcis ^j) on lint, to erosions and ulcerated indurations (B). Calomel 



540 CHANCROID — CHAPPED HANDS — CHEST PAINS. 

alone as dry dressing. Internal use of Mercury best postponed until secondary 
symptoms appear (St). Carbolic Acid, as wet dressing, gr. ij of crystals to 
J iv aquae ter die (St). Iodoform, heads the list of dry dressings; with Lyco- 
podium, equal parts, or I to 2 of Zinc Oxide; 2 to 1 of Calomel (St). Hydro- 
gen Dioxide, said to destroy the specific character. Wash lesions thrice daily, 
and apply lint soaked in it (R). Caustics, should never be used unless chan- 
cre attacked by phagedena (St). Caustic Alkalies, to hard edges (R). Bro- 
mine, Chromic Acid, are the best escharotics (B). Dressings, are effective as 
far as the local trouble is concerned, in the majority of cases ; sometimes a 
piece of lint on the erosion will suffice. Never cauterize an initial lesion unless 
it is attacked by phagedena (St). Cleanliness, of great importance ; tepid water 
locally frequently suffices for the outward treatment of infecting chancre. 
[Compare Syphilis.] 

Chancroid. 

Mercurjr, the Acid Nitrate one of the best caustics ; apply with a glass rod 
(B). Nitric Acid, fuming, as caustic (B. R) ; gj to ^viij aquae is an excellent 
dressing (St). Carbolic Acid, injected into sore (B) ; ^ij-vto Oj aquae locally 
in phagedena (St). Ferri et Potassii Tartras, the born enemy of phagedena 
(Ricord) ; ^j to ^vj aquae, internally, teasp. doses thrice daily ; also locally (St). 
Ferrous Iodide, in sloughing phagedena, or simple chancroid in debilitated 
constitutions (B). Iodoform, powdered and dusted over the sore, allays pain, 
changes morbid action, and is antiseptic (R) ; 1 part to 2 of Lycopodium, or 
one of Tannic Acid; as stimulant and alterative (St). Does no good except to 
relieve pain (Gross). Potassium Chlorate, in impalpable powder, is better than 
Iodoform (B). Chloral, gr. iij ad ^j aquae, the best local application to relieve 
pain (Gross). Caustics, in severe cases, the white-hot iron, strong Sulphuric 
Acid, pure Nitric Acid, pure Carbolic Acid, are effective in the order named (St). 
[Compare Bubo.] 

Chapped Hands and Lips. 

Sulphurous Acid, as solution, or by fumigation, will speedily cure (R). 
Glycerin, diluted, or better still, Glycerite of Starch, or with l / 2 the quantity of 
Eau de Cologne (R). Benzoin, the comp. tinct. 1 part to 4 of Glycerin ; an ad- 
mirable application (P). Hydrastis, on compress as lotion (P). Collodion, is 
usefully employed (P). Carbolic Acid, 1 to 2 of Glycerin, locally ; one applica- 
tion is generally sufficient. Unguentum Aquae Rosae alone, is often efficient ; 
may be combined with Zinc Oxide. 



Prescriptions. 

R . Resinae, J;j. 

Cerse Albae, ^ij. 

Adipis, i|ij. 

Zinci Oxidi, 3^ vij . 

M. Ft. unguentum. 



R-. Cetacei, 3J. 

Glycerini, gij. 

Cerae Albae, gr. xv. 

01. Amygd. Amarse, . . . rr\^iij. 
M. Ft. unguentum. 



Chest-pains. 

Belladonna, as ointment, when tenderness is in the skin (pleurodynia) (R). 
Iodine, as oint. when pain in muscles (myalgia) of chest, they being tender on 
pressure, while the skin may be pinched without pain (R). Strychnine, affords 
relief in functional irritability of the nervous system, manifested by wandering 
neuralgic pains (B). Arnica, for a stitch in the side. Bryonia, when painful 
catching of breath. Cimicifuga, for intercostal rheumatism and pains under 
the breasts in women. 



CHICKEN-POX CHILBLAINS — CHLOROSIS. 

Chicken-pox. 



541 



Aconite, is of great value (B). Water, hot and cold baths and packs are of 
great utility; cold, if hyperpyrexia ; cold compress if sore-throat ; hot or warm 
pack when free diaphoresis required (B). Treatment, precautionary only 
required. Avoid exposure to cold and wet ; maintain the action of the skin 
and bowels (H). Ammonium Acetate, in diaphoretic and antifebrile mixture. 
[See Fever, Simple, for formula.] Inunction, with Camphorated Oil, or thin 
starch, to relieve itching and allay inflammation (P). 



Chilblains. 

Digitalis, internally and locally, to improve the circulation, and combat the 
arterial hypo-tension and peripheral vaso-dilatation which is always present in 
those subject to chilblains (Pilatte). Caffeine and Kola may sometimes be sub- 
stituted for Digitalis. Iodine, as ointment, the best application (R) ; the tincture 
lightly painted over the surface every 3 or 4 days, is particularly serviceable 
for the itching. Fatty substances, including Vaselin, should never be applied 
(Pilatte). Arnica, is a useful application (Wa). Carbolic Acid, with Iodine, as 
ointment, is a very efficient application for chilblains. Benzoin, the tincture in 
Glycerin, applied after thorough washing in soap and water and drying, the 
best application. Sulphurous Acid, an efficient application; £j to giij each of 
water and glycerin (B) ; as solution or fumigation (D). Balsam of Peru, in 
ointment for broken chilblains (R). Capsicum, tinct. painted over unbroken 
chilblains (R). Cajuput Oil, applied locally (R). Turpentine, as wash, then 
apply Basilicon Ointment, mixed with Turpentine (B). Ichthyol, as oint. has 
been of service. Thiol, the dry form, as a dusting powder, is used efficiently. 
Alcohol, as Eau de Cologne, or camphorated, with friction, after careful drying 
of the hands and feet. 



Prescriptions. 



J£. Tinct. Digitalis, 3J SS - 

Thymoli (cryst.), . . . . gr. xlv. 
Alcoholis (70 C), 

Glycerini, aa^xv. 

M. Sig. — For local use. {Pilatte.) 



R- . Tinct. Benzoini, £ ij. 

Olei Lini, 3 iv. 

Cerse Flavse, 3 ij. 

Glycerini, q. s. 

M. Sig. — Ointment. [Reveil. 



Chlorosis. 

Iron, combined with Arsenic or Strychnine. Occasional purgation and active 
exercise. Also chalybeate waters for blood deficiencies (R). Is not a specific 
in chlorosis, and acts best in the purest types (Tr) ; the Iodide, when much 
torpor of the system, is often speedily efficacious (Wa). Arsenic, if Iron fails, 
or disagrees (B). Ergot, in chlorotic amenorrhcea (P). Manganese, the sac- 
charated Carbonate of Manganese and Iron (B). Nux Vomica, stimulates the 
blood-making organs, and may be combined with Iron. A very generally use- 
ful preparation is the syrup or elixir of Iron, Quinine and Strychnine (B). Coc- 
culus Indicus. when amenorrhcea and exhausting leucorrhcea (P). Hypo- 
phosphites, of Calcium or Sodium (R). Benzoin, has been used with advantage 
(P). Pepsin, benefits, especially where digestive derangement (B). Sulphur, 
of great benefit in cases where Iron is of no effect ; also to prepare the system 
for benefit from Iron (Schulz). Purgation, is very important, to prevent auto- 
infection from putrid intestinal decomposition, which is the true cause of this 
disease (Duclos) ; absorption of such products tending to impoverish the blood, 
and produce a " faecal anaemia " (Sir A. Clark). Oils" and Fats, as inunctions, 
after baths, of great benefit (B). Galvanization, central, will aid the action of 
the remedies (B). [Compare Anaemia, Amenorrhcea.] 



542 



CHOKING CHOLERA ASIATICA. 



R. Ferri Arsenatis, .... 
Extracti Cinchonae, . . 
Fiant pil. xij. Sig. — One 
meal. 



R. 



Ferri Sulph. Exsiccat., 
Quininae Sulphatis, 
Strychninae Sulphat., . 
Ft. pil. xx. Sig. — One thrice daily. 



Prescri 


'ptions. 




■ g r - y- 


R. Pulv. Aloes Socot, 


. . gr. v. 


. gr. xij. 


Ferri Sulph. Exsiccat., 


. . gr. xv. 


after each 


01. Tanaceti, vel 




(B.) 


01. Sabinae, .... 
Myrrhae, Croci, 


. . gtt. XXX. 


gr. xl. 


Cantharidis, ... 


aa gr. xxx. 


gr. xx. 


Ft. pil. lx. Sig. — Two 


thrice daily 


. gr. ss. 


gradually increased to four. 





( Wallace. 



Choking. 

Potassium Bromide, benefits a curious affection, sometimes found in children 
who from their birth can swallow solids with ease, but choke at drinks (B). Oil 
of Cajuput, in one case of persistent " choking " sensation in the throat, a few 
doses removed the symptoms, which had lasted several weeks (Hale). 



Cholera Asiatica. 

Camphor, a drop or two of the saturated tincture, or gtt. v-x of the spirit 
with a little Opium every half-hour (B) ; gtt. iv-vj of strong spirit every ten 
minutes until symptoms abate, then hourly (R). Arsenic, in epidemic cholera ; 
some cases of arsenic poisoning not distinguishable from cholera (B) ; for the 
vomiting and in collapse (R). Copper salts have been given (R). Turpentine, 
rt^x-xx every two hours, promises to be a remedy of value (Wa). Chloral, as 
injection, the most efficient treatment, especially when Morphine and Atropine 
are given coincidently (B). Chloroform, a few drops frequently repeated, or 
x-xxx drops of Chlorodyne, of great value (B). Opium, ^ to )/ z gr. Morphine 
hypodermically in preliminary diarrhoea (P) ; Y% to % gr. of the greatest value 
even in collapse (R) ; dangerous if kidney complications exist (P). Lead, the 
Acetate in early stages (R). Carbolic Acid, with Iodine, has given good results 
(B). Salol, has done excellent service. Sulphuric Acid, the aromatic, with 
Opium, is very effective (B) ; two parts of the former with one of Laudanum, 
of this J to 30 drops as per age, is one of the best prophylactics (McClellan). 
Strychnine, as prophylactic during the preliminary diarrhoea, and in epidemic 
form when nearing collapse (B). Alcohol, small doses of iced brandy for 
vomiting (B). Spinal Ice-bag, for cramps (R). Saline Injections, into the 
veins, have been successful in the collapse (B). Transfusion, of milk, in the 
collapse (B). Absolute Rest, recumbent posture, no food, ice ad libitum ; ene- 
mata of warm milk ; fresh air, friction, and heat to abdomen, legs and feet; 
stimulants worse than useless. 



Prescriptions. 



R. Chloralis Hydrat., . . . . giij. 
Morphinae Sulph., . . . . gr. iv. 
Aquae Laurocerasi, . . . ^j. 
M. Sig. — Fifteen to twenty drops as 
injection hypodermically. (B.) 



R 



M 



Chloroformi, gj. 

Tinct. Opii, 
Spt. Camphorse, 
Tinct. Capsici, . . . aa ^iij. 
Alcoholis, .... q.s. ad §ij. 
Sig. — 30 to 60 drops in water. 

[Squibb' s Cholera Mixture.) 



R. Acidi Carbolici, gr. iv. 

Tinct. Iodi, gtt. xvj. 

Aq. Menth. Pip., . . . . £iv. 
M. Sig. — A tablesp. every hour or oft- 
ener. (B.) 



R. Acidi Carbolici, . . . . gr. viij. 

Bismuthi Subnit. , . . . . gij. 

Mucil. Acaciae, 

Aquae Laurocerasi, . . aa ^j. 
M. Sig. — Teasp. every hour or two, for 
vomiting and diarrhoea. 



CHOLERA. 



543 



Cholera Infantum. 

Bismuth Subnitrate, in hourly doses of 3 to 6 grains, is regarded by many as 
almost a specific. Ipecacuanha, greenish stools with mucus and often blood 
(B). Arsenic, for vomiting and collapse (R). Mercury, gr. ]4> of gray powder 
hourly of great Service in infantile cholera with incessant sickness, profuse 
almost continuous diarrhoea, offensive and nearly colorless stools. A Starch 
injection, with a minute quantity of Laudanum, assists the gray powder, and 
should be given in urgent cases (R). Zinc Oxide, with Bismuth and Pepsin, is 
very useful (B). Camphor, £>j to %\v of milk, very serviceable (B); an admir- 
able remedy for summer and choleraic diarrhoea (R). Opium, generally neces- 
sary. Enemata of Starch and Laudanum (see above under Mercury). Mor- 
phine, hypodermically, in doses of gr. ^0 t0 3V according to age, the latter 
dose for a child of one year, with 5 or 6 drops of Ether, to be repeated in an 
hour, the most efficient treatment (E. Smith). Copper Sulphate, often very suc- 
cessful (B). Carbolic Acid, with Bismuth, may arrest the disorder promptly 
(Br). Lead Acetate, is one of the most useful astringents in this complaint 
(Br). Potassium Bromide, when due to nervous irritation or cerebral conges- 
tion (B). Silver Nitrate, is beneficial after the acute symptoms have passed 
(B). Caffeine, when due to nervous irritation (R). Goto Bark, the tinct. gtt. 
j-iij, is highly recommended by Rohrer-for choleraic diarrhoea in children. 
Alcohol, in grave cases, with tendency to collapse, gtt. x-xx of brandy with 
milk every 30 to 60 minutes. Diet. Farinaceous food a common cause. 
Cow's milk 0}( with sacch. lactis gj to 0% aquae-bul., or cold milk with Lime- 
water (R) ; milk, animal broths ; no starches or fats (B). Drinks, as water, 
weak tea, etc., freely, to keep vessels filled and prevent paralysis of the heart 
(Meinert). Spice Poultice, to abdomen, composed of Cloves, Ginger and 
Cinnamon, mixed with brandy or whisky. Mustard Bath, in stage of collapse, 
with mustard over the heart, and Ether hypodermically (Smith). Lactic Acid, 
a 2 per cent, solution in drachm doses, 5 to 8 times in 24 hours, in epidemic 
diarrhoea of infants with green discharges, with local antisepsis as to linen and 
diapers, on the theory of a bacillary origin for the disease (Hayem). 



Prescriptions. 



R- . Cupri Sulphat., gr. j. 

Tinct. OpiiDeod., .... gtt. viij. 

Aquae Destil., ^iv. 

M. Sig. — Teasp. every 2, 3, or 4 hours 
for a child of one to two years old. (B.) 



R 



M 



Acidi Carbolici, . . , . . gr. xxiv. 

Spt. Vini Gallici, .... gtt. xxiv. 

Aquae Menth. Pip., . . ,^jss. 

Mucil. Acaciae, %v], 

Syr. Papaveris, gvj. 

Tinct. Opii Deod., . . gtt. x. 
Sig. — A teasp. every 2 hours. 



R . Hydrarg. Chlor. Mitis, . . gr. ^L. 
Bismuthi Subnitrat., . . . gr. ij-v. 
In powder every half-hour for the vomit- 
ing and purging. 



R . Acidi Carbolici, . . . . gr. iv. 
Bismuthi Subnit., . . . . gij. 

Mucil. Acaciae, Jj. 

Aquae Menth. Pip., . . . ^iij. 
M. Sig. — Teasp. every 2, 3, or 4 hours. 
. (B.) 



R. Plumbi Acetat, .... 

Pulv. Opii, 

Pulv. Camphorae, . . . 
Sacch. Lactis., .... 
Triturat. et div. in chart, xij 
Sig. — One every hour. 



gr. xxiv. 

gr.xij. 

3 SS - 

q. s. 



(B-) 



R. 



g r - 



Hydrarg. Chlor. Mitis, 

Plumbi Acetatis, . . . . gr. 1. 

Opii, ■ '. m gr. I-tV 

Ft. pulv. no. j. Repeat every half-hour 
or hour for the acute gastric symptoms. 



Cholera Simplex. 

Camphor, an admirable remedy (R). Salol, is highly efficient. Salophen, 
is equally so. Veratrum Album, for the vomiting (R). Copper Salts, have 
been given (R). Arsenic, for vomiting ; also for collapse in latter stages (R). 
Chloral, by injection, the most efficient treatment (B). [See C. Asiatica for 



544 



CHORDEE CHOREA. 



formula.] For the cramps, Chloral §i, in Lin. Saponis ^iv-vj, applied with 
friction to the abdomen (DaC). Carbolic Acid, with Bismuth, very effective 
(B). [See above, C. Infantum.] Lead, the Acetate, in early stages (R). 
Opium, gr. %-Yz Morphine, hypodermically ; very useful (B) ; Opium, gr. x /e, 
% y or }i, every 2, 4, or 6 hours in early stage (P). Calumba, as anti-emetic, 
of great value (P). Ipecacuanha, has been used with much advantage (Wa). 
Sumbul, said to have proved successful (P). Mustard, as an emetic in collapse, 
to stimulate a failing heart (P). Cajuput Oil, much used in India for choleraic 
affections (P). Alcohol. Iced brandy in small doses for vomiting (B). The 
value of stimulants justly doubted ; if given, should be largely diluted (Wa). 
[Compare Cholera Asiatica and Infantum, above.] 



Chordee. 

Aconite, gtt. j, of tinct. hourly, will relieve (R. P). Belladonna, combined 
with Camphor or Opium, gives the best results of remedies administered inter- 
nally (St). Camphor, Z] doses of the spirit will relieve (R). Cantharis, gtt. 
j of tinct. ter die, will prevent (R). Cannabis Indica or Cannabis Sativa (P). 
Lupulin, valuable (P) ; said to prevent (B). Morphine, hypodermically, the 
one sure remedy; should be injected into the perineum at bedtime (St). Co- 
caine, a few drops of a 4 per cent, solution, locally to the glans ; or injected 
into urethra, promptly relieves chordee. Diet, should be plain, even low, no 
stimulants ; copious draughts of barley-water, or linseed tea. 



Prescriptions. 



R. 



Liq. Morph. Magendie, . . g iv. 
Atropinae Sulphat., . . . gr. j. 

Acidi Acetici, q. s. 

Aquae Destillat., . . . ad %]. 
M. Sig. — TTLv-viij hypodermically at 
bedtime. (St.) 



R . Pulv. Opii, 

Pul. Camphorse, . . 

Sacch. Alb., .... 

Fiant capsulae xij. 

Sig. — One at bedtime, to be repeated in 

2 hours if required. (St.) 



gr. xij. 
gr. xxiv. 
q.s. 



Chorea. 

Exalgin, is held by many observers to have specific power over chorea, given 
in doses of gr. ij three times a day, gradually increased, if necessary, to gr. iij 
five times a day ; with Citrate of Iron and Quinine after meals (Dana). Anti- 
pyrin, is successfully employed. Cimicifuga, in cases due to menstrual de- 
rangement, is very useful (P) ; when rheumatic history (R) ; a very valuable 
remedy (P). Strychnine, in doses gradually increasing to toxic (Tr) ; 
minute doses (gr. -g 1 ^ to 4^) have been of much use when from fright or 
commencing puberty (B). Arsenic, large doses required, n^v ter die, when 
non-anaemic (B) ; very successful in uncomplicated cases (R). Zinc, the 
Sulphate, has similar action to Arsenic, but is inferior (B) ; in large and increas- 
ing doses it is very useful (R). Iron, large doses of the Subcarbonate in anae- 
mic cases, about the time of puberty (B). Chalybeate waters often relieve or 
cure. Arsenic generally better, unless anaemia coexists (R). Hyoscyamine, 
gr. 2tW ter die. gradually increased, has cured cases which resisted all other 
remedies (Da C). The mydriatics are very suitable in nervous, delicate 
children. Cuprum Ammoniatum has been used successfully (B). Veratrum 
Viride, has been employed (R). Cocculus, or Picrotoxin, large doses (P). 
Conium, in large doses, to quiet muscular agitation (B) ; is only palliative (R) ; 
evidence contradictory as to its value (P). Valerian, said to restrain the move- 
ments (R) ; useful when from worms (P). Chloral, contributes to a cure by 
inducing quiet sleep (R). Chloroform, inhalations, often of great service in 
severe cases (R). Morphine, with Chloral, hypodermically in large doses for 
severe cases Tr) ; when the movements prevent sleep (R). Physostigma, is 
recommended (R) ; of doubtful benefit (B). Musk, has been given (R). Cod- 



CHOROIDITIS CLIMACTERIC COCCYODYNIA. 



545 



liver Oil, in low nutrition (R). Water. Cold affusion to head and spine, and 
cold baths, important (B) ; not to be used if rheumatism, fever, or pain in joints. 
Tepid water first (R). Galvanism, the constant current, used by Benedict in 
twenty cases, all recovering. Galvanic chain around neck and down the back. 



Prescriptions. 



£. Tinct. Ferri Chloridi, . . gj. 

Liq. Acidi Arsenosi, . . . % ij. 

Syr. Limonis, ^ ss. 

Syr. Simplicis, 

Aquae, . . . . a.a q. s. ad £ iv. 
M. Sig. — Half a teaspoonful thrice 
daily, after meals, gradually increased, and 
effects carefully watched. 



R . Chloralis Hydrat, . . . . 3 iv. 
Tinct. Hyoscyami, . . . ]|j. 

Syr. Limonis, ^j. 

Aquae Cinnamomi, . . . . ^ iv. 
M. Sig. — A teasp. 3 or 4 times daily, 
according to age. 



Choroiditis. 

Mercury, as in iritis; cannot be borne to the same extent as in latter dis- 
ease (A). Opiates, necessary externally and internally to overcome pain (A). 
Treatment, is generally the same as in corresponding forms of iritis, but when 
atrophic spots appear on the choroid, no treatment can repair the damage 
(A). Rest of eyes and protection from light by blue glasses. In suppurative 
form (panophthalmitis) use Atropine, in strong solution, with ice compresses 
and leeches in early stage. Paracentesis repeatedly to relieve tension and 
give exit to pus. Canthoplasty of outer canthus to relieve the pressure of the 
lids (Roosa). 

Climacteric Disorders. 

Aconite, for nervous palpitations, and restlessness or " fidgets ; " gtt. j hourly 
(R). Cimicifuga, for distressing headache (R). Amyl Nitrite, in small doses 
when the " heats " predominate, followed by cold, clammy, pale skin (R). 
Ergot, for the flooding, gr. ij. of Squibb's extract, in fresh pill every hour until 
relieved. Cannabis Indica may be well combined with it. Cannabis Indica, 
is used in the headaches of the menopause with uniformly good results. [See 
Headache, for formula.] Nux Vomica, Opium, and Belladonna, when 
symptoms described under Iron are limited to head and face (R). Iron, for 
flutterings of the heart, with fullness of head, heat and weight on the vertex, 
frequent flushings, and hot and cold perspirations. Large doses of Sesqui- 
chloride ter die (R). Ammonia, Raspail's sedative lotion to painful part of 
head, in headaches (R). Potassium Bromide, for despondency, with sleep- 
lessness and irritability, often also with heats, flushings, perspirations (R). 
Physostigma, the extract, gr. -fa every ]/ 2 hour for 7 or 8 doses for flatulence 
and a sensation of fluttering at the pit of the stomach (Smith). Camphor, 
for drowsiness and headache. Eau-de-cologne saturated with Camphor rubbed 
to the head (R). Zinc Valerianate, hysterical symptoms (R). Change of air 
and scene, where other treatment only partially successful (R). Warm Bath, 
to promote free perspiration ; at 90 to 95 Fah. for an hour once a week, will 
obviate many of the symptoms (R). [Compare Metrorrhagia.] 



Coccyodynia. 

Chloroform, injected as deeply as possible about seat of greatest pain (B). 
Electricity, has cured one severe case of 12 years' standing, and helped others. 
Surgical treatment the only resource in rebellious and painful cases (Ros). 
Nott extirpated the coccyx ; Simpson performed subcutaneous section of mus- 
cles and ligaments. Goodell removes the bone, after first treating the case as 
a local expression of a general neurosis. 

35 



546 



COLDNESS COLIC. 



Coldness. 

Strychnine, for cold hands and feet (R). Cold Baths, with friction to the 
skin, nightly for cold feet (R). Spinal Ice-bag, is often efficiently employed 
in general coldness of the surface, and persistent coldness of the hands and 
feet (R). Cocaine or Atropine, will raise the body-temperature. (Seepage 43, 
ante.) 



Colic, Intestinal. 

Nux Vomica, quickly subdues abdominal cramps and spasms (P). Bella- 
donna, especially in children (R). Chamomile Oil, tt\, iv-vj, in colicky 
attacks of hysterical women (P). Cocculus, of great value, especially during 
pregnancy (P). Chloral, sometimes relieves (R). Chloroform, effective in 
flatulent colic ; also useful in hepatic and saturnine (B) ; often used combined 
with Opium (D). Potassium Bromide, in a peculiar form in young children 
(R) ; given in Anise-or Peppermint-water is of greater efficacy for the colic of 
infants than the opium preparations in general use, and perfectly safe (B). 
Asafcetida, no better remedy in flatulent colic of infants ; teasp. doses of the 
Emulsum Asafcetidae (B). Morphine, gr. )/%-% hypodermically, repeated in 15 
minutes, gives more relief than any other remedy, in all forms of colic (B) ; 
frequent small doses (R. P). Arsenic, will cure in a surprising manner when 
enteralgia is idiopathic (B). Essential Oils, especially those of Cloves and 
Cinnamon (R) ; of Anise, Cardamom, etc., Oil of Rue in flatulent colic of 
children (P). Magnesium, the Carbonate with Opium and Asafetida, as in 
Dewees's Carminative (see page 135), the dose being til xx for an infant of 2 
to 4 weeks old. Tobacco, as enema ; dangerous ! (B) ; as clyster, or by 
stomach (R). Ammonia, in spasm of intestinal canal and in colic of children 
or infants from bad feeding (R). Lime Water, for young children who eject 
milk in lumpy masses, with colic and flatulence (R). Water. Hot fomenta- 
tions to ease pain (R). A copious enema of warm water often gives imme- 
diate relief. 

Prescriptions. 



Ijl . Spiritus Chloroformi, 

Tinct. Cardamomi Co., . aa^ij. 
M. Sig. — Teasp. in water every y 2 
hour. (B.) 

&. Atropinae Sulph., . . . . gr. j. 

Zinci Sulphatis, gr. xxx. 

Aquae Destil., ^j. 

M. Sig. — 3 to 5 drops 2 or 3 times 
daily. (B.) 



R . Ext. Gentianae, 

Pulv. Rhei, aagj. 

Ft. pil. xx. Sig. — One or two thrice 
daily for tendency to colic. 



R ■ Pulv. Camphorae, 
Pulv. Capsici, 

Pulv. Zingiberis, . . . aa gr. ij. 
Ft. pil. xij. Sig. — One as required. 



Colic, Lead. 

Alum, singularly, is the best remedy (B) ; gr. x hourly (R) ; converts the 
poisonous salt of lead in the system into a comparatively innocuous sulphate ; 
3jss-ij daily with HLxl-1 Tinct. Opii, and an occasional dose of Castor or Croton 
Oil to procure one or two motions daily (Wa). Opium, gives more relief than 
any other remedy, gr. ^ to X of Morphine hypodermically (B) ; gr. ij— iv of 
Opium, with a moderate dose of Castor Oil (P). Sulphuric Acid, diluted well, 
as a prophylactic, and is useful in the treatment of the disease (B) ; considered 
remarkably efficient when used in association with repeated Sulphur baths 
(Wa). Calomel, a full dose, with or without Opium, followed in a fewhours|by 
Castor Oil and a Turpentine enema, often affords speedy and marked relief 
(Wa). Tobacco, may control, but is dangerous (B). Croton Oil, in half-drop 
doses, with sufficient Opium to relieve the pain, repeated every 3 or 4 hours 
until free evacuations are produced ; proves effectual when other remedies fail 



COLIC COMA — CONDYLOMATA. 



547 



(Wa). Magnesium Sulphate, for the constipation, and to remove the poison 
from the system ; should be combined with Potassium Iodide, 3j of the former 
given ter in die and about two hours after having given gr. v-x of the Iodide. 
This treatment dissolves the lead in the tissues, causes its elimination by the 
intestinal mucus, renders it insoluble after it has entered the intestinal canal, 
and quickly removes it from the body (Br). Atropine, gr. 3-^, with Potassium 
Iodide, gr. v, gives excellent results in the treatment of lead poisoning, the 
former relieving the colic and pain in the head in the most rapid manner, 
keeping the bowels open freely, assisting in the return of the bodily powers, 
and aiding in the removal of the lead by the Iodide (Humphreys). [Compare 
the treatment of Lead-poisoning in the Appendix.] 



Prescriptions. 



R. Aluminis, ^ij. 

Ac. Sulphurici Dil., . . . ^j. 

Syr. Limonis, ^j. 

Aquae, . . . Jiij. 

M. Sig. — Tablesp. every hour or two 
for colic. (B.) 



R. 



IJ. 



Magnesii Sulphatis, . 

Ac. Sulphurici Dil., . . . ^j. 

Aquge, ^iv. 

M. Sig. — Tablesp. every 3 hours (B) ; 
or thrice daily, each time preceded by a 5 
to io-grain dose of Potassium Iodide. (Br.) 



Colic,* Renal and Hepatic. 

Ether, inhaled in paroxysms of hepatic colic (R). Chloroform, inhalation in 
renal and biliary colic, inferior only to Morphine injection, superior to Opium, 
warm baths, etc. ; two or three administrations will be required (R). [See also 
Colic, Intestinal.] Counter-irritation, flying blisters for renal colic (R). 
Opium, small doses with Spt. Chloroformi every five or ten minutes until the 
pain gives way, or Morphine hypoderm (R). Turpentine, has been given with 
benefit in biliary colic (R). Dioscorea, is used successfully in so-called bilious 
colic, tt\,xv-xxx of the fluid extract. Water, warm baths to ease the pain (R). 
Aliment. Withhold all starches and fats. Alkaline mineral waters are useful 
(B). [Compare Calculi.] 

Coma. 

Blisters, in the comatose condition, large blisters or mustard poultices should 
be applied in quick succession to different parts of the body — chest, abdomen, 
thighs and calves ; often very valuable in the critical condition near the end of 
an acute illness (R). Cold Douche, for stupor of drunkenness or of opium 
poisoning ; may have to be repeated if relapses occur. It should be kept up 
for a long time if pulse and breathing improve, or no worse (R). Croton Oil, 
as purgative, tt\,X or }/$ every hour (R). Potassium Bitartrate, as purgative 
when blood is poisoned (R). Mustard, as poultice to the feet and ankles in 
the coma of narcotic poisoning (P). Exercise. In coma from poisoning the 
patient should be persistently walked about. [Compare Cerebral Conges- 
tion, Uremia, and the Treatment of Narcotic Poisoning, ante, page 316.] 



Condylomata. 

Nitric Acid, %] to Oj aquae, as wash, frequently used (R). Thuja, locally a 
strong iinct. with gtt. v in water, night and morning, internally, for warts with 
narrow base and pendulous body. Warts about anus or pudenda of either 
sex, whether syphilitic or not, often rapidly cured by Thuja (P) ; in non-syphi- 
litic warts of penis or vulva, I have employed it with satisfaction (Pf ). Mer- 
cury, Calomel dusted over, after washing with a solution of Chlorinated Soda 
(Ricord, R. B) ; the Nitrate locally, or a 20 per cent, oleate (R). Zinc, the 
Chloride, Iodide or Nitrate as local applications (R). Arsenic, Arsenous Acid 
as a caustic (R). Carbolic Acid, as a mild escharotic (B). Chromic Acid, gr. c 
to :|j aquae dest. ; a good local application (B). [Compare Syphilis, Warts.] 



54 8 



CONJUNCTIVITIS. 



Conjunctivitis, Catarrhal. 

Zinc, a weak solution of the sulphate or acetate as astringent collyrium (B) ; 
gr. j-ij ad 3 j aquae destil. as mild astringent lotion every few hours, with ice 
locally in the earlier stage (Roosa). Sodium Borate, gr. v ad ^j aquae dest. a 
good and mild astringent for ordinary cases. Boric Acid, gr. vj ad Jj each of 
aq. camph. and aq. destil., as collyrium (Fox). Boroglyceride, gss ad £j of 
aq. camph. and aq. dest. a very efficient application. (See ante, page 63.) 
Carbolic Acid, a 5 per cent, solution applied every two hours by spray of steam 
atomizer, which dilutes it one-half, an extremely efficient application, relieving 
the pain and contracting the vessels. Cocaine, the Hydrochlorate in 3 to 5 
per cent, solution or oleate, applied to the palpebral conjunctiva, is a very 
efficient palliative, especially where much pain and photophobia (Koller). Alum, 
Potassa Alum after acute symptoms subside (Br) ; gr. iij-v ad gij aq. destil. 
brushed over the conjunctiva twice daily. Pulsatilla, gj-ij of tinct. to !fiv 
aquas, as wash several times daily, also TT|J-x internally every 3 or 4 hours (P). 
Opium, the wine dropped into the eye relieves pain and improves the condition 
of the conjunctiva (R) ; Morphine, gr. j-ij ad %}, is often used in collyria with 
Zinc salts or Alum ; but is irritant. Mercury, Calomel dusted over the palpe- 
bral conjunctiva, in severe cases ; should be finely levigated and dusted from 
a camel's hair brush (B) ; the Oleate of Mercury and Morphine to the outside 
of the lids in palpebral conjunctivitis (R) ; the Red Oxide as ointment, gr. x 
ad gj Vaselin (Bader) ; the Yellow Oxide, gr. viij-x ad %j Vaselin (Seely). 
Cadmium, as collyrium, gr. ij of the sulphate to |jj aquae rosae (B). Tannin, 
in Glycerin, Z] ad ^j, every second day in chronic catarrhal conjunctivitis, 
presenting diffused injection of vessels with oedema (Hansell). Silver Nitrate, 
solutions of strength gr. j-iv ad ^j applied. by physician to conjunctiva (R) ; 
should not be given to patient ; Zinc and Copper salts are preferred (B). 
Copper, the Sulphate crystal in chronic cases where great swelling or hyper- 
trophy of the papillary layer ; is too irritating to be entrusted to the patient. 
Lead salts should never be used lest deposits occur in slight abrasions or ul- 
cerations of the cornea. Sulphates, of Zinc, Copper and Iron with Alum aa, 
gr. j to ^j of aq. destil. as collyria, extremely efficient ; in severe cases may 
be used in saturated solution by the physician (Holmes). Castor Oil, a drop 
placed in the eye often allays the pain and photophobia caused by an irritant 
(R). Belladonna, locally and internally (B). Atropine in strong solution, gr. 
iv to ^j, is one of the best local applications where mydriasis is not objection- 
able. Euphrasia, as a mild astringent (P). Blisters, behind the ears in bad 
cases (R). Ergot, the fluid extract locally gives excellent results in acute con- 
junctivitis (B). Staphisagria, especially in tarsal ophthalmia (P). Colchicum, 
when gouty diathesis (A). Spigelia, in rheumatic form (P). 



R. Zinci Sulphatis, 

Morphinse Sulph., . . aa . gr. j. 
Atropine Sulph., . . . . gr. ss 

Aqua? Rosa?, ^j. 

M. Sig. — Eye-water. 



Prescriptions : 

R . Hydrarg. Oxidi Rub., . . gr. x. 
Atrophias Sulph., . . . . gr. j. 

Vaselini, g). 

M. Sig. — A minute portion as an oint- 
ment for the eye. [Bader.) 



R. 



3J- 

3 u h 



Liq. Plumbi Subacetat. 

Aquae Destillatae, . . 
M. Sig. — For local use. To be brushed 
over conjunctiva of everted lids by the sur- 
geon and washed off with water. (Butter.) 



R. 



Ung. Hydrarg. Nitrat., . . gr. xx. 
Cocainae Hydrochlorat., . gr. v. 

Vaselini Albi, 3 ij. 

Use a fresh ointment, triturate thor- 
oughly, and label " Ointment for the eye." 



Conjunctivitis, Diphtheritic. 

Zinc Chloride, gr. ij-iv ad ^j, as collyrium, has succeeded admirably (Wa). 
Atropine, locally throughout the disease ; not very effectual (Roosa) ; is, for 
severe cases, powerless ; cornea sure to be attacked and liable to slough 



CONJUNCTIVITIS. 549 

(Noyes). Boric Acid, 4 per cent, solution, as antiseptic, the best application, 
with Quinine, internally in full doses (Noyes). Iron, the Pyrophosphate for 
children, 3j in ^iij of simple syrup, of which a teasp. thrice daily after meals, 
with Quinine in 1 to 3-grain doses thrice daily, and good food (Derby). Cold 
by compresses, as in purulent ophthalmia, in early stages. Silver Nitrate in 
solution locally, a 10 grain solution or the mitigated stick in the second stage. 
Tannin, gr. xx to the % of Glycerin, later on, applied every day, with hot water 
lotions if corneal complications. 



Conjunctivitis, Gonorrhceal. 

Zinc Chloride, gr. j-ij ad ^j aquae, as collyrium, used with marked benefit 
(Wa). Silver Nitrate, a 2-gr. to the % solution, after syringing out the eye with 
warm water, followed by ice compresses, in hope to abort the attack, if seen 
early (Roosa). Cold, by ice or wet compresses, essential in the early stages 
(C). Atropine, may be used from the beginning, as corneal complications begin 
very early. Treatment, generally the same as for Purulent Conjunctivitis. 
Isolation and cleanliness are of prime importance. 



Conjunctivitis, Granular. 

Silver Nitrate, the diluted stick applied lightly and quickly (C) ; strong solu- 
tions to granular lids, gr. xx ad %] cautiously when corneal ulcers exist (B) ; 
mild solutions better, gr. v ad ^j, daily in the papillary form ; in miliary 
trachoma it should not be stronger than gr. ij ad ^j (Noyes). Applications 
lose their effect after a time, and should be changed (Roosa). Copper Sulphate, 
the solid crystal lightly touched to the membrane once a day, the favorite 
astringent and caustic in all forms of trachoma (Roosa) ; when membrane 
torpid to other stimulation and when lymphoid substance is predominant ; as 
ointment gr. v-x ad ^j Vaselin, when for use by patient (Noyes). Alum, a 
smooth crystal is a useful daily application (Noyes). Tannin, gr. x-xxx ad 
Glycerini ^j, an application to change to from others (Roosa). Bismuth is one 
of the numerous applications in chronic conjunctivitis and granular lids (B). 
Phytolacca internally, is undoubtedly efficient in granular conjunctivitis (W). 
Jequirity, to excite substitutive inflammation. (See ante, page 57.) Atropine, 
gr. ij ad ^j aquse, thrice daily, is often advisable, where moderate irritation and 
haziness of the cornea (Noyes). Hygienic Measures, of great value. Protec- 
tion by blue or smoked glasses. Rest of eyes, best secured by using Atropine 
collyria. Hot or cold water as local bath frequently. Tobacco must be 
avoided, also all locations contaminated by impure air. Canthoplasty of outer 
commissure when lids press on globe. 



Conjunctivitis, Phlyctenular. • 

Mercury. Calomel finely levigated and dusted from a camel's-hair pencil 
over the membrane in phlyctenular ophthalmia, an excellent local application ; 
which should never be used when Iodine is being taken. In more obstinate 
cases a small bit of Pagenstecker's ointment, the size of a pin-head (Hydrarg. 
Ox. Flav. gr. j-iij, Vaselini 3j)> placed between the lids (Noyes). Ergot, the 
fluid extract, applied undiluted, gives excellent results in the phlyctenular oph- 
thalmia of children (B). Antimony. Tartar Emetic gr. ^ to ^ 3 or 4 times 
daily in strumous ophthalmia, with sharp purgation at the outset (R). Bella- 
donna, or Atropine, locally in strumous ophthalmia, of great service in relieving 
pain ; constitutional treatment also required ( Wa). Arsenic, invaluable in 
inveterate cases of strumous ophthalmia, especially when complicated with 
cutaneous eruptions (Wa). Tannin? finely powdered and dusted over the 
everted lid, gives remarkably good results in this and other forms of conjunc- 
tivitis, causing very little pain and no inflammatory reaction (B). Carbonic 



55o 



CONSTIPATION. 



Acid Gas, applied to the eye is said to relieve the pain and photophobia of 
strumous ophthalmia (R). Hydrastis, as lotion, is serviceable when Meibo- 
main follicles are implicated, causing adhesion of lids in the morning (P). 
Eserine, locally, to reduce the pupil and shut out the light (P). Iodine, is em- 
ployed locally in strumous ophthalmia, for its alterative stimulation (W). Zinc 
Chloride, gr. ij-iv ad ^j, as collyrium, has succeeded admirably in pustular 
ophthalmia (Wa). Zinc Sulphate, gr. j-iv ad 3J, is very serviceable ; the addi- 
tion of Liquor Plumbi improves its efficacy (Wa). Rhubarb, the Mistura Rhei 
et Sodse where much disturbance of digestion present. Tonics, may be given 
later, preparations of Cinchona and Iron. Cod-liver Oil, in strumous subjects, 
tends to remove the manifestations of the disease (R). 



Conjunctivitis, Purulent. 

Alum, gr. ij ad ^j aquas, a sufficient astringent application in ophthalmia 
neonatorum (Roosa) ; gr. viij ad !|j aquae, applied every % or % hour in the 
purulent ophthalmia of children, its success depending on the frequency of the 
application (R). Copper Sulphate, gr. j ad 3J aquae camph. as collyrium in 
purulent ophthalmia of infants (Wa). Silver Nitrate, gr. iij-x ad %) aquae destil., 
rarely so strong as gr. x, once daily applied by brush to everted lids in purulent 
ophthalmia of infants (Noyes) ; solution gr. j( ad 3J twice daily under lids 
(Meigs) ; by many considered needless and injurious (Roosa). Boric Acid, 
a 4 per cent, solution, as antiseptic, is all that is necessary in mild cases ; in 
others it is the proper fluid for cleansing the eye (Noyes). Atropine, when the 
cornea becomes invaded, and shows haziness, a solution gr. ij ad %j, must be 
instilled every 3 hours (R). Cold, by ice or wet compresses, essential in the 
early stages of acute purulent ophthalmia (C). Cleanliness, a matter of great 
importance. As the discharge is infectious the patient should be isolated and 
care taken to prevent inoculation of the other eye therewith. 



Prescriptions. 



R. Sodii Boratis, gr. xij. 

Zinci Sulphatis, gr. j. 

Aquae Camph., g]. 

Aquae Destillat., . . . . 5jj. 

M. Sig. — Apply to lids 2 or 3 times daily 

in oph. neonatorum, with solution of Silver 

Nitrate^ gr. ^ ad ^j injected under lids 

twice daily. [Meigs.) 



gr. iij. 



R. Sodii Boratis, .... 

Aquae Rosae, 

Aquae, aa ^j. 

M. Sig. — Apply beneath lids three or 
four times daily after cleansing. 



R 



. Atropinae Sulph., . . . . gr. j. 

Glycerini, £ss. Aquae, . . gij. 
M. Sig. — Two drops into the eye. 



Constipation. 

Nux Vomica, gtt. j-ij of tincture bis vel ter in die (R) ; gtt. v-x in a glass of 
cold water before breakfast and dinner, often overcomes the most obstinate 
constipation (P) ; especially useful when great fecal accumulations from torpor 
of bowel (B). Sulphur, gr. x with Confectio Sennas, often succeeds after other 
remedies fail (R). Sulphurous mineral waters (B) ; or Sulphates in purgative 
waters ; frequent small doses (R). Podophyllum, the most generally used 
cathartic when secretion deficient (B); gr. -^ to J night and morning when 
constipation with nervous and bilious headaches (P). Senna, as in the Pulvis 
Glycyrrhizae Compos., which may be taken in doses of a teasp. to a tablesp. 
as required, and kept up for months (Goodell). Mercury, Calomel or gray 
powder as a cathartic (R). Hydrastis, very valuable, when constipation refer- 
able to a sluggish liver (P). Magnesium, the Bicarbonate, a useful and mild 
aperient (R). Alum, a cheap and serviceable laxative (B). Aloes, in minute 
doses, in pill with Ferric Sulphate, as the official Pil. Aloes et Ferri, is one of 
the best agents in the management of chronic cases ; purgation should not be 



CONVALESCENCE. 



551 



aimed at. Ipecacuanha, gr. j every morning, fasting, when great torpor of 
bowel (R). Cocculus, flatus, hard lumpy motions (P). Turpentine, in purely 
atonic constipation, with gaseous distention of colon, has triumphed when all 
other remedies failed (P). Physostigma, very effective in intestinal torpor (B). 
Stillingia, Tr\,x of fluid extract in habitual constipation (B). Castor Oil, a mild 
efficient cathartic (B). Ammonium Chloride, in the so-called bilious state, with 
constipation (B). Arsenic, small doses (™Jj) of Fowler's solution often over- 
come constipation (R). Belladonna, gr. y z of the extract at night, in habitual 
constipation (B) ; gr. Ye- 1 /, once a day, especially when dyspepsia (R) ; acts 
directly on the bowel as a stimulant (P). Croton Oil, the most efficient ca- 
thartic, when simple impaction without inflammation ; gtt. j-ij (B) ; when 
evacution of blackened feces (R). Cascara Sagrada, the fluid extract in doses 
of 5j\ produces large, soft evacuations without griping, and leaves behind it a 
laxative influence. Frangula, in similar doses, is equally efficient, but if from 
a fresh bark may produce griping. Cathartics, especially Confectio Sennae, 
Pil. Rhei Compos., Pil. Aloes, the Comp. Cathartic Pill, as well as those above 
(B). Purgation as usually practiced denounced by the editor of the Lancet, 
October 1, 1870. Saline Waters, are useful (B) ; Pullna, Friedrichshall, or 
Hunyadi, the first two with milk, are good for children (R). Enemata, of soap- 
suds and salt, or a pint of cold water (B) ; or Turpentine, Castor Oil, aa gss to 
Oss-j of gruel (P) ; the habitual use of warm enemata increases torpor of the 
bowels (R). Tamar-Indien, a favorite mild aperient, is proprietary, and sup- 
posed to contain Cocculus, Glauber's salt, etc. Aliment, important in habitual 
constipation ; corn bread, cracked wheat, oatmeal, bread of unbolted flour, 
fruits, green corn, tomatoes, and celery ; % dozen each of almonds and raisins 
daily. A glass of cold water before breakfast may overcome habitual consti- 
pation (B). An orange or a smoke after breakfast (R). Tobacco habitues 
rarely suffer from constipation. [Compare Intestinal Obstruction.] 



R. Ext. Colocynth Co., . . . gr. xij. 
Ext. Belladonnse, . .• . . gr. ij. 

Ext. Gentianse, gr. vj. 

Olei Cari, gtt. iij. 

Ft. pil. vj. Sig. — One pill at bedtime. 
(Goodell.) 

R . Podopbylli Resinae. . . . gr. ij. 

Quininae Sulphatis, 

Ext. Aloes, aa gr. viij. 

Fellis Bovini, gr. xvj. 

Ft. pil. no. xvj. Sig. — One or two at 
bedtime. [Goodell.) 

R. Ext. Rhamn. Pursh. Fl., . |j. 

Ext. Belladonna Fl., . . gj. 

Tinct. Nucis Vom., . . . gij. 

Syrupi et Aquae, . . aa ad ^ iv. 
M. Sig. — Teasp. thrice daily in obsti- 
nate constipation. [Clarke.) 



Prescriptions. 



Castor Oil Emulsion. 



R 



. 01. Ricini, 

Glycerini, aa 3J- 

Tinct. Aurantii, rr^xx. 

Tinct. Senegae, rr\,v. 

Aq. Cinnamomi, . .q.s. ad ^ss. 
M. ft. emulsio. Sig. — One dose. 



Artificial Htmyadi Water. 

R. Magnesii Sulph., 
Sodii Sulph., . 
Potas. Sulph., . 
Sodii Bicarb., . 
Sodii Chloridi, 
Aquae, .... 
M. Sig. — A wineg 



. . . . gr. ij. 
. . . . gr. viij. 
.... gr.xx. 
q. s. ad ^ viij. 
before breakfast. 



Convalescence. 

Lime, as Lime-water, or the Carbonate, in convalescence from serious dis- 
ease (R). Quinine or Hydrastine, to promote digestion and appetite (B). 
Fats, especially Cod-liver Oil (R). Alcohol, before or during meals (R). Kou- 
miss, possesses great value (B). Bitters, especially Gentian and Calumba (B) ; 
the latter especially when stomach weak (R). Eucalyptus, a serviceable tonic 
(B). Coca, gss-ij of the fluid extract as a dose (B). Guarana, gr. xv-£j may 
be given (B). Opium, as Laudanum, injected per rectum, for insomnia of con- 
valescents (R). Sea-Baths, valuable in many cases (R). Diet, requires the 



552 



CONVULSIONS CORNEAL OPACITIES. 



most careful attention ; the prevalent error of giving food of difficult digestion 
too early must be guarded against, especially in intestinal and gastric disorders. 
The strictest moderation should be enjoined. The symptoms must be watched 
closely, and combated by appropriate medication. [Compare Adynamia for 
Tonic Prescriptions.] 

Convulsions. 

General Directions. — In all cases, horizontal posture, fresh air, loosen the 
clothing ; insert a plug of soft wood, or a cork, between the teeth, to prevent 
biting the tongue ; sprinkle the face and chest with cold water. Epileptic. — 
The general directions above will usually suffice. [See also Epilepsy.] Hys- 
terical. — The diagnostic peculiarities are : pupils not dilated, but are sensitive 
to light; no wounding of tongue ; face not livid; pulse usually normal. [See 
also Hysteria.] Infantile. — Administer some anti-spasmodic, as Ether, alone 
or combined with Musk or Belladonna ; then search for any mechanical cause, 
as a pin in a dress, etc. Lance gums if dentition the cause (A). [See Convul- 
sions, Infantile.] Solanum Carolinense, has a good reputation in the south- 
ern states for epilepsy and other convulsive affections, and has rendered 
excellent service in my hands (Napier) ; a tincture is prepared by bruising the 
berries and steeping them in whiskey, of which the dose is Z], repeated until 
drowsiness is produced. [Compare Epilepsy, Hysteria, Albuminuria, Puer- 
peral Convulsions, Uremia.] 



Convulsions, Infantile. 

Belladonna is of the highest value in certain congestive forms, as in fits due 
to the irritation of teething, or those referable to whooping cough (P). Ignatia, 
is efficient in convulsions of children from intestinal irritation, no cerebral con- 
gestion being present (P). Valerian, has been successfully used when from 
worms, to which parasites it is fatal (P). Potassium Bromide in all forms of 
convulsions in children (R) ; children bear it in large doses, gr. v thrice daily 
or oftener for a child a year old in convulsions from teething (Br). Chloral, 
in large doses, gr. v, by mouth or rectum (Br) ; best used as a suppository 
rather than by liquid injection, and often very useful (R) ; it gives better results 
than any other agent. Chloroform, inhalations of great service (R) ; useful in 
all forms (B) ; should be used to arrest the convulsion and prevent recurrence 
(Smith). Alcohol, has remarkable power in arresting convulsions of dentition ; 
small doses of wine or brandy (W). Asafetida, in the convulsions of teething, 
a small portion in enema, appears to mitigate them (Wa). Opium, efficient, 
but dangerous in young children. Veratrum Viride has been employed suc- 
cessfully (R). Amyl Nitrite, gtt. v with gr. ]^ of Morphine, used in one case 
as a last resort, after five hours' convulsions in a child of 18 months, which re- 
sulted in producing quiet sleep (Engel). Hot Baths, are important, with cold 
affusions or ice to the head (B). Spinal Ice-bag, may be very efficient (R). 



Prescriptions. 



B 



Chloralis Hydratis, ... gr. v. 

Lactis, !|j. 

M. Sig. — As rectal injection. Or the 
dose may be made into a suppository with 
cacao-butter and inserted well up into the 
rectum. 



R . Sodii Bromidi, 

Chloralis Hydratis, 

Sodii Bicarb., . . . . aa gr. viij. 

Aquse, %] 

M. Sig. — A teaspoonful every hour to 
a child under four months old. 



Corneal Opacities 

Cadmium, is said to promote their absorption ; gr. ij of the Sulphate to ^j of 
rose-water as collyrium (R. Wa). Mercury, Calomel by insufflation, or the red 
Iodide gr.ij, Cerate gr. xl, Olive Oil gtt. xx, as ointment, successfully used (Wa) ; 



CORNS COUGH. 



553 



weak solutions of the Bichloride, or ointments of the Oxides, gr. }{ ad §j, as 
remedies, among many others, to hasten their absorption in recent cases (Arlt). 
Oils, Eel-liver and Cod-liver Oils, Ox-gall, Juniper Oil, Oil of Turpentine com- 
bined with Olive Oil, and others, dropped into the eye once or twice daily for 
the same purpose (Arlt). Opium, the wine at first, then insufflations of Calomel 
and Red Precipitate or Yellow Oxide ointment, most frequently used by me in 
recent cases (Arlt). Potassium Iodide, as ointment with Potassium Carbonate 
after Cod-liver oil or Oil of Turpentine with Olive Oil, in cases of longer 
standing (Arlt). Silver Nitrate, gr. v-x ad ^j aquae, as lotion (C). Iodine, 
internally and as collyria, has been efficacious, especially in strumous cases 
(Wa). Sodium Chloride, gr. x ad 3J aquae destil., of which rr^v-x injected 
subconjunctival^, to hasten disappearance of turbidity (C). Operative Meas- 
ures, only in case of incrustations (as of lead and lime) situated superficially 
by removal of epithelium and anterior elastic layer ; deeper interference may 
lead to suppurative keratitis. Excision of opaque cornea and transplanting of 
one from an animal's or a recently enucleated human eye (keratoplasty), has 
always failed. Artificial pupil by iridectomy, for central opacities which are 
unremovable. Tattooing to relieve deformity of disfiguring leucomata (Arlt). 
Pannus and leucoma are best let alone (D). Stenopaic Spectacles, for semi- 
transparent opacities in pupillary region (Donders). [Compare Keratitis.] 



Corns. 

Salicylic Acid, in strong solution, removes excess of epidermis, warts and 
corns ; is the essential ingredient of all " corn-cures." Silver Nitrate, solid, 
after soaking and paring (Wa) ; the best application for soft corns, and very 
irritable ones (D). Acetic Acid, strong, to remove corns (Wa). Mercury, 
Corrosive Sublimate in alcoholic solution locally to remove corns (Wa). 
Iodine, gr. xl ad %] Alcoholis, locally (Wa). Poultices, are useful ; or a 
plaster of soft material with hole in centre (D). Water, hot and cold, alter- 
nately applied to inflamed corns. Keep a corn thin by frequent washing and 
paring. In performing the latter operation, the knife should work downward 
to the apex of the corn, so as to remove pressure from its centre. 



Prescription. 



R . Acidi Salicylici, . . . . gr. xv. 
Extr. Cannabis Ind., . . . gr. vijss. 

Alcoholis, 90 , rr^ xv. 

^Etheris, 62 TY^xxxvij. 

Collodii Flexilis, .... TT\lxxv. 



Mix, and keep in closely-corked vial. 
Paint the corn every other day for a week, 
then it can be easily squeezed out. 

( Vigier, ) 



Cough. 

Opium, in some form, is much used in cough-mixtures; Morphine and Gly- 
cerin to fauces (B) ; moderate doses only useful in irritative affections of the 
air-passages, to allay irritation and hypersecretion, but it may do even fatal 
mischief in cases where secretion is copious and expulsory power feeble (P) ; 
opiates inadmissible when with copious expectoration there is any indication 
of bronchial congestion (Wa) ; very useful in violent and frequent cough with 
little rhonchus and no signs of obstructed oxidation ; also, when cough is due 
to red, inflamed and ulcerated throat; Opium or Morphine given so as to 
cling for some time in contact with the pharyngeal structures (R). Codeine, 
is often efficient in cough (Br) ; of particular value in % gr. doses ; is slightly 
expectorant, also laxative, does not nauseate nor cause vomiting, nor affect the 
appetite ; is far the best agent for the cough of phthisis, when morphine is not 
well borne (Kobler). Nux Vomica, in laryngeal cough of neurotic origin, 
i-drop doses of the tincture every five minutes, is promptly efficient (Macfar- 
lan) ; has specific action on the pneumogastric, and is one of the most efficient 



554 cough. 

remedies in cough of any kind, whether from bronchitis, pneumonia, phthisis 
or emphysema, but especially in nervous coughs and periodic coughs which 
come on in evening and stay all night {Jour de Med.). Pulsatilla, as Ane- 
monine, % gr. and gr. doses, very useful in irritative cough, asthma, whoop- 
ing-cough (P). Iodine, by inhalation for children in hoarse, hollow cough, 
wheezing (R) ; the tincture, 5-10 drops, inhaled from boiling water, for five 
minutes at bedtime, often gives most signal relief in the irritating cough of 
phthisis. Apomorphine Hydrochlorate, very valuable in cough where a per- 
sistent hacking without expectoration, or with difficult expectoration ; the dose 
is only gr. -^ to -^ in the 24 hours ; solution rapidly alters unless a few drops 
of Hydrochloric Acid are added (Stocquardt). Terpin Hydrate, in bronchial 
cough, and night-cough from habit, is very efficient in a 2-grain dose at bed- 
time, repeated early in the morning (Boyland). [See under Bronchitis, 
Chronic, for formula.] Aconite, irritable, tickling throat- cough ; short, dry 
cough of asthmatics, with anxious look, full, strong pulse (P). Belladonna, 
often useful; no indications (R) ; internally and externally as plaster to the 
chest, very serviceable in spasmodic and nervous coughs (Wa). Hyoscyamus, 
very useful in spasmodic tickling night coughs (P). 

Hydrocyanic Acid, for nervous, irritable cough, and cough of phthisis and 
mother's sympathetic cough (B) ; no more certain palliative for simple, ner- 
vous cough due to irritable state of the system (S) ; a valuable adjunct to ordi- 
nary remedies in cough of phthisis (Wa). Potassium Cyanide, is equally 
useful, gr. iij with 3J each of Ext. Grindeliae Fl., Syr. Scillse and Syr. Tolutan., 
makes a good non-opiate cough mixture, of which the dose is 3j every 4 hours 
(Waugh). Prunus Virginiana, has some influence due to its Hydrocyanic 
Acid ; is much used in cough mixtures (P). Laurocerasus, used as a substi- 
tute for Hydrocyanic Acid in spasmodic coughs (B). Conium, supposed to be 
useful (R) ; is very useful in spasmodic cough (Wa). Ipecacuanha, the fld. 
extr. for troublesome night-cough (B) ; in obstinate winter-cough, with wheez- 
ing, the wine as spray to fauces, efficacious (R) ; in coughs of childhood Ipecac 
is one of the most generally serviceable expectorants we can use (Wa). 
Lobelia, dry cough, continued tickling sensation, even in sleep (P). San- 
guinaria, combined with Hyoscyamus, in nervous, spasmodic cough (P). 
Senega, as a stimulant expectorant in the cough of chronic bronchitis and 
subacute chest affections. Gelsemium, excessive irritability of the respiratory 
centre (R) ; often remarkably relieves convulsive or spasmodic, reflex, nervous 
coughs (B) ; Alum, internally in spasmodic cough ; gr. x to §j aquae as spray, 
in chronic cough also (R). Drosera Rotundifolia, the fluid extr. in }4 teasp. 
dose to an adult every 2 or 3 hours, of high value when spasm predominates. 
[See ante, page 225.] Potassium Bromide, serviceable in various reflex 
coughs (uterine, renal, etc.), and in cough of phthisis occasionally, it is ame- 
liorative as a gargle (B). Cubeb, 3ss-j of the tinct. in half-glass of Linseed 
tea thrice daily, often cures like a charm the coughs of chronic catarrh, of 
emphysema, or acute catarrh, or following an attack of influenza (R). Asafce- 
tida, Garrod ascribes its value to the sulphur in it (P) ; very serviceable in 
after-cough from habit, and in mother's sympathetic whooping-cough (B). 
Carbolic Acid, as spray, a 5 per cent, solution in a steam atomizer will often 
prevent as well as cure a cough from cold. Valerian, in asthmatical and hys- 
terical coughs (P). Chloroform, with Morphine and molasses in paroxysmal 
dry cough ; may be painted on throat also (R) ; in irritable reflex cough the 
vapor of a teaspoonful of the spirit may be inhaled from the surface of hot 
water and repeated every five minutes for four or five times (B). Chloral, in 
convulsive coughs, ameliorates symptoms after hypnotic effect (Wa). Cam- 
phor, equal parts of Camphor and Chloral triturated together are said to allay 
spasmodic cough when painted over larynx (B). Glycerite of Tannin, applied 
to throat when chronically inflamed and so producing cough ; often the case 
with children (R). Grindelia, used in cough of habit and spasmodic cough 
(B). Squill, in catarrhal cough, should not be employed until active inflam- 
mation has subsided (Wa) ; the syrup or vinegar of Squill is the best prepara- 
tion for cough with tickling in the throat (P). Cod-liver Oil, in chronic 



COXALGIA CROUP. 



555 



coughs (R. Wa), Lactucarium, the syrup as vehicle in cough-mixtures (B). 
Chamomile Oil, gtt. ij-viij, in coughs due to heightened reflex irritability, 
especially in hysterical women (P). Pix, Tar-water, in winter cough, espe- 
cially when paroxysmal (R) ; allays the cough of bronchitis and phthisis 
(P) ; the Plaster as rubefacient and counter-irritant in chronic coughs (Wa). 
The frequency and violence of nervous coughs may be controlled by a de- 
termined effort of the patient's will. [Compare Bronchitis, Pertussis, 
Phthisis.] 

Prescriptions for Cough Mixtures. 



For Adults. 
R. Spiritus Etheris Nitrosi, . . gij. 

Vini Ipecac, 3 ss. 

Tinct. Opii Deodorat., . . 7,). 
Syrupi Tolutani, .... ad %'\]. 
M. Sig. — A teaspoonful twice or thrice 
daily. (Powdilch.) 

R- . Liq. Magendie, 

Spt. Limonis, . . . . -aa^j. . 

Syr. Ipecac, 

Spt. Lavand. Cornp., . . aa giv. 

Syr. Scillae Comp., 

Syr. Tolutani, aa 3J. 

Syr. Pruni Virgin, . q. s. ad 5VJ. 
M. Sig. — A teasp. as required. 
Each dose has of Morph. Sulph. gr. ^V 



For Children. 
R. Mist. Glycyrrh. Co., . . . ifij. 
Syr. Pruni Virginian., 

Syr. Tolutan, aa^j. 

M. Sig. — Half teaspoonful 3 or 4 times 
daily for infants, teaspoonful doses at I to 
2 years, larger doses for older children. 

. ( Potter. ) 

R 



aa 3 ss. 



Tinct. Opii Deodorat., 

Vini Antimonii, . . 

Ext. Valerianae Fl., 

Syr. Simplicis, aa^ij. 

Aquae, %W" 

M. Sig. — A teaspoonful every hour or 
two until cough controlled. For those of 
4 years and upwards. [Meigs 6° Pepper.) 



Coxalgia. 
Barium Chloride, in considerable doses (gr. j-ij) persevered in for a month, 
thought to be a most valuable remedy in scrofulous diseases of joints (Wa). 
Sulphuric Acid, Z) ad ^j Adipis, as ointment, persevered in, has resulted in 
great benefit ; a powerful irritant (Wa). Counter-irritation, by blisters around 
the hip, with perfect rest in the straight posture, Cod-liver Oil, etc. (D). Ferrous 
Iodide, in scrofulous disease of the joints, with Cod-liver Oil and nutritious 
diet (Wa). Iodoform, very successfully used by many continental practitioners 
in scrofulous diseases of the joints (Wa). Cod-liver Oil, the remedy on which 
most reliance is to be placed (R). [Compare Abscess, Caries, Suppuration, 
Synovitis.] 

Croup, Catarrhal. 
Aconite, valuable (R. Wa) ; has been employed with the best results (P) ; 
from gtt. y 2 to j every half hour, until an impression is made on the fever 
movement, then every hour or two (B). Hot Water, applications beneath the 
chin and along the whole course of the larynx (Wa). Hot fomentations or 
turpentine stupe to throat (El) ; hot bath (95°-io2°) in the paroxysm, a good 
method (M & P). Potassium Bromide, locally, a solution by atomization has 
proved highly efficient in spasmodic croup (Wa). Lobelia, has been used with 
occasional success (P). Ipecacuanha, the syrup or fluid extract as an emetic 
at the outset (EI) ; is a slower emetic than Tartar Emetic (P) ; the syrup to 
vomiting during the paroxysm, and tt\,v-x every 2 or 3 hours next day (M & 
P). [Compare Laryngismus Stridulus.] 

Prescriptions, 



R. Potassii Citratis gj. 

Syr. Ipecac, gij. 

Tr. Opii Deodorat., .... gtt. xij. 

Syr. Simplicis, 5jij. 

Aquae, E) ss - 

M. Sig. — Teaspoonful every two hours 
at 2 years of age. In severe form of spas- 
modic laryngitis. [M. dV P.) 



R. Tinct. Belladon., gtt. iv. 

Tinct. Opii Camph., . . . gtt. 1. 

Pulv. Aluminis, gr. yj. 

Syr. Acaciae, % ss. 

Aquae, ,3J SS - 

M. Sig. — Teaspoonful every 2 or 3 
hours at 6 months old when cough fre- 
quent and harassing. (M. 6° P.) 



556 



CROUP CYANOSIS CYSTITIS. 



Croup, Membranous. 

Mercury, a remedy of established value, gr. ss-j of Calomel, with gr. y$-}4 
of Ipecac, according to age, every 2 hours, with local and other general meas- 
ures, especially the use of a hot (70°-75°) and moist atmosphere (Wa). The 
Sub-sulphate, given early, is the best emetic, gr. iij-v ; Calomel is strongly 
urged as a laryngeal sedative and aplastic agent, allaying laryngeal spasm and 
preventing formation of membrane (B). Alum, one of the best emetics in this 
disease, a teasp. in honey or syrup, repeated every ten or fifteen minutes until 
it operates (M & P) ; a very useful and non-depressant emetic (B). Sanguinaria, 
by many considered specific, is undoubtedly the best emetic for this disease 
(P) ; is too harsh and too uncertain in action (B). Tartar Emetic, as an 
emetic, has established value in croup (Wa) ; is injurious, too depressant (B). 
Potassium Chlorate, as alkali, after emetics, the most reliable internal remedy, 
gr. ij-iij every 2 hours to a child of 4 years (M & P). Ferric Chloride, may 
be combined with the preceding, in doses of 3-5 drops of the tincture, at the 
same age (M & P). Emetics, besides the above, are — Copper Sulphate, in 
small frequent doses (R) ; — Ipecacuanha, inferior to Mercury (B) ; in severe 
cases, vomiting should be caused 2 or 3 times a day, and should be commenced 
early (R), — Apomorphine, effective, but highly dangerous (B). Senega, is con- 
sidered a valuable auxiliary (P), has been employed (R). Quinine, in full doses 
is highly useful (B). Sulphurous Acid, as spray, hourly or more frequently 
(R). Tannin, a 5 per cent, spray, several times a day for 15 or 20 minutes 
(R). Hydrogen Dioxide, the solution 1 to 4 of water copiously sprayed over 
the nose, throat, mouth, etc., to destroy the membranes and prevent their 
reproduction ; then Glycozone, a teasp. in a winegl. of water thrice daily inter- 
nally, prevents any disturbance of the stomach and regulates the bowels 
(Edson). Lactic Acid, as solvent of membrane (B). Iodine, the tincture, ex- 
ternally, affords great relief, and tends to prevent formation of false mem- 
branes (Wa). Water. Warm bath, hot fomentations or compresses to throat. 
Watery vapor in room. Steam inhalations, with a few drops of Iodine or Bro- 
mine. Diet. Water only in small quantities during attack. Supporting diet 
maybe required afterward. Lime-water, by vaporization, or inhalations of the 
vapor of slaking lime for a few minutes in every hour, or some other alkaline 
solution during the whole treatment (M & P). Tracheotomy fully justifiable, 
2i}4 per cent, recovered, out of 1024 operations; should be done when par- 
oxysms become very frequent, and dyspnoea is rather persistent than par- 
oxysmal (M & P). [Compare Laryngitis, Diphtheria.] 



Prescriptions. 



Pulv. Sanguinariae, . . . gr. xx. 

Pulv. Ipecac, gr. v. 

Syr. Ipecac, . . . . . - !|ij. 



M. Sig. — A teasp. every 



hour until 



emesis, then y z teasp. every hour. (P.} 



rjt. Acidi Lactici, ^iijss. 

Aq. Destillat., . , . . . J x. 
M. Sig. — To be used as a spray, or ap- 
plied by a mop. 

[London Throat Hospital.) 



Cyanosis. 

Amyl Nitrite, by inhalation, often gives marked relief (P). Quebracho, in 
that from asthmatic attacks of consumptives, lessened the cyanosis or entirely 
relieved it (Rohrer). Leeching is of service, in a manner not easily understood 
(P). Treatment must depend on the nature of the lesion or disease giving rise 
to the cyanotic condition (A). 



Cystitis, Acute. 

Belladonna, is a good remedy in almost every form of vesical irritation (G) ; 
when the vesical mucous membrane is irritable (B) ; very useful in recent 
catarrh from chill, with pain (P). Cantharis, in large doses causes inflamma- 



CYSTITIS, CHRONIC. 



557 



tion of the urinary tract, but gtt. j of the tincture every hour will often relieve 
vesical catarrh (Smith) ; in small doses continued, very efficient (B) ; gtt. j-v 
of the tincture thrice daily, when bladder is irritable, its sphincter weak, and 
pain along the urethra (P) ; may be employed in cystitis with benefit (R) ; 
in small doses, the best remedy for acute cystitis. Aconite, for febrile symptoms 
(R. P). Quinine, often useful for acute symptoms (B). Iodoform, in supposi- 
tory for painful cystitis (R). Opium, a rectal injection of Starch and Laudanum 
will subdue pain and prevent the frequent micturition (R) ; Opium is dangerous 
if kidneys are diseased (P). Alkalies, the Citrates and Bicarbonates if urine 
is highly acid ; stop when it becomes alkaline (R). Liquor Potassse in barley- 
water or in a decoction of Triticum repens, prefened to all other alkalies; 
urine must be maintained at a neutral or very slightly acid reaction (Thomp- 
son). Cannabis Indica, an excellent anodyne in all bladder cases, having 
specific effect on that organ. Rest in horizontal posture, mucilaginous drinks, 
hot fomentations and hip-baths, from ioo° to no°, laxatives for the bowels, 
light food. Milk-diet often necessary, especially in children. [Compare 
Bladder Irritable, Calculus, Dysuria, Enuresis, Hematuria.1 



Prescriptions. 



R. 



g r -J- 

gtt. XX. 



Atropine Sulphatis, . . 
Acidi Acetici, .... 
Alcoholis, 

Aquae, aa ^ ss. 

M. big. — Four drops in a winegl. of 
water before each meal. (G.) 



R. Pulv. Opii, gr. xij. 

Camphorae, gr. xxx. 

Ext. Belladon., gr. iij. 

01. Theobrom., q. s. 

M. et div. in supposit. no vj. 
Sig. — One at bed-time. 



Cystitis, Chronic. 

Benzoic Acid, and the Benzoates, in chronic cystitis, from any cause, when 
urine is alkaline (B) ; has some balsamic character, and is useful in some cases 
of chronic cystitis ; gr, xxiv at least in the day, in pills made with Glycerin 
(Thompson). Sodii Benzoas, 3j in Tinct. Gelsemii ^ij-iij, and water to ^vj, 
makes an excellent wash for painful cystitis of old men with enlarged prostate ; 
a fluidounce should be warmed and injected, and retained 20 to 30 minutes 
(Copeland). Alkalies, when urine is acid ; the Liquor Potassse, with Hyoscya- 
mus as an anodyne, preferred notwithstanding its chemical incompatibility, to 
control painful and frequent micturition (Thompson) ; Bicarbonates or Citrates 
better, as the strong reaction of liq. potassae unfits it to be given in doses suf- 
ficiently large to affect in any great degree the reaction of the urine (R). 
Triticum, is very efficient as an internal remedy, ^ij-iv of the rhizome boiled in 
a quart of water until reduced to a pint, this strained to be taken in four doses 
in the 24 hours (Thompson) ; a very useful remedy (Pancoast). Buchu, is 
probably the most efficient of the urino-genital remedies, the fluid extract in 
doses of rr\,x-5j (B) ; the best drug in chronic cystitis, especially when the 
catarrh implicates the ureters or the kidneys themselves, producing consider- 
able muco-purulent discharge (P). Uva Ursi, is decidedly effective (P) ; is less 
so than Buchu (B). Stigmata Maydis, an infusion, ^ij ad Oj, wineglassful 
every 3 or 4 hours, has been used internally with considerable success (Des- 
sein). Pareira, considered superior to Uva Ursi (Brodie) ; often very successful 
(P). Chimaphila, is often very efficient, but is more actively diuretic than the 
preceding named remedies (B) ; by many practitioners it is considered the best 
remedy for chronic cystitis. Copaiba, is very useful by virtue of its local action 
on the mucous membrane, but objectionable forks nauseous taste and resulting 
gastric disturbance (B). Cubeb, is often useful from its stimulating effect (P). 
Turpentine, has been useful in many cases (R. P) ; when cystitis is due to 
urethral inflammation or prostatic disease (B). Juniper, the oil is indicated 
under the same conditions as is Turpentine (B). Eucalyptus, there is no more 
efficient remedy in chronic cystitis than this (B) ; the oxygenated oil of Merck 
is best in doses of 3 drops on sugar every 6 or 8 hours. Salicylic Acid, in large 



558 



CYSTS. 



doses, either internally or by injection into the bladder, is most efficient (B) ; 
the acid or Salicylates often useful to prevent decomposition (P). Salol, proves 
an efficient disinfectant, as its constituents are excreted with the urine ; solu- 
tions of 5 to 10 per cent, in Retinol, give gratifying results in subacute cases 
of obstinate character, where other agents were of no avail ; this solution 
remains in the bladder, in diminishing quantity of course, after 6 or 8 urina- 
tions (Desnos). Camphoric Acid, in ^ to 3 per cent, solution in hot water, as 
injection, has cured several cases. Carbolic Acid, and Sulpho-carbolates to 
preserve the urine sweet (R). Sulphites will accomplish the same object (B). 
Silver Nitrate, by intra-vesical injection, gr. j ad ^iv to begin with, increased 
gradually to gr. ^ ad gj at most (Thompson). Stronger solutions are advo- 
cated by Professor Richardson of New Orleans, and Professor Gardiner of 
McGill College, Montreal. In the writer's experience a solution of gr. v to the 
J used as a vesical wash, has been promptly efficient in curing many cases 
which resisted other treatment for months ; it sometimes produces serious 
symptoms, and it is therefore well to have a neutralizing solution of Sodium 
Chloride on hand for use if required. Other Injections, which may be used to 
wash out the bladder are — Lead Acetate, gr. j to ^iv of warm water, once 
daily ; Nitric Acid, dilute, wy-ij to the S5J °f water ; Tannic Acid, gr. j to gj ; 
Borax, !|j in jfij of Glycerin and Sjij of water, of which gss to ^iv of warm 
water for one injection ; Quinine, gr. j-ij to the £j of water, with a drop of 
Acetic Acid. All injections must be used with great care, not more than §ij 
forced in at once and that very slowly ; use flexible catheter, warm solutions, 
and a rubber injecting-bottle with a long nozzle and stop-cock (Thompson). 
Washing the bladder is of great value (R). Evacuation of the urine, some of 
which is often retained in the bladder, is a matter of great importance. Ergotin, 
hypodermically, increases the contractile power of the bladder, and enables 
it to empty itself more perfectly (Langenbeck). Pichi, the fluid extract, TTLxx to 
xxx four times daily, gave excellent results in bad cases of long standing, 
urine being alkaline, ammoniacal, ropy and purulent (Delamere). [Compare 
Bladder Irritable, Calculus, Dysuria, Enuresis, Hematuria.] 

Prescriptions. 



R . Uvae Ursi Fol. , 

Pareirae Radicis, . . . aa^j-ij. 
Sig. — Boil in 3 pints of water until re- 
duced to a quart, then strain, and take I or 
2 wineglassfuls 3 or 4 times daily. 

[Thompson.) 



R . Ext. Tritici Repentis Fluidi, 

Syr. Amygdala;, . . . . aa^ij. 
M. Sig. — A dessertsp. in water 5 or 6 
times daily. (Pancoast.) 



R. 01. Terebinth., gss. 

Camphorae, gr. xv. 

Extr. Hyoscyami, . . . . gr. ss. 
Fiat massa. Sig. — Take a piece the size 
of a cherry-stone morning and evening. 
[Chauvel.) 



R. Quininse Sulphatis, . . . gss. 

Acaciae, gij. 

Morphinae Sulphatis, . . . gr. jss. 

Aquae, q. s. ad Jiij. 

M. Sig. — A tablesp. to 3^ ounces of 
warm water, which inject in 3 parts, daily. 



R . Sodii Boratis, ^ j. 

Glycerini, 

Aquae, aa Jij- 

M. Sig. — Tablesp. in four ounces 
warm water as an injection. 



of 



R 



Argent! Nitratis, gr. vij. 

Aquae Destillat, 25 iijss. 

M . Sig. — Injection every third or fourth 
day after washing the bladder out with 
warm water. (Picord.) 



Cysts. 

Iodine, injection very effective in cysts of neck, and sometimes in unilocular 
ovarian cysts (B) ; ^x after tapping (R). Silver Nitrate, gtt. v-x of a strong 
solution (gr. xx ad gij), as injection into cystic tumors (wens), after allowing the 
contents to escape, will cure by setting up adhesive inflammation (B). Galvano- 



DEAFNESS DELIRIUM. 



559 



puncture, will permanently occlude cysts of neck (B). Aurum Chloride, may 
sometimes cure ovarian dropsy (B). Remedies, internally have all been proved 
worthless (E). 

Deafness. 

Quinine, cures some forms, and often causes deafness (Brown-Sequard). 
Glycerin, for dryness of meatus ; also to form a film to ruptured tympanum 
(R) ; either alone or in combination with Olive Oil (P) ; effects are temporary 
(Wa). Tannin, the glycerite as application for throat deafness (R. Wa). 
Gelsemium, the tincture, nrxv-xx, repeated 2 or 3 times a day, is often useful 
in the treatment of nervous deafness, and seems to have an influence on the 
organ of hearing similar to that of Nux Vomica on the organ of sight. 
Colchicum, when from gout in ear (A). Cantharides, as ointment; gr. xxx ad 
^j Adipis, below and behind the ear bis die, with alterative mercurial treatment, 
in deafness from thickened tympanum (Wa). Gargles, in throat-deafness, are 
of great value ; of Potassium Nitrate, Borax, etc., in sthenic cases ; tincture of 
Capsicum added in nervous forms ; of Hydrargyrum Bichloride, when from 
secondary syphilis (Wa). Water, washing in warm water, in deafness from 
general debility (Toynbee). Faradization, of the ear in nervous deafness, in 
which slight results only to be expected from the treatment (R) ; demands the 
utmost caution (Wa). Collodion, contractile, applied to the membrana tympani, 
in deafness from relaxation of the membrane, has exerted a permanently bene- 
ficial influence, even in cases of long standing (Wa). Turpentine, gtt. xl in 
^ss Glycerin, a few drops into the meatus in deafness depending on deficient 
secretion of cerumen, results in much benefit (Wa). Morphine, gr. ss sprinkled 
on surface behind the ear denuded by a small blister, has proved curative in 
chronic deafness, after all other remedies had failed (Wa). 



Delirium. 

Belladonna, in delirium of typhus and other fevers (R) ; severe forms of de- 
lirium (P). Hyoscyamus, in delirium of typhus ; mild, less inflammatory form, 
hallucinations, nervous excitement, little cerebral congestion (P). Stramo- 
nium, in wild and furious delirium of puerperal mania, with general restless- 
ness and suicidal or destructive tendency (Wa) ; no drug deserving of more 
confidence in the greater number of maniacal cases (Cullen). Opium, in 
traumatic delirium, as a rectal injection, combined with Tartar Emetic in fevers, 
or, better still, Morphine hypoder. ; Laudanum in low, muttering delirium (R) ; 
is regarded with suspicion (P). Cannabis Indica, the extract in doses of gr. 
%~Yz in nocturnal delirium occurring in softening of the brain (Wa). Potas- 
sium Bromide, in delirium resembling delirium tremens (R). Camphor Mono- 
bromide, useful in rambling delirium (Wa). Camphor, in 20-gr. doses, every 2 
or 3 hours, especially in low, muttering delirium (R). Chloral, in violent deli- 
rium of fevers (R). Antimony, delirium of fevers (R). [See Fevers.] 
Water, the cold douche in maniacal delirium ; place patient in warm bath 
during application (R). [Compare Cerebral Congestion, Fever, Mania.] 

Delirium Tremens. 

Chloral at outset (R) ; very successful, but dangerous to old drunkards or 
when heart disease exists (B) : the experience of inebriate asylum physicians 
does not bear out the teaching that chloral is dangerous to old alcoholic 
cases, it being by them commonly given in 30-grain doses every 3 or 4 hours 
until sleep is induced, without apparent danger. Belladonna, of proven effi- 
cacy when congestion of the brain (P) ; useful for the insomnia when coma 
vigil, cold surface, cyanosis (B). Stramonium can do all that Belladonna can 
do, and is more powerful (Tr). Hyoscyamus, in some forms admirable (P). 
Hyoscine, is a useful drug in delirium tremens, and in other affections in which 



560 



DEMENTIA PARALYTICA. 



tremor is a marked symptom (Weatherly). Opium, cautiously, if at all (B) : as 
rectal injection, hypodermically, or with spirits; if patient strong, delirium 
boisterous, and pulse full, add Tartar Emetic or Aconite (R). Bromides in the 
" horrors " preceding the delirium Z) every 4 to 6 hours ; are of less value in 
the delirium, and in subsequent attacks (B. R) ; Ammonium Bromide has been 
used with very good results (Wa). Chloroform, inhalations to procure sleep (R.) 
Anaesthetics dangerous (B). Cannabis Indica, gr. ss-j of extract, one of the 
least dangerous and most useful hypnotics (P). Tartar Emetic, as hypnotic 
(B); combined with Opium to control mania and insomnia (R). Capsicum, 
to induce sleep in early stages, gr. xx-xxx in a bolus with honey, repeated after 
three hours (R) ; in 20-30 gr. doses has remarkable success (P) ; the tincture in 
gss doses every three hours of great benefit ( Wa). Nux Vomica, or Strychnine, 
should be more freely used than it is in alcoholism, and in delirium tremens may 
be used hypodermically almost to the commencement of tetanic action (Luton). 
Arnica, the tincture is exceptionally serviceable in cases where there is depres- 
sion (B). Coffee, often exceedingly useful (P). Digitalis, £>ss of tinct. repeated 
in 4 to 6 hours (R) ; a tablesp. of the infusion every 4 hours in pale subjects, 
anaemia of brain, with effusion and oedema (B) ; has cured many cases promptly 
without producing any unfavorable symptoms. Its safety and efficacy are alike 
questionable (Wa). Cimicifuga, an excellent tonic for the nervous system, 
very successful (P). Quinine, with a mineral acid to restore digestion, in the 
" horrors," and in adynamic states (B) ; gr. j two or three times daily as a 
tonic, the best to produce nervous tranquillity (Anstie.) Sumbul, very efficient 
for insomnia (P). Zinc Phosphide, gr. jss daily, in divided doses, for many 
weeks, is used with decided benefit. Zinc Oxide, is of essential benefit as a 
nerve tonic and sedative, gr. ij-viij, twice daily, gradually increased to the 
higher dose named (Wa). Lupulin, the tinct. or oleo-resin, useful in mild 
cases as stomachic tonic and cerebral sedative (B). Ammonium Carbonate, 
when anaemia of brain and feeble heart-action (B). Conium, combined with 
Opium, useful (P). Alcohol, of undoubted use where failure of stomach to ap- 
propriate food (B) ; is best omitted entirely from the treatment, the experience 
in inebriate asylums showing that cases recover more rapidly and surely without 
alcohol. Water, about 6o° with ice to head, to reduce temperature in the 
hyperpyrexia (R). Treatment, should tend to nourishment, and establishing 
of digestion. Concentrated liquid nourishment, with moderate use of stimulants 
(H). Diet and Hygiene. The immediate source of danger is exhaustion, 
hence animalized and nutritious, digestible diet in fluid form, small quantities 
frequently repeated ; beef-tea, soups, yolk of eggs, warm milk, cocoa, cayenne 
pepper or stimulants in soups ; coffee, to still nervous excitement ; hot baths 
and wet pack to eliminate the poison. A quiet, darkroom, sleep a necessity, 
often induced by Belladonna. [Compare Alcoholism, also page 101, ante, 
for Treatment of Delirium Tremens.] 

Prescriptions. 



R . Tinct. Capsici, 

Ext. Lupulini Fl., . . aa j|j. 

Mucil. Acacise, ^ ss. 

Aquae Cinnamomi, . . . j^ jss. 
M. Sig. — Dessertsp. as required for the 
wakefulness and excitement which pre- 
cedes an attack. 



&. Chloralis Hydrat., . . . JJvj. 

Ext. Conii Fl., . . „. . . giij. 

Ext. Hyoscyami FL, . . . £iv. 

Mucil. Acacise, ,^ij. 

Aquse Menth. Virid., . ad Jij. 
M. Sig. — Teaspoonful in water after 
each meal. 



Dementia Paralytica. 

Physostigma, has seemed to retard the progress of the disease in some few 
cases (B). Paraldehyde, in one or two drachm doses as a calmative and hyp- 
notic, is as efficient as Chloral and without danger (B). Tonics, may be used, 
though treatment is only palliative ; Calcium Lacto-phosphate, Cod-liver Oil, 
etc. No remedies have hitherto been of any avail (B). 



DENGUE DENTITION DIABETES. 



561 



Dengue. 

Emetics and Purgatives are indicated at the outset, also free diaphoresis. 
Treatment is entirely symptomatic. Quinine, in five-grain doses every four 
or five hours for the fever (Da C) ; should be given more for its tonic than 
for its antiperiodic effects (Fayrer). Opium, in some form for the pains and 
nocturnal restlessness. Salicylic Acid or Salicylates for the pains in joints 
and muscles. Carbolic Acid, as lotion, a 5 per cent, solution, for the itching, 
or Camphorated Oil. Belladonna, confers great relief in this disease, rr^x-xv 
of the tincture may be given every hour for two or three doses (Fayrer). 
Aconite, with salines and Nitrous Ether, during the pyrexia, which may be so 
high that cold sponging or the cold bath may be required. Bitter Tonics, as 
Gentian or Calumba, with Quinine and a mineral acid or Strychnine during 
convalescence. 

Prescriptions. 



]&. Tinct. Colchici Sem., . . gij. 

Spt. ^Etheris Nitrosi, . . spv. 

Potassii Nitratis, . . . . gr. xl. 

Aquae, ad ^vj. 

M. Sig. — Tablespoonful well diluted 
every hour or two until profuse dia- 
phoresis occurs. For relief of the violent 
pains. 



Tinct. Aconiti, n\xvj. 

Morph. Acetatis, . . . . gr. ij. 

Spt. ^Etheris Nitrosi, . . 3 iv. 

Liq. Amnion. Acetat., . . %\\\. 

Aquas Camphors, . . ad Jiv. 
M. Sig. — Teasp. to dessertsp. according 
to age, every hour for three hours, then 
every two hours. 



Dentition. 

Belladonna, in convulsions of dentition, rarely fails to relieve (P). Hyoscy- 
amus, to alleviate pain and subdue irritation ; better than Opium for children 
(P). Chamomilla, try of the tincture every % hour, an excellent sedative for 
children (A. A. Smith). Potassium Bromide for irritability and convulsions in 
teething (R). Dulcamara, the infusion, in diarrhoea of dentition, quickly 
checks symptoms (P). Calumba, excellent for the accompanying vomiting and 
diarrhoea (P). Hypophosphites, of Calcium or Sodium, as a general tonic, are 
highly recommended (R). Rhubarb, with Soda, internally for the aphthae, with 
perfect cleanliness of the mouth and a wash of Borax or Potassium Chlorate 
in Glycerin, gr. x ad S£j (E. Smith). Castor Oil, for the diarrhoea of detention 
to clear out the bowels, then a mixture of Chalk and Catechu, or Zinc Oxide, 
gr. j to the dose, with gtt. j of Laudanum if required to reduce peristalsis (E. 
Smith). Lancing the Gums to relieve tension when gum is actually swollen ; 
should not be indulged in indiscriminately. 



R . Potassii Bromidi, . . 

Olei Anisi, . . . . 

Mucil. Acacise, 

Aq. Menth. Pip., . . 

M. Sig. — Teasp. every 

relieved. 



Prescriptions. 

R. 



Eh 



. aa 5 j. 
half-hour until 
(B.) 



Sodii Bromidi, 
Sodii Bicarbonat., 

Chloralis, aa gr. xx. 

Aq. Menth. Viridis, . . . ^jss. 

Syr. Zingiberis, 5SS. 

M. Sig. — Half-teasp. to desertsp., ac- 
cording to age. 



Diabetes Insipidus. 

Opium, large doses necessary, gr. vj-xij a day (B) ; combined with Gallic 
Acid, the most generally useful remedy (W). Ergot has cured many cases, the 
fluid extract in doses of gss-j thrice daily (Da C) ; one of the most efficient 
remedies (B) : is the most useful remedy (R). Iron and Strychnine are very 
useful for tonic effects (Da C). Valerian restrains the flow of urine but does 
not cure (B). Muscarine has been used with apparent success (R). Potassium 
Iodide is curative in many cases of syphilitic origin (B). Alum has produced 

36 



562 DIABETES MELLITUS. 

good results (B). Jaborandi, used successfully to reduce the quantity of urine 
(B). Valerian, large, increasing doses (R). Krameria lessens the quantity of 
urine (P). Diet, a dry diet beneficial (B). 



Prescriptions 

R. Extr. Ergotse Fl., . . . . giij. 

Sig. — Half-teasp. thrice daily, gradually 
increased to a dessertspoonful. 



R. Acidi Gallici, ^iij. 

Div. in chartulas xij. 
Sig. — One thrice daily. 



Diabetes Mellitus. 

Phosphoric Acid, largely diluted, assuages the inordinate thirst ; in one case 
it seemed to act as a curative agent (Wa). Arsenic, when from faulty assimi- 
lation, in diabetes of hepatic origin, and in thin subjects (B) ; the Bromide is 
credited with several cures. The Lithiated Arsenical Water, used in 70 cases 
with cure of 96 per cent. (Martineau). [See infra for formulae.] Morphine, is 
very efficient in reducing sugar when used by mouth, but is of no value when 
employed subcutaneously, even in the same case (Bruce). Opium in large 
doses (gr. vj -xij a day), ameliorative. Codeine, is especially serviceable (B) ; 
abates thirst and controls appetite (R) ; its value much disputed (P) ; is of 
great value in many cases (W) ; is one of the best remedies in doses of gr. %- 
y 2 (Da C). Jambul, has given favorable results after abandoning all the usual 
remedies (Lawrence) ; in 2 severe cases, in which 7 and 3 per cent, of glucose 
were excreted, the urine was brought back to normal by preparations of the 
bark, and kept so for two years (Vix) ; should be given after meals, in water 
or wine sweetened with Saccharin. Sodium Salicylate has cured when all 
other drugs have failed (R) ; gr. x-xv in compound spirit of Lavender, and 
water, thrice daily, is my favorite remedy (Da C). Ergot is one of the useful 
drugs (Da C) ; decreases the quantity of sugar and the volume of urine. 
Potassium Bromide, gr. xx ter die, cured two cases in six weeks (Begbie) ; use- 
less (Da C). Krameria lessens the quantity of urine (P). Phosphates, to avert 
failure of nutrition (B). Glycerin has produced good results (B) ; is used in 
place of sugar (W). Aurum. The Chloride is one of the promising remedies 
(B). The Bromide of Gold and Arsenic caused so much improvement in one 
case that he was accepted as a good risk by one of the foremost life insurance 
companies (E. A. Wood), Iodoform, in doses of gr. j-ij, rapidly reduced the 
sugar and caused its disappearance in 4 or 5 days, in five cases, without any 
change in diet being made (Moleschott) ; the amount of testimony for its value 
in this disease is quite considerable (B). Iodol, can be advantageously substi- 
tuted for Iodoform in all the diseases to which the latter is applicable (B). 

Oxygen, as oxygenated water, instead of carbonated, very successfully used 
(Le Blond). Uranium Nitrate, gr. i-iij, thrice daily has caused decided im- 
provement in several cases (Hughes). Alkalies are used on theoretical 
-grounds, but have not produced much benefit ; one case apparently cured by 
the diligent use of Ammonium Carbonate (B) ; are serviceable (Da C) ; alka- 
line mineral waters for diabetes of hepatic origin and in obese subjects, are 
extremely useful (B). Salines, a warm solution of the Phosphate and Chloride 
of Sodium, by intravenous injection, in diabetic coma, produced astonishing 
results in one case (B). Aloin, for the accompanying constipation (Da C). 
Nux Vomica, or Strychnine, is generally beneficial. Calcium Lactophosphate 
benefits the thin, nervous type of diabetic remarkably (B). Alkaline Waters, 
when of hepatic origin and in obese subjects. Tepid drinks in the intense 
thirst (B). Diet and Hygiene are of the utmost importance. Avoid amylaceous 
food, and everything containing sugar, especially ordinary bread ; use fresh, 
nutritious animal food, with bread of bran or almonds. Warm baths, warm 
climate, flannel underclothing. Peanuts, are an excellent article of food for 
diabetics, being rich in albumen, of which they contain 47 per cent., together 
with 19 per cent, of fat and non-nitrogenous extractive matters (Furbringer). 



I 



DIARRHCEA. 



563 



Milk-cure, by skimmed milk, very successful, 6 to 10 pints daily. No other 
food for six weeks, then animal food. Caution, — the urine of patients taking 
Salicylic Acid gives the reaction of sugar with Trommer'stest (R). Saccharin, 
as a substitute for sugar, does well for sweetening purposes, but is not a nutrient, 
and has no influence on the disease. 

Levulose, is a saccharine food which can be taken freely and without any 
injury by diabetic patients ; it most nearly approaches the ideal carbohydrate 
food indicated in diabetes (Hebra) ; it is assimilated well and nearly all oxid- 
ized by diabetics, who are able to parta^ke freely of it in comparatively large 
quantity (Ebstein). Sugar and sugar-forming food constitutes more than half 
of the nourishment needed by a healthy person, and it is the imperative duty 
of the physician to furnish a diabetic with a moderate amount thereof, to pre- 
vent death from inanition, and to lessen the danger of diabetic coma which is 
induced by a diet of meat alone (Leyden). Levulose, formerly very high in 
price, is now sold at a reasonable rate under the name Diabetin. 



Prescriptions. 



R. Liq. Potassii Arsenitis, . . gjss. 
Tinct. Opii Deodorat., . . 3 v. 
Syrupi Zingiberis, . . . . ,^j. 
Aquae Cinnamomi, q. s. . ad ^fiv. 
M. Sig. — Teasp. thrice daily. 



R . Lithii Carbonat., ..... gr. xl. 

Sodii Arsenat., gr. j. 

Ext. Gentianas, gr. xx. 

Ft. pil. no. xxv. Sig — One night and 
morning until sugar disappears from urine. 
More convenient than Martineau's liquid. 

( Vigier.) 



R- . Codeinae, 



M. 



gr. viij. 

J* 



Syrupi, et Aquae, 3 rj. 

. Sig. — Half teasp. thrice daily, grad- 
ually increased up to two teaspoonfuls. 

{Pavy.) 



R. Sodii Arsenat. , gr. iij. 

Aquae, Oj. 

A tablesp. of this with Lithii Carbonat. 
gr. iij, into a quart siphon filled with car- 
bonated water, which is to be taken freely, 
as daily beverage. (Martineau.) 



Diarrhoea. 

Aconite, when from chill, with high fever, cutting abdominal pains (P). Anti- 
pyrin, in doses of gr. ss to gr. jss, has rendered signal service in the diarrhoea 
of children. Mercury : Calomel for infantile diarrhoea (ileo-colitis), gr. -^ to -^ 
every half-hour (B) ; the Bichloride, gr. j in Jx aquae, a teasp. frequently, in 
acute or chronic diarrhoea of adults or children with slimy, bloody stools, pain 
and straining ; gr. l /e of gray powder hourly, or gr. -^q of Corrosive Sublimate 
every two or three hours (R) ; gr. j of the Bichloride to a quart of water, of this 
a teasp. every hour in mucous diarrhoea (Smith). Camphor, in summer diar- 
rhoea and the preliminary diarrhoea of Asiatic Cholera (B) ; when from effluvia 
of drains or exposure to cold (R) ; useful in many forms (P). Ipecacuanha, 
in summer diarrhoea and dysentery of children with greenish stools (B); 
hourly drop-doses of the wine especially if vomiting (R) ; when from nervous 
irritation, especially in young children (P). Dulcamara, in diarrhoea of children 
from damp, or with dentition (P). Pulsatilla, dyspeptic diarrhoea, mucous 
discharges, active piles (P). Quinine, in periodic diarrhoea, with dysentery 
and jaundice (B). Veratrum Album, in the vomiting and purging of summer 
diarrhoea (R). Podophyllum, in chronic, with high-colored motions and cutting 
pains, also, in morning diarrhoea (R) ; gr. ^ to ^, with occasional doses of 
Aconite, for vomiting and diarrhoea of gastro-enteritis and prolapse of rectum 
(P). Chamomile, an infusion in summer diarrhoea of adults, or in that of 
dentition (R) ; the Oil in diarrhoea of children, especially from worms (P). 
Arsenic, for evacuation of undigested food (B) ; gtt. j of Liq. Arsenicalis before 
meals when diarrhoea excited by food ; also in chronic and membranous forms 
(R). Nux Vomica, a very useful adjunct to other remedies (B) ; often of much 
service in epidemic diarrhoea (P). Sulphuric Acid, in summer and choleraic 
diarrhoea ; small doses in the chronic form and in the straining diarrhoea of 



564 



DIARRHGEA. 



children (R). Calcium Carbonate, in later stages, as Chalk-mixture in diarrhoea 
of typhoid or phthisis (R). Zinc Salts, very efficient in summer diarrhoea of 
children (B). Rhubarb, in early stages to get rid of irritant, afterward to check 
the diarrhoea (R) ; when torrefied it has no purgative power, but its astringency 
is retained. Rumex, in morning diarrhoea (R). Arnica checks exhausting 
diarrhoea with great certainty (P). Silver Nitrate, in diarrhoea of children, 
with white, pasty, and offensive stools ; combined with Opium the most effec- 
tive remedy for that of phthisis and typhoid (B). Mineral Acids, in painless, 
watery stools, light color and alkaline (B). Alkalies, Mistura Cretse in sour- 
smelling stools (B) ; Sodium, Potassium or Magnesium Bicarbonates when 
acid canal (R). Lead Acetate is excellent in all forms (B) ; with Opium as an 
injection (R). Bismuth Subnitrate, is effective, requires large doses ; gr. 
xxx-lx every 3 or 4 hours ; is especially indicated when desire for stool is felt 
immediately after eating (B) ; gr. j hourly with milk, sometimes with gr. l /e of 
gray powder, in various forms of infantile diarrhoea (R). Bismuth and Ammo- 
nium Citrate, in diarrhoea without irritation, but rather relaxation of the intes- 
tinal mucous membrane. Bismuth Salicylate, is highly praised in the diar- 
rhoea of phthisis and in that of typhoid. Salol, is very efficient in acute diar- 
rhoea due to action of microbes. Resorcin, gives very marked satisfaction in 
the diarrhoea of children. Opium, commonly used, but is best in watery 
evacuations, combined with mineral acids or Lead Acetate (B) ; as injection 
with Starch in severe cases (R). Calumba, when not inflammatory (B). Coto 
Bark, the fluid ext. or Cotoin, is one of the new remedies for atonic diarrhoea. 
Purgatives, Saline, a teasp. of Epsom salts (Magnes. Sulph.) in a wineglass of 
water every three hours when intestinal inflam'n (B). Copper Sulphate, the 
most effective astringent in chronic diarrhoea and that of phthisis (B). Ergot, 
in persistent, chronic diarrhoea (B). Iodine, one or two drops of tinct. in diar- 
rhoea from atony of mucous membrane (B). Tannic Acid, very useful in pro- 
fuse and chronic diarrhoea ; Stille advises Tannic Acid and milk diet for chronic 
diarrhoea and dysentery (B). Thymol, gr. xx to 3'\] in 24 hours in divided 
doses for adults, is a very efficient internal antiseptic in all cases of diarrhoea, 
especially that of phthisis, teething children, chronic diarrhoea, etc. (Martini). 
Carbolic Acid, very useful in fermentative diarrhoeas, especially combined with 
Bismuth in cholera nostras and cholera infantum (B). Diet. Cool or cold, 
light, bland food ; gruel, rice, arrowroot, whey, barley-water, in recent cases ; 
in chronic cases the most digestible but nutritious food, as fresh fish, game, 
raw eggs, rice, mucilaginous drinks ; milk and Lime-water or Soda-water 
very useful ; also raw meat pulp. Avoid beef, pork, veal, and much starchy 
food. [Compare Dysentery, Cholera.] 



Prescriptions. 



R 



Bismuthi Subnit., .... gj-ij. 

Pepsini Saccharat., . . . g ss. 

Zinci Oxidi, . . .... gr.vj-xij. 

Trit. et div. in chartulas xij. 
Sig. — One every four hours in summer 
diarrhoea of children. 



R- . Sodii Bromidi, 3 ss. 

Mucil. Acacise, 

Aquae Purae, . . aaq. s. ad ^ ij. 
M. Sig. — Teasp. every three hours in 
the diarrhoea of dentition, for child less than 
a year old. {A. A. Smilk.) 



U . Zinci Sulphatis, 
Pulv. Opii, 

Pulv. Ipecac, . . . . aa gr. xij. 
M. Fiant pil. no. xij. Sig. — One 3 or 
4 times daily in chronic diarrhoea of adults. 



R . Tinct. Opii Camph., 

Tinct. Catechu, .... aagiij. 

Mist. Cretae, %x. 

M. Sig. — A teasp. four or five times 
daily for children. 



R. Spt. Athens Co., 

Tinct. Opii Camph., . . aa^j. 

Syr. Simplicis, gij. 

M. Sig. — Dessertsp. after each move- 
ment. 



R- . Cupri Sulphat., gr. j. 

Morph. Sulphat., . . . . gr. ij. 

Quininae Sulph., . . . . gr. xxiv. 
Fiant pil. no. xij. Sig. — One pill thrice 
daily. 



DIPHTHERIA. 



565 



R. Tinct. Opii Deod., . . . . %]. 
Tinct. Calumbae, . . . ad Jij. 
M. Sig. — Teasp. in a winegl. of water 
before meals. 



R. Zinci Oxidi, .... 
Sodii Bicarb., .... 
M. et. div. in chartulas iv. 
Sig. — One every 6 hours. 



gr. xvij. 
gr. viij. 



R 



. Plumbi Acetat., gr. xx. 

Pulv. Opii, gr. x. 

Fiat massa, et, div. in pil. x. 
Sig. — One twice daily. 



S'J- 



R . Ac. Nitrici Diluti, . . 

Tinct. Camphorae, 

Tinct. Opii, aa t ^j. 

Syr. Zingiberis, giv. 

Aq. Menthae Pip., . ad Jvj. 

M. Sig. — Tablesp. doses to be used after 
a cathartic. {Hope's Mixture modified by 
Thompson.} 



R. 



Tinct. Opii Campb., 
Syr. Rhei Aromat., . .aa^ss 
Aquas Calcis, .... ad % ij. 
M. Sig. — A teasp. for children. 



Diphtheria. 

Mercury, the Corrosive Chloride, gr. -^"i every 2 or 3 hours, has given 
me most success, with Thymol or Boric Acid gargle ; and Potassium Chlorate, 
Iron and Quinine together, where the membrane is not spreading (Da C.) ; gr. 
jss in ^iv of Glycerin and water, of which 5j every }4 hour for 6 doses, then 
every hour night and day, to a child of 4 years (Grant-Bey) ; locally very effi- 
cient, gr. ij to Oj of water, applied on a cotton swab, which should be burned 
after one using; this hourly night and day (Oatman). Hydrargyrum Cyanide, 
in solution of gr. ^ to the ^, of which a teasp. every }i hour day and night 
to older children and adults, with a gargle of the same solution (Sellden) ; gr. 
• ff6 ~ 4V » according to age, every hour or two (Erichsen) ; gr. \ in ^iv of water, 
of which 3j to iv as per age every hour (Schultz) ; used by homoeopaths in 
Berlin almost entirely, sometimes alternated with Apis, but most efficacious 
alone ; table of 484 cases so treated, with 28 deaths. {Brit. Jour. Homoeop., 
1884, p. 382). Calomel is next in importance to Quinine and Iron, has proved 
successful in cases where other means failed, gr. y%-)i every 3 hours, with a 
little Dover's powder (Da C) ; checks plastic exudation, its use limited to chil- 
dren of good constitution, with sthenic symptoms ; gr. x / z to j every 2 or 3 
hours with or without Dover's powder (gr. j) or Ipecac (gr. j) till bowels be- 
come relaxed, with greenish stools (Wa) ; gr. v repeated boldly every hour to 
3'w, for a child of 3 years, until the stools appear like polyps in water-troughs, 
gelatinous, and of a bright, dark-green hue, — then a dose of Castor Oil if sali- 
vation is feared (Reiter) ; the safest and most efficient germicide with which we 
can saturate the system ; nothing like it in diphtheria, — gr. l /6- l A every hour, 
even gr. j every 2 hours has no bad effects, no salivation (Fowler). 

Belladonna, an excellent remedy ; if given early will abort the exudation and 
later is useful to sustain the heart (B) ; especially when throat and tonsils 
acutely inflamed and much swollen (R). Pilocarpine, used in 80 cases without 
a single death ; produces free salivary discharge but is depressant to the heart 
(Guttmann). Many opinions for and against it ; is decidedly injurious in ady- 
namic cases (B). Quinine, in tonic doses recommended from my experience 
(Da C) ; when headache with high temperature, vomiting, and symptoms of 
septic poisoning, then in full doses (Wa) ; is most useful after serious symptoms 
have abated, then with Iron and a mineral acid (Mackenzie). Arsenic, in 
medicinal doses for malignant cases, or when sloughing of Throat (R) ; the 
Iodide, in doses of gr. -^ every hour or so, (see under Throat, Sore), an ex- 
cellent remedy for the so-called diphtheritic sore throat. Calcium Chlorate, 
solution locally as lotion for the mouth ; considered almost specific by some ; 
its chief utility is in removing fetor ; may influence germs (R). Potassium 
Chlorate, grain-doses every % hour (Smith) ; is more largely used than any 
remedy, both internally and locally (B); in full doses with Liq. Cinchonas, 
seems to be of service in some cases (Wa). Carbolic Acid, as spray, a 5 per 
cent, solution in the atomizer cup ; locally to the fauces, to remove fetor and 
destroy disease-germs (B) ; the strong acid in Glycerin as caustic on a mop or 



566 DIPHTHERIA. 

brush (W) ; with Iodine internally to prevent systemic infection (B). Sodium 
Sulpho-carbolate, internally, has been found useful, in lieu of Carbolic Acid 
(Wa). Salicylic Acid, locally and internally (gr. x), has produced good re- 
sults (B). Sulphurous Acid, the gas, recommended by a royal commission in 
Victoria, as a means of arresting the disease ; crude sulphur burned in the 
room, all apertures being closed (R) : in full and frequent doses, causes rapid 
disappearance of the exudation, and improvement in the general condition ; 
3j every l / z hour to an adult in severe cases, in ordinary ones every two hours : 
an 8-ounce mixture should have 2 or 3 ounces of syrup, and should be given 
in milk to very young children (Snow). Sodium Sulphite, 3j to ^j aquae, 
locally, an easily managed application (B) ; an injection for nares in nasal 
diphtheria (Da C). [See formula below.] Sodium Hyposulphite, in solution 
of 3j to ^ij of water, of which hourly doses of £>j, to be retained in throat 
several minutes before being swallowed, an excellent local and constitutional 
remedy, which may also be used by a brush or spray to the throat, and by a 
syringe to the nares (Fruitnight). Sodium Benzoate, is highly efficient, 75 to 
100 grains daily, according to age, also used locally (B). 

Lime Water, dissolves false membrane ; the vapor of slacking lime inhaled ; 
or, better, Lime-water by atomizer to back of fauces while patient respires 
deeply (W). Ferric Chloride, as solution painted on or applied by spray to 
the throat (R) : of no advantage locally, internally may serve by supporting 
the organism (B) ; tinct. of the Chloride, gtt. xx every 2 or 3 hours ; or better 
the Perchloride, gr. y 2 to j every 2 hours in syrup and water, is easier to take 
and doesn't hurt the throat (Da C). Hydrogen Dioxide, the solution, as spray 
or gargle, is a very useful application, and may be diluted with 3 to 4 parts of 
water ; is much more powerful against young bacilli of diphtheria thanagainst 
those of two days' old cultures, and hence its therapeutic value is especially 
available at the very outset of the disease, and as a prophylactic during epi- 
demics thereof (Traugott) . Glycozone internally, a tablesp. in a winegl. of water 
every 3 hours, has an excellent effect (Edson). 

Tartaric Acid, locally converts membrane into a gelatinous mass, easily ex- 
pelled (Vrdal). Thymol, gr. xx to the jf of water, with a little Glycerin, is the 
best gargle ; may need weakening (Da C). Boracic Acid, in solution, is next 
best as gargle (Da C). Alum and Sulphur, equal parts, powdered and blown 
into the throat at moment of deep inspiration, as often as asphyxia is threatened, 
has been found efficient (Jones). Trypsin, is a good solvent of the false mem- 
brane ; of all remedies used with the, spray-atomizer, it has given me the 
largest percentage of recoveries (Fruitnight). Chinolin, a 5 per cent, solution 
painted over the affected parts with great advantage (Seifert) ; the tartrate in 
10-grain doses internally (B). Bromine, the vapor by inhalation, is useful 
(Wa) ; a yi^- solution in distilled water, of which gtt. j-iij every l / 2 hour in a 
teasp. of sweetened water, using a glass spoon ; and a saucer full of Bromine 
Water in the room, renewed every 12 hours, has seemed to be extremely effi- 
cient in a number of cases. Iodine as inhalation frequently [See formula 
below] ; with use the solution may be increased to §ss at each inhalation (R). 
Potassium Permanganate, gr. yi in distilled water, internally, and also used 
locally, is of undoubted benefit (B) ; is credited with brilliant results even in 
malignant cases. Sanguinaria, the best emetic, and by many is considered 
specific in this disease (P). [See formula below.] Lactic Acid, giijss to £x of 
distilled water, as gargle, on mop or by spray, to dissolve membrane (B). 
Tannin, a 5 per cent, solution as spray (R). Alcohol, is probably as good a 
local antiseptic as any ; diluted with equal parts of water, by hand-ball atomizer 
every y z hour ; is the prince of antiseptics, and the most perfect and reliable 
medicine in diphtheria of which we have any knowledge (Hills). Stimulation, 
freely, the essential part of the treatment ; infants are not injuriously affected 
by even teasp. doses of whiskey every x /z hour: stimulate for effect and not by 
dose ; those cases do best which are stimulated freely and early (Da C). There 
is more danger from giving too little alcohol than from too much ; a three- 
year-old child can comfortably take ^j-^v of Cognac, or gr. xv of Musk or 
Camphor, or gr. xv-gj of Ammonium Carbonate in 24 hours; in the septic 



DIPHTHERIA. 



567 



form especially, the intoxicating action of Alcohol is out of the question ; 
young children with general sepsis began to improve when their 3W of brandy 
were increased to ^xvj daily (Jacobi). Turpentine, Z] of the oil thrice daily, 
with rr\,iv of Spiritus ^Etheris as a corrective, at the same time using ice-bags, 
and a gargle of Potas. Chlorate solution, and internally J^-ounce doses every 
2 hours of a 2 per cent, solution of Sodium Salicylate (Roesse, Baruch). Tar 
and Turpentine vapor, made by burning in the room Coal-tar 7 parts to 01. 
Terebinth. 3 (Delthil). Methylene Blue, was used with success after losing 
cases by other treatment ; even in simple non-diphtheritic ulceration of the 
throat, patients would, after one or two applications of the solution, express 
themselves with delight as being cured (Rose). Chlorine-water, tablesp. doses 
internally and as a gargle, highly efficient. Cubeb, very efficient in the catar- 
rhal forms of diphtheria (Robinson) ; the freshly ground berries in large doses 
in early stages of the disease, a very successful treatment (Trideau). Water. 
Ice in the mouth, and the wet pack to the throat are extremely serviceable 
(B) ; Ice sucked, especially at commencement, and continued until the disease 
declines (R) ; Ice packed in bladders or thin india-rubber bags, to the throat 
(W). Aliment. Good foods, wines or brandy necessary from the start to main- 
tain the patient's strength (R) ; a teasp. of glycerin every 3 or 4 hours, plenty 
of good soup and wine, nutritive enemata, are necessary to sustain system. 
Moist inhalations. Temp, of room 68° Fah. Removal from the house wherein 
attacked is advisable. Ice very grateful to the patient. Tracheotomy, only in 
extremis (R) ; is not successful in diphtheria, though very much so in mem- 
branous croup (Da C). Intubation of the Larynx, as an alternative to trache- 
otomy, is enthusiastically advocated by many operators. Strychnine, hypoder- 
mically, for the subsequent paralyses (R). 



Prescriptions. 



R . Hydrarg. Chlor. Corros., . gr. jss. 

Glycerini, %]. 

Aquae Destillat., .... ^iij. 
M. Sig. — A teasp. every y 2 hour for 6 
doses, then every hour night and day to a 
child of four years. Also, — 
R . Ung. Iodoformi, I in ro, rubbed in 
over swollen glands every 3 hours. 

{Grant-Bey.) 



R . Thymol, . . 

Glycerini, . . 

Aquae, .... 

M. Sig. — Gargle. 



(Da Costa.) 



R. 



Pulv. Potass. Chlorat, . . gj. 

Ac. Hydrochlor., . . . . 5pj. 

Mix in a strong pint bottle, cork until 

effervescence ceases. Add f, xvj of Water, 

Jj at a time, shaking at each time. Cork 

tightly. Paint the bottle. 

Sig. — Chlorine-water. A tablesp. or two 
to be taken frequently, according to age. 



R . Potassii Chloratis, . . . . gr. xl. 
Syrupi Simplicis, (calid.) . ^ijss. 
Solve, et adde — 

Ac. Sulphurici Aromat., 
Tinct. Ferri Chloridi, . aa gj. 
M. Sig. — Teasp. doses for adults, every 
2 to 4 hours, reduced as improvement ad- 
vances, but kept up throughout disease. 



3J- 



R . Tinct. Ferri Chloridi, 
Syrupi Tolutani, 
Liq. Potassi Citratis, . aa 3 ijss. 
M. Sig.— Teasp. to dessertsp. accord- 
ing to age, every 3 hours, 3 j = TT^x of the 
tincture. (Anderson.) 

R . Hydrarg. Chlor. Corros., gr. j, maybe 
added to the above formula, which should 
then be given in teasp. doses. 



R 



Sodii Sulphit., .^"j- 

Glycerini, . . ■ ■ ■ . . Zij. 

Aquae, q.s. ad % iv. 

M. Sig. — Nasal injection. (Da Costa. 



•5J- 

5 s: 



R . Tinct. Ferri Chloridi, 
Potassii Chloratis, 
Misce et adde — 

Aquae, q.s. ad ^viij. 

Sig. — Gargle. [Jacobi.) 

For the chemistry of this combination 
see under Chlortjm, ante, page 190. Gly- 
cerin should not be added, as in Dr. Ja- 
cobi's original R , which makes a mixture 
which may explode. 



R. Ac. Tartarici, |j. 

Glycerini, .^j ss « 

Aquae Menth. Pip., . .adgiv. 
M. Sig.— Gargle frequently. (Vidal.) 



568 



DROPSY. 



Dropsy. 

Arsenic, in dropsy from feebleness of heart, and in old age (B) ; swelled 
feet from debility (R). Digitalis, one of the best remedies, esp. in renal dropsy 
from acute desquamative nephritis ; the infusion in doses of ^ss (B) ; the fresh 
infusion best for heart disease, esp. when tricuspid regurgitation (R) ; induces 
striking effects in cardiac dropsy, when scanty urine and venous engorgement ; 
has high rank as a diuretic (P). Apocynum Cannabinum, actively diuretic 
(P). Diuretin has been employed with marked benefit in both cardiac and 
renal dropsy, in hepatic cirrhosis, and in various diseases of the heart and 
kidneys accompanied by oedema : gr. xv several times daily, in aqueous solu- 
tion, avoiding acids or acid vegetable juices. Caffeine, the Citrate in 5-grain 
doses is eminently diuretic. Hydrargyrum, a classical pill in dropsy with 
dyspnoea from cardiac disease is the combination of Dr. Baillie, containing 
Mercury, Digitalis, and Squill. (See formula below.) Calomel in doses of gr. 
ss-ij is eminently diuretic, especially in cardiac dropsy ; but by many it is 
thought to act by aiding the action of other diuretics. Bryonia, as a drastic 
purgative and diuretic ; care necessary as it depresses the heart ; the infusion 
best (P). Hellebore, the tinct. in doses of gtt. v-xv, every 2 or 3 hours, very 
successful in dropsical effusions, especially in general anasarca after scarlatina 
(P). Senega, as a diuretic when dropsy is dependent on kidney disease ; has 
been praised (P). Chimaphila, is useful as a diuretic in renal dropsy esp. when 
with loss of appetite and debility (P) ; may be substituted for Scoparius (B). 
Juniper, largely used as a diuretic in cardiac and renal dropsy (B) ; esteemed 
in post-scarlatinal dropsy (R). Iron, purgative chalybeate waters (B) : the 
Liquor Ferri et Ammonii Acetatis (Basham's Mixture), in anaemic dropsy (Da 
C). Pilocarpus, very valuable in renal dropsy when secretion of urine is much 
reduced or suppressed (B). Jalap, the compound Jalap powder, gr. xv-xx, with 
giij of Potas. Bitart. and a little Ginger, early in the morning, 2 or 3 times a 
week; no hydragogue superior, in dropsy from Bright's disease (Wa). Tur- 
pentine, controls dropsy with albuminous urine, from non-desq. renal disease ; 
gtt. ss. every 2 to 4 hours (P). Colchicum, as a hydragogue in hepatic and 
cardiac dropsy when patient is vigorous, also in post-scarlatinal dropsy (B). 
Scoparius, esteemed by English physicians (B) ; is most useful in cardiac 
dropsy : Cullen found it the most certain diuretic. Diluents should be freely 
used with it (P). Squill, in cardiac dropsy ; cautiously if from kidney disease ; 
if anaemic add Iron (R). Taraxacum, is occasionally used as a diuretic, with 
limited utility (B). Copaiba, gives good results, especially in Ascites, which see 
for formula (B). Potassium Bitartrate and Acetate, are very certain as 
diuretics when largely diluted with water, as " Cream-of-tartar lemonade : 
Indicated in desquamative nephritis, and general dropsy from valvular disease 
of the heart (R). Elaterium, of unquestionable value as a derivative in many 
passive forms of dropsy ; though many fear it (P). Acupuncture, or better still, 
incisions from j( to an inch long, one over each external malleolus generally 
sufficient. A hot sponge, moist with weak Carbolic Acid solution kept to inci- 
sions (R). Aliment, dry diet is of advantage in dropsy of serous cavities (B) ; 
should be light in acute dropsies ; in chronic nourishing. Water not injurious 
but beneficial as drink. Warm baths, Hollands gin in small doses, tapping for 
alleviation in incurable cases. A moderately warm, dry atmosphere. Skim- 
milk diet said to be of great value in renal dropsy. [Compare Ascites, 
Hydrocele, Hydrocephalus, Hydrothorax, etc.] 



Prescriptions. 



Jjt . Vini Colchici Seminis, . . Jf ss. 

Liq. Ammonii Acetat., . . 3 ijss. 

Infusi Petroselini, . . . . J; v. 
M. Sig. — Teasp. every 4 hours. An 
excellent diuretic, esp. adapted to dropsy of 
scarlatina. (B.) 



£. Tinct. Digitalis, .... gj-ij. 

Tinct. Scillse, gij. 

Spt. Juniperi Comp., . . . ^iv-vj. 
Potassii Acetatis, . . . . 3 iv. 
ViniAlbi, . . . . q. s. ad ^vj. 
M. Sig. — A tablesp. 3 or 4 times daily. 



DUODENAL CATARRH DYSENTERY. 



569 



R. 


Elaterini, 


• • gr.j. 




Spt. Etheris Nitrosi, . 


. . gij. 




Tinct. Scillse, 






Tinct. Colchici, . . . 


aa ^ ss. 




Syr. Symplicis, . . . 


: • ii- 


M 


. Sig. — Teasp. 3 or 4 


times daily, in 


hepatic and cardiac dropsy : 


n sthenic sub- 


jects 






R. 


Pulv. Digitalis, . . . 


. . gr. j-jss. 




Pulv. Scillse, .... 


. . gr. j. 




Hydrarg. c. Creta vel 






Pil. Hydrargyri, . . 


. . gr. j-iij. 


Ft 


. pil. no. j. Sig. — One 


thrice daily. 



R . Pulv. Scillse, 

Pulv. Digitalis, . . . aa ^ss. 

Potassii Nitratis, . . . . gj. 
M. Fiat massa, et div. in pil. xxx. 
Sig. — One pill thrice daily. 



R . Potassii Acetatis, .... 3 vss. 
Spt. Etheris Nitrosi, . . . ^ij. 

Aquae, q.s. ad '% viij. 

M. Sig. — Tablesp. every 3 or 4 hours. 



R . Potassii Bitartrat., . . . ^ j. 

Ext. Taraxaci, 3 S s. 

Decocti Taraxaci, . . . . ^ viij. 
M. Sig. — y 2 winegl. twice or thrice 
daily. 

R. Aceti Scillse, ^ss. 

Infusi Digitalis, . . . ad J iv. 
M. Sig. — A tablesp. 2 or 3 times daily. 



R . Liq. Ferri et Ammonii Ace- 

tatis (U.S. P.), . . . gvj. 
Sig. — Dessertsp. or two three or four 
times daily. {BashanCs Mixt.) 



Duodenal Catarrh. 

Salol, is the most efficient remedy. Sodium Phosphate, Z) four times daily, 
extremely efficient in catarrhal conditions of the duodenum and bile-ducts, 
resulting in jaundice, hepatic colic, etc. (B). Vichy Water, in similar condi- 
tions, probably owes its efficacy to the Sodium Phosphate contained in it (B). 
Potassium Bichromate, in doses of gr. xVi, two or three times a day, is an 
excellent remedy in so-called duodenal dyspepsia, manifested by a bitter taste, 
coated tongue, pale stools, vomiting of glairy fluid and dull pain in right hy- 
pochondrium. Arsenic, has been used with success in jaundice from catarrh 
of bile-ducts after duodenal catarrh (B). Podophyllum, in catarrhal and 
malarial duodenitis. Nitro-muriatic Acid, internally in mucous duodenitis ; 
also as bath to right hypochondrium (giij to gall, j), temp, of bath 96 (B). 
Aliment. No starches or fats ; milk, eggs, oysters, beef-broth, broiled or raw 
beefsteak, white-fish (B). Diet should be exclusively animal, in order to let 
the stomach deal with it. [Compare Jaundice, Biliousness.] 



Dysentery. 

Mercury, in minute doses for the ileo-colitis of children ; gr. ^ to ^ of 
Calomel or Hydrargyrum cum Creta every half hour (B) ; gr. -^ of the Bi- 
chloride hourly or every 2 hours, in acute or chronic dysentery if stools are 
slimy or bloody (R). Ipecacuanha, is par excellence the remedy for acute 
dysentery of the ordinary type ; large doses ; gr. xxv-xxx (P) ; gr. xv in milk 
(B) ; valuable in acute or epidemic forms, also in summer dysentery of 
children, with greenish stools, mucus and blood, gr. ij-v every 2 hours, in milk 
(B) ; in dysenteric diarrhoea of children, especially with vomiting, which will 
often yield to hourly drop doses of Ipecac wine (R). Hamamelis, when the 
discharges contain much blood (R). Aconite, when fever and cutting pains 
(P). Nux Vomica, in epidemic dysentery (P) ; prune-juice stools, much gas, 
vital depression (B). Arsenic, Fowler's solution gtt. ij with gtt. v of Opium 
often benefits (B). Quinine, when periodic (B) ; in malarial subjects is as suc- 
cessful as Ipecacuanha in dysentery of the ordinary type (P). Gamboge, gr. 
% in 24 hours, exceedingly valuable, especially in young persons (P). Castor 
Oil, as a mild cathartic, is very valuable in appropriate cases (Wa) ; gtt. v 
every hour, in water with sugar and gum, is excellent for dysenteric diarrhoea 
of children (Smith). Bismuth Subnitrate, in doses of 15 to 20 grains every hour 
or so, is highly efficient ; may also be used in suspension with Starch or Chalk- 



570 



DYSENTERY. 



mixture, as a rectal injection. Arnica, is highly extolled for cases where the 
vital powers are depressed (Wa). Salol, is highly efficient. Saline Purgatives, 
Epsom salts the best treatment for acute dysentery, especially when fever, 
pain, tenesmus and stools of mucus and blood (B). Potassium Bitartrate, 
in acute dysentery with scorbutic symptoms, as seen in miners, sailors, etc. ; 
a full cathartic dose, 3SS or more, has acted most beneficially as a preliminary 
to other treatment, and in many cases has proven to be the only remedy 
required. Silver Nitrate, in pill. gr. X~j> w i tn Opium, in acute dysentery 
after subsidence of acute symptoms ; also as enema beyond the sigmoid flexure 
(gr. x-xx ad Oj aquae) ; also as escharotic through speculum to ulcer of rectum 
(B). Opium, as enema, with starch and milk, after canal is emptied by salines ; 
indispensable in chronic dysentery (B) ; for the purging (R) ; a remedy of 
great value, and applicable to every stage and every form of the disease, allaying 
pain and vascular excitement, moderating peristalsis, promoting the cutaneous 
secretion : is inferior to Ipecac in acute dysentery, and is most valuable in the 
chronic form (Wa). Glycerin, with infusion of Linseed (i to 4), to allay 
tenesmus (B). Lead Acetate, as enemata in acute and chronic dysentery, 
to allay tenesmus (B) ; with Ipecac and Opium in pill, for acute form. 
(Da C). Sulphuric Acid, with saline purgatives (B). Copper Sulphate, useful 
in acute dysentery ; in chronic the most valuable astringent (B) ; gr. x-xx ad 
Oj aquae (R). Ergot, in chronic, after acute ; and also in the acute form (R). 
Grape-cure, is used successfully in the chronic form (P). Iron Pernitrate, 
sometimes in chronic (army) dysentery (B). Calumba, is of great value in 
chronic, with ulceration of colon (P). Injections of mucilaginous enemata 
(as Linseed) are of great value (R). Diet is of prime importance (B). Avoid 
animal food and stimulants ; liquid foods best ; all cold (R). [Compare Diar- 
rhoea, Enteritis.] 



Prescriptions. 



R. 



Plumbi Acetat., gr. xxiv. 

Ipecacuanhas, gr. iij. 

Pulv. Opii, gr. iij. 

Fiant pil. no. xij. Sig. — One every 2 
hours until blood ceases, then at longer in- 
tervals. {Da Costa.) 



R 



Plumbi Acetat., gr. iv 

Morph. Acetat., . . . . gr. s; 

Aq. Fervid., ^j. 

M. Sig. — Enema to allay tenesmus 



R. 



Morphinas Sulph., . . 
Strychninae Sulph., . 
Ac. Sulphurici Dil., . 
Aquae Camphorae, . . 
M. Sig. — Teasp. well 



• • gr- ij. 
■ • gr. %. 
. . ;f ss. 
• ( • Ifiijss. 
diluted, every 



hour or two. In epidemic dysentery with 
prune-juice stools and marked depression. 



5c. Bismuthi Subnit., . . . gij. 

Spt. Ammon. Aromat., . . ^j. 

Tinct. Opii, git. xvj. 

Syrupi Simplicis, , . , . ^ ss. 

Misturae Cretae, ^j ss - 

M. Sig. — Dessertsp. to child over one 
year ; tablesp. or more to an adult, every 2 
or 3 hours, after emptying bowels by a 
laxative. 



R. Magnesii Sulph., .... ^viij. 
Ac. Sulphurici Dil., . . . # ^ss. 

Aquas, Jf viij. 

M. Sig. — Tablesp. in awinegl. of water 
every hour or two until it operates. (B.) 



R . Ergotini, gr. xx. 

Ext. Nucis Vom., . . . . gr. v. 

Ext. Opii, * gr. x. 

Fiant pil. no. xx. Sig. — One every 6 
hours. {King.) 



R- . Liq. Ferri Nitratis, 

Ac. Nitrici Dil., . . . . aa gss. 

Syr. Zingiberis, ^j. 

Aquas, q. s. ad % iij. 

M. Sig. — Teasp. thrice daily for a child 
of 2 years. Tonic to follow palliative 
treatment. {Starr.) 



R 



. Ext. Ergotas Fl., .... ^iijss. 

Tinct. Opii Deodor., . . . ^ ss. 
M. Sig. — Teasp. thrice daily. 

{Andrew.) 



R- . Ferri Sulphatis, gr. xl. 

Pulv. Opii, gr. xx. 

Fiant pil. no. xx. Sig. — One thrice 
daily, in chronic dysentery. 



DYSMENORRHEA. 



571 



Dysmenorrhcea. 

Pulsatilla, in the functional form ; is of much benefit when discharge is 
scanty or profuse, black and clotted ; should be persevered in for 2 months or 
more (P) ; gtt. ij every hour is most effective when the affection is not of mem- 
branous, obstructive, or neuralgic character (Smith). Hydrastinine, has been 
used with benefit. [See under Menorrhagia.] Chloralamid, in one dose of 
gr. xxx, to prevent an impending attack, has been of service. Belladonna, in 
neuralgic or spasmodic forms, dark and fetid discharge, crampy pains, and 
cold chills; a suppository or mild injection, together with internal administra- 
tion, will relieve (P) ; in neuralgic dysmenorrhcea it will permanently relieve 
(B). Aconite, a valuable remedy when commenced early (P) ; for the con- 
gestive form in plethoric subjects (B). Cimicifuga, relieves the pain in the con- 
gestive variety, and is decidedly useful (P) ; is said to be very efficient (R) ; is 
valuable (Wa). Opium, necessary when pain is very severe; one hypodermic 
of Morphine at each period is often sufficient (Wa). Codeine, when Morphine 
is not well borne, has given very complete satisfaction in several cases ; gr. % 
to x /z morning and evening (Oliver). Gelsemium, relieves pain in the neuralgic 
form, tr\,v-x of the fluid extract every 2 hours (B). Chloroform, as the liniment 
on a flannel wrung out of hot water, or by inhalation as anaesthetic when pains 
very severe ; sometimes exerts a permanent influence (Wa). Ergot, given 
when the molimen begins, is useful in the congestive form (B). Amyl Nitrite, 
may be inhaled with benefit in the neuralgic variety, especially in chlorotic 
girls (Wa). Sodium Borate, in the membranous form, has been used with great 
benefit combined with Ext. Belladonnas (Wa). Ammonium Acetate, has 
remarkable power over many forms of dysmenorrhcea ; the Liq. Ammonii 
Acetatis, in Jss doses, with gr. y^ of Ipecac, every 2 or 3 hours, to keep up the 
action of the skin until the flow is well established (E). Camphor, is my 
favorite remedy, gr. x in mucilage and Cinnamon-water ; repeat the dose in 
an hour or two if necessary (Dewees). Guaiacum, is very useful (P) ; drachm 
doses of the ammoniated tincture in the neuralgic or rheumatic forms (B). 
Caulophyllum, is by many considered the best curative remedy for spasmodic 
dysmenorrhcea, if given in the intervals. Viburnum Opulus, the fluid extract, 
in half-drachm doses, has considerable reputation in some sections for uterine 
pains of various kinds, and is useful in the spasmodic variety of this affection ; 
may be used in combination with Cannabis Indica (Thomas). Arsenic, gtt. 
iij-x of Fowler's sol. with gtt. x of Tinct. Digitalis, ter die between the periods, 
gives excellent results (Athill) ; indicated when copious membranous discharge 
from bowels and uterus (R). Cannabis Indica, is very useful as a palliative in 
painful menstruation (B) ; gr. ss-j thrice daily to relieve the pain (R). Nux 
Vomica, in neuralgic form. Syrup or Elixir of Iron, Quinine, and Strychnine 
(B). Apiol, neuralgic form (B) ; as emmenagogue, night and morning, for 
several days near the period (Wa). Electricity : in neuralgic, a galvanic cur- 
rent ; in congestive, inverse current (B). Croton-chloral, in neuralgic form 
(R). Iron, if depending on anaemia (B). [See Amenorrhgea for formula.] 
Cajuput Oil, said to relieve the pains (R). Rue and Sumbul, are reported use- 
ful (P). Emetic of Ipecac, with warm covering in bed, feet in hot water, hot 
ginger tea, Liquor Ammonii Acetatis. If pain very severe, a suppository of 
Morphine and Belladonna per rectum ; best to avoid anodynes (E). Acces- 
sories, spinal ice-bag, when scanty discharge ; when menorrhagic, hot water 
spinal-bag. Sitz-baths, either hot or cold, or cold alone, during intervals. 



Prescriptions. 



R. Ext. Cimicifugce Fl., . . . giv. 

Ext. Pulsatilla Fl., . . . 3Jss. 

Ext. EriodyctiiFl., . . . z,). 

Syr. Aurantii, . . . q. s. ad J iv. 
M. Sig. — One or two teasp. every 
hours to six doses. 



Be. Ext. Belladonnse, .... gr. iv. 

Ext. Stramonii, 

Ext. Hyoscyami, . . . aa gr. v. 

Quininas Sulphatis, . . . gr. xl. 
Fiant pil. no. xx. Sig.— One pill thrice 
daily. Neuralgic dysmenorrhcea. 



572 



DYSPEPSIA. 



R. Ext. Viburni Prunifol. Fl., gij. 
Ext. Senec. Aurei. . . . ^ij. 
Tinct. Guaiaci Volat., 
(Dewees.) See U. S. Disp., 

P- 1380, |xij. 

Sig. — A teasp. in new milk, thrice daily, 
between attacks, gj every hour during at- 
tack, and a hot sitz-bath. 

R. Ext. Ergotae Fluidi, . . . £vij. 

Tinct. Gelsemii, .... gj. 

Tinct. Aconiti, Tf^xvj. 

M. Sig. — Teasp. every 2, 3, or 4 hours. 
In congestive dysmenorrhea. 



R. Ext. Opii, . . . 
Ext. Cannabis Ind. 
Ext. Hyoscyami, 
Camphorae, . . . 
M. Fiant. pil. no. x. 

or three times daily. 



. . . gr. v. 

. . aa gr. x. 
. . . gr. xxv. 
Sig. — One pill 2 
(McLane.) 



R. 



Ext. Cannabis Ind. Fl., . . gjss. 
Ext. Viburni Op. Fl., . . gvj. 

Mucil. Acacise, ^iij. 

Aq. Cinnamomi, . . . ad %iv. 
M. Sig. — Dessertsp. every 4 to 6 hours. 



Dyspepsia. 

Pepsin, is very beneficial; Scheffer's or Beale's saccharated pepsin with 
diluted HO acid (B) : is especially adapted to gastric indigestion. Pancreatin, 
for intestinal indigestion. Liquor Pancreaticus to peptonize milk, gruel, soups, 
etc., before administration, in cases of great digestive debility. Papain (Papoid), 
acts equally well in gastric and intestinal indigestion, and hence is particularly 
indicated in cases of difficult diagnosis as to the location of the trouble ; is used 
in the various forms of dyspepsia and indigestion with most excellent results. 
Has marked proteolytic action in acid, alkaline and neutral solutions, and in 
the presence of many chemicals, antiseptics and therapeutic agents (Chittenden). 
Ingluvin, also promotes digestion (B). Pineapple Juice has the power of diges- 
ting proteids (Marcano) ; the fresh juice is a very constant and powerful diges- 
tant of albuminous matters, its ferment being decidedly active in the presence 
of either acids or alkaline carbonates, but most energetic in neutral solution, 
and between 122 and 140 F. (Chittenden). Mineral Acids. Hydrochloric 
or Lactic with Pepsin after meals in atonic dyspepsia ; Hydrochloric after meals 
for acid pyrosis ; Nitro-muriatic for dyspepsia with mental despondency, 
oxalates in urine, offensive gas, sallow complexion (R) ; Phosphoric, dilute, 
very efficient before meals (Da C). Sulphurous Acid, Tr^v-^j, well diluted, 
for acid pyrosis (B). Alkaline Mineral Waters, before meals in atonic dys- 
pepsia, and highly useful in the dyspepsia of obese subjects (B). Alkalies, 
shortly before a meal increase the gastric juice, and are usually better than 
acids in atonic dyspepsia ; Sodium Bicarbonate is the best (R) ; a full dose 
(gr. xl-lx) in dyspeptic attacks, with flatulence, etc., usually affords speedy relief 
(Wa.) 

Nux Vomica, gtt. v-x ter in die before meals as stomachic tonic (B) ; when 
flatulence, weight on head, and heartburn (R) ; often of the highest possible 
value in simple atonic form, or in the dyspepsia of drunkards (P). Arsenic, 
drop doses of Fowler's solution before meals in irritative dyspepsia (B) ; also 
when diarrhoea is excited by food (R). Bryonia, in dyspepsia of liver origin, 
"bilious" headache with vomiting (P). Charcoal, when flatulence; Nux 
Vomica in 5 tt\, doses before meals, better (R). Mercury, Gray powder, gr. j, 
3 or 4 times a day, when dyspepsia during chronic disease or convalescence. 
If constipated, Calomel, gr. ss, with extract Hyoscyami, gr. iij, in pill for 3 
nights (R). The Yellow Oxide, in doses of gr. ^-^V» f° r dyspepsia septica and 
kindred disorders of the alimentary canal ; remarkably efficient in Austrian 
navy (Schaffer). Ipecacuanha, ttlv-x of the wine most valuable in atonic and 
chronic catarrhal dyspepsia (P) ; constipation, depression, food " like a heavy 
weight " (R). Hydrastis, gtt. v-xv of the tincture before meals, a good stom- 
achic tonic (B) ; in chronic dyspepsia, sluggish liver (P). Pulsatilla, a good 
remedy when depression with fear of death, white-coated tongue, little or greasy 
taste, nausea, flatulency, heartburn ; gtt. v in water every 4 hours (P). Cin- 
chona, with mineral acids in atonic dyspepsia (P). Quinine, especially for 



DYSPEPSIA. 



573 



town-dwellers and elderly people ; checks excessive fermentation in aliment- 
ary canal (R. P). Chamomile, rr\jj of oil, very useful in atonic dyspepsia (P). 
Ignatia, useful in nervous dyspepsia (P). Taraxacum, certainly does good in 
simple atonic dyspepsia (P). Belladonna, gr. l /e to % of the extract, once a 
day when there is constipation (R). Bismuth, mixed with vegetable Charcoal 
in flatulent dyspepsia (R) ; gr. x with same quantity of Calcined Magnesia, in 
chronic gastric catarrh, where diet cannot be regulated (Rose). Manganese, 
gr. x-xv of the Black Oxide in gastrodynia and pyrosis (B). Sanguinaria, 
gtt. ij-v of tincture or gr. ■£% of alkaloid, in atonic dyspepsia promotes secretion 
and increases the appetite (B). Silver Oxide, ^-grain doses with same quan- 
tity of Ext. Hyoscyami before meals in nervous dyspepsia (B). Xanthoxylum, 
as stomachic tonic, Z] fl. ext.in atonic dyspepsia (B). Simple Bitters, Calumba 
best; Quassia or Gentian or infusions of them as vehicles for acids and alkalies 
(B) ; Calumba easily tolerated when stomach weak (R) ; Gentian as stomachic 
and tonic very useful in atonic dyspepsia, and that of gouty subjects; the 
tinct. in some aromatic water, or in combination with alkalies and sedatives 
(Wa). Rhamnus Purshiana, in all cases of dyspepsia associated with a torpid 
liver and constipation ; small doses at first, gradually increased (Wa) Salo- 
phen, is used with decided benefit in intestinal dyspepsia with flatulence. 
Strontium Bromide, is excellent in dyspepsia, also in acetic and lactic fermen- 
tations. Glycozone, is an excellent remedy for atonic and acid dyspepsias, in 
which it gives very gratifying results (Edson). Chloroform, gtt. xv-xx in 
sweetened water, when rapid fermentation of food and evolution of gas soon 
after eating ; is promptly efficient in giving relief (Willis). Aloes, combined 
with other agents, where habitual constipation accompanies dyspepsia (R) ; 
especially indicated in duodenal dyspepsia, gr. ij-iv with Ipecac gr. j-ij, two 
or three times a week (Wa). Water. A dry diet will entirely relieve the ice- 
water dyspepsia, or that due to excessive beer-drinking (B) ; half a tumbler of 
cold water % hour before breakfast acts to some people as a purgative and 
removes many dyspeptic symptoms, but flatulent dyspepsia is often traceable 
to excessive water drinking at meals, especially that of iced beverages (R). 
Hot "Water, % a pint to a pint at no°-i5o° F. an hour before each meal and y 2 
an hour before going to bed, each draught sipped slowly during 15-30 minutes. 
As a cure for dyspepsia this is an old and efficient practice (Wa). Milk-cure, 
has succeeded admirably (B) ; fresh Buttermilk a most excellent article for 
dyspeptics, as also is Kumyss. Alcohol, in any form, especially good wines, is 
useful in the atonic dyspepsia of sedentary livers (B) ; when loss of appetite 
and of digestive power from fatigue, a glass of wine or brandy-and-water be- 
fore eating is very appropriate ; useful also in indigestion of town dwellers, or 
during convalescence from acute disease (R). Diet. Avoid tea and hot bev- 
erages, over-cooked food, over-feeding and iced-water ; masticate all food 
well, eat slowly, small quantities and frequently. Active out-of-door habits 
should be cultivated, and all articles of food known to disagree should be 
strictly avoided. [Compare Acidity, Biliousness, Flatulence, Gastral- 
gia, Pyrosis.] 

Prescriptions. 



Be. Acidi Hydrochlor. Diluti, . ^jss. 
Glycerini, % ij. 

Syr. Rubi Idsei, ^j ss - 

Liq. Pepsini (Fairchild), . . ijiij. 

Spt. Chloroformi, % ss. 

Vini Albi vel Xerici, q. s. ad ^ xij. 
M. Sig. — A tablesp. thrice daily after 
meals. 

R. Pepsini (Jensen), Z'^ %s - 

Ac. Tartarici, gr. v. 

Glycerini, ojss. 

Vini Xerici, ad^vn]. 

M. Sig. — Teasp. or two after meals. 



R-. Tinct. Nucis Vom., .... giij. 
Ac. Hydrochlorici Dil., . . gv. 
Glycerini, jfij. 

Aquae Lauro-cerasi, . . . . ^§j. 
M. Sig. — Dessertsp. before meals, to 
improve appetite and digestion. 



J&. Bismuthi.Subnit., gjss. 

Pepsini, ^j. 

Strych. Sulph., gr. j. 

Tinct., Cardam. Co., q. s. ad ^iv. 
M. Sig. — Teasp., thrice daily in water. 
For bilious dyspepsia. 



574 



DYSPHAGIA DYSPNCEA. 



R. Ac. Hydrochlorici Dil., . . gj. 

Tinct. Capsici, 55. ss. 

Tinct. Calumbae, Jj ss - 

Vini Pepsini, . . . q. s. ad ^ iv. 
M. Sig. — Dessertsp. after meals. In 

atonic dyspepsia. (Pancoast.) 

R. Tinct. Capsici ttL x vj. 

Tinct. Nucis Vom., . . . . 3 ij. 

Tinct. Gentianae Co., . . ad ^ij. 

M. Sig. — A teasp. in water thrice daily, 

with gr. \ Aloin at bedtime, avoiding a 

starchy diet. For aggravated dyspepsia 

with constipation. [Da Costa.) 

r£ . Sodii Bicarb., gij. 

Spt. Ammon. Aromat., . . 3 ij. 

Tinct. Zingib., %). 

Infusi Gentianae Co., 

(U. S. P. 1870), q. s. ad %vi\). 
M. Sig. — Teasp. or two thrice daily. 
For acid dyspepsia. 



R. Creosoti, TT^viij . 

Bism. Subcarb., gij. 

Glycerini, 

Aq. Menth. Pip., . . . . aa^j. 
M. Sig. — To be well shaken. A teasp. 
every 3, 4 or 6 hours, for pain in stomach 
and wind. (B.) 



R . Rhei, Gentianae, et Carda- 

momi, contus., .... aa^ij. 

Spt. Vini Gallici, f ij. 

Aquae, ^vj. 

Macera per horas 48, cola, et adde — 
Tinct. Nucis Vom., . . . . £j. 
Potassii Carbon at , . . . . gj. 
M. Sig. — Tablesp. in water thrice daily, 
before meals. 



R. Tinct. Gentianae Co., . .. . !|ij. 
Sig. — Teasp. in water thrice daily. 



Dysphagia. 

Cocaine, the Hydrochlorate in solution, 20 per cent., as spray or by swab, re- 
lieves the dysphagia of phthisical laryngitis (P). Cajuput Oil, in nervous dys- 
phagia, used in India with considerable success (P). Potassium Bromide, for 
congenital dysphagia of liquids in children, when no diphtheria or malforma- 
tion (R) ; in hysterical dysphagia (Wa) ; benefits a curious affection sometimes 
seen in children, who from their birth can swallow solids with ease but choke at 
liquids (R). Sprays of Ammonium Bromide, Chlorine-water, or other sedative 
agents in warm solution, for the dysphagia depending on specific disease of the 
larynx (Muirhead). Galvanism, in the vicinity of the oesophagus will speedily 
remove hysterical dysphagia (Muirhead). Tonics, as Strychnine, Iron and 
Quinine, for post-diphtheritic dysphagia. Iced Fluids, slowly swallowed, will 
often remove spasmodic dysphagia (Wa). 



Dyspnoea. 

Morphine, hypodermically, the most efficient agent in relieving dyspnoea 
from cardiac disease, or any other form ; but if albumen in the urine it must be 
withheld (Allbutt) ; controls dyspnoea from any cause, more energetically than 
any other agent, giving the very power to breathe (Huchard). Grindelia, of 
great service in dyspnoea with cough, occurring in emphysema ( W). Cimicifuga, 
has often relieved most distressing cases from cardiac disease (P). Spigelia 
Anthelmia, produces and often relieves it when with palpitations (P). Valerian 
has proved useful when nervous (P). Prunus Virginiana, has proved very 
efficacious in cardiac dyspnoea (P). Amyl Nitrite, serviceable in cardiac 
dyspnoea and other forms (Wa). Asafcetida, in combination with other anti- 
spasmodics, often very beneficial in dyspnoea of chronic bronchitis (Wa). 
Chloroform, a few whiffs give temporary relief in the cough and dyspnoea of 
phthisis and bronchitis (Wa). Ethyl Iodide, by inhalation, is very serviceable 
in many forms (See). Terpin Hydrate, of especial value in asthmatic dyspnoea, 
gr. ij every % hour until gr. x are taken (Boyland). Terebene, for the dyspnoea 
of chronic emphysema of the lungs; efficient in combating this symptom of 
various pulmonary affections. Arsenic, for the dyspnoea of weak heart. 
Dyspnoea is a symptom, and may be referable to cardiac, pulmonary, pharyn- 



DYSURIA EAR ECCHYMOSIS ECTHYMA. 575 

geal, laryngeal or tracheal disease (T). [Compare Asthma, Bronchitis, 
Croup, Emphysema, Phthisis, etc.] 



Prescriptions. 



1£ . Potassii Iodidi, g j. 

Tinct. Lobelia?, 55 iv. 

Syr. Sanguinarire, . . . • %'}• 
M. Sig. — Teasp. every hour. 



R. Liq. Morph. (Magendie), . gj. 
Spt. Etheris Compos., . . '^ij. 
Syr. et Aquas, . . q. s. ad g ij. 

M. Sig. — 3 ss-j thrice daily. 



Dysuria. 

Cantharis, gtt. j (sometimes v) of tinct. ter die, for frequent micturition with 
pain (R) ; for irritable bladder, vesical tenesmus (B). Cannabis Indica, relieves 
dysuria (R) ; when bloody urine (P) ; an excellent anodyne in painful affections 
of the bladder, having specific action on that organ. Belladonna and Hyos- 
cyamus have similar sedative effects in vesical and urethral irritation (P). 
Linseed, as infusion, is often a valuable adjunct (P). Opium, in suppository, 
gr. ij combined with Hyoscyamus, gr. x, an excellent palliative (P) ; an enema 
of Laudanum or Morphine hypodermically to relieve the strangury caused 
by blisters (B). Camphor, is said to relieve strangury (R). Chimaphila, has 
undoubted power (P). Squill, often produces the best effects, especially a com- 
bination of the Acetum with Spt. ./Etheris Nitrosi, equal parts, of which 3ss in 
^ij of Anise-water, every hour or oftener (Wa). Gelsemium, a useful remedy 
(B). Ergot, in paralytic dysuria, with sensation of bladder being imperfectly 
emptied (P). Alkalies, the Citrates, when dysuria from uric acid crystals in 
young male children (R). Nitrous Ether, Spt. ./Etheris Nitrosi, 3j-jss in any 
convenient vehicle, a popular and efficacious remedy (Wa). Diluent Drinks, 
freely, especially a decoction of Uva Ursi, or of Cotton-root (P). [Compare 
Vesical Sedatives, Bladder Irritable, and Cystitis]. 

Ear Affections. 

Iodol, renders good service in eczema of the ear. In moist, confluent eczema 
of the pinna, extending within the auditory canal, the surfaces should be thor- 
oughly cleansed, and the powder insufflated into the canal. In dry, external 
eczema it is best applied in the form of a Lanolin ointment. The inflam'n 
disappears completely under this treatment, in about 2 weeks, but irrigation 
should be kept up for a short time afterwards to complete the cure (Chatel- 
lier). [Compare Boils, Otalgia, Otitis, Otorrhcea.] 

Ecchymosis. 

Arnica, rapidly disperses, if administered shortly after injury, rrrv-x in water 
every two or three hours (P). Alcohol, diluted more or less, according to the 
amount of irritation present, is a good lotion (P). Hamamelis, the tincture 
diluted with 5 to 8 parts of water, as lotion when much discoloration. Ammo- 
nium Chloride, in solution, as lotion on lint, or with bread or Linseed to form a 
poultice, in ecchymosis of the eyelids (Wa). [Compare Bruises, Purpura.] 

Ecthyma. 

Quinine, cures, though in many subjects will cause it (B) ; malnutrition (R). 
Lead, the Liquor Plumbi Subacet., 3j ad Oj aquae, a soothing application (Wa). 
Zinc Oxide, the Glycerite, with a little Camphor, an excellent application (Wa). 
Cod-liver Oil, internally and locally (B). Grape-cure, often happily modifies 
(P). Borax, a solution in Rose or Elder-flower Water (Wa). Chlorinated Lime, 
a solution as a lotion (Wilson). Chrysarobin, internally, half-grain doses, in 
water or pill, given with good results (Stocquart). 



576 ECTROPIUM ECZEMA. 

Ectropium and Entropium. 

Silver Nitrate, freely to the exposed surface, in ectropium of lower lid due to 
hypertrophy of conjunctiva after inflammation (C). Collodion, successfully 
used in entropium to restore position of the lid by its contraction. Should be 
concentrated (Wa). Faradization, in paralytic ectropium (C). Operative 
Measures, of great variety, are in use, Ark's being the best for bad cases in 
the upper lid (Roosa). Epilation of lashes gives temporary relief in entropium. 



Eczema. 

Aristol, is an excellent application. Mercury, as black and yellow wash in 
early vesicular and pustular conditions. Mercurial ointments are the most 
efficient of the local applications, especially those of White Precipitate, Nitrate, 
mild Chloride, and Black Oxide. Ointments of the Biniodide or Bichloride as 
irritating application in chronic indolent form (Pf). Brown Citrine Ointment 
nightly in eczema of the margin of the eyelids after detaching scales (B) ; very 
useful when eczema on hairy parts of face ; often is best mixed with a tar oint. 
(R). Arsenic, rr^v of Fowler's solution thrice daily on a full stomach, gradu- 
ally diminishing the dose for chronic type (B) ; especially in eczema of vulva, 
anus and scrotum (R) ; small doses for acute, full doses for chronic form ; the 
urine to be closely watched and the drug discontinued on the least sign of renal 
irritation (Pf). Sodium Arsenate, hypodermically into an eczematous patch, 
to change the indolent form into an active one (Pf ). Rhus Tox., externally and 
internally, when burning and itching, quickly subdues in some cases (P) ; in 
chronic form with rheumatism, worse at night-time ; also in acute cases if given 
at the very beginning, Kl^ho °f a good tincture enough dose to begin with (Pf). 
Phosphorus, of undoubted service in eczema of long standing, probably acts as 
a hepatic stimulant, gr. y^ to ■£% in oil, or reliable pill (Pf ). Viola Tricolor, 
an infusion the best form, with purgative doses of Senna for a few days, then 
alone, in eczema of the head and face ; gives prompt results (good or bad), often 
aggravating, which, though good in chronic forms, must be avoided in acute 
types (Pf ). Calcium Sulphide, gr. t ^q to ■£$ in acute and chronic cases of pus- 
tular character, the impetigo of old writers ; small doses in acute form, larger 
ones in chronic cases (Pf ). Sulphur, internally and Sulphides as baths, but 
not in the acute stage (R) ; solution of Potassium Sulphide in water locally (B). 
Liquor Potassae, or a stronger solution of Potash, to infiltrated patch of chronic 
eczema, before attempting to heal it (Pf ). Croton Tiglium, the seeds bruised 
in alcohol, as liniment (Wa) ; the Oil as basis of stimulating applications in the 
chronic form (Pf ). Glycerite of Tannin, locally (R). Potassium Iodide, is often 
efficient where a syphilitic history or inheritance can be traced. Salicylic Acid, 
locally, in eczema of hands and feet has been very successful (B) ; in plaster 
is of very great value, and becoming more recognized every day, especially by 
Unna, Pick, etc. The best form is a salicylated soap-plaster. [See formula 
below.] Salol, as an antiseptic powder, has done good service. Belladonna, 
gr. ]i of extract with gr. iij of Quinine Sulphate thrice daily in eczema of the 
hand, with Bismuth Subcarbonate as a dusting powder (B). Zinc Salts, the 
Oxide and Carbonate as dusting powder, or the Sulphate, etc., in astringent 
ointments (Bulkley). Buckwheat Flour, one of the best dressings ; a limb 
may be enveloped in a bag filled with the flour (Bulkley). Tar, internally, the 
Pix Liquida in doses of gr. ij-v thrice daily, when Arsenic fails to relieve or is 
contraindicated ; locally in third stage when redness, drying and scaling. 
Oleum Cadini, when genuine, is the best form of tar, mixed with simple oint- 
ment (3ss-j ad ^). 01. Rusci or Pix Liquida may be used (Pf ). Tar should 
never be used in the moist stage, but only after the acute inflammatory symp- 
toms have subsided, and then cautiously. A useful combination, and one less 
likely than tar ointments to cause irritation, is 01. Cadini, 3j-iij, 01. Amygd. 
Dulc, q. s. ad ^j, brushed lightly over the diseased surface. 

Conium, the tincture may be added to one of the ointments for the pruritus, 



ECZEMA. 



577 



which is usually very obstinate; so also Stramonium or crude Petroleum (Pf). 
Hamamelis, locally as antipruritic, and in chronic eczema marked by decided 
venous retardation (Pf). Benzoin, to allay itching, the compound tincture 
painted on the skin (R). Lead, soluble salts as lotions when much inflamma- 
tion and discharge (R) ; also in early vesicular and pustular conditions. 
Diachylon ointment comes next in efficiency to mercurial ointments (Pf). 
Zinc, the Oxide and Carbonate as dusting powders (R) ; the Sulphate with 
Alum, Glycerin, and Rose-water, an excellent lotion (B) ; the Oxide is not 
curative, but as a protective is the best ointment when freshly and well made, 
for use over a large surface (Pf ). Lime-water, as sedative application and to 
check discharge ; after inflammation is subdued, Lime-water and Glycerin (R). 
Carbolic Acid, externally and internally in chronic forms (B) ; is analogous to 
Tar, and suitable to the same types of the affection as the latter is given for 
(Pf ). Phytolacca has cured obstinate cases (B). Graphite, in ointment, I to 
10, or with some inert powder, as Lycopodium or precipitated Calcium Phos- 
phate, in fissured eczema, especially that of the hands and behind ears (Pf ). 
Bismuth, the Subnitrate or Subcarbonate locally (R) ; the Subgallate (Derma- 
tol), has proven very useful in the treatment of moist eczema. Ichthyol, a 
promptly efficient remedy. Thiol, may well replace Ichthyol ; the dry form as 
a dusting powder has been used with remarkable benefit. Anacardium Orien- 
tale (Oil of Cashew), as ointment in patches of indolent chronic eczema (Pf ). 
Iris Versicolor, in chronic eczema of gouty patients invaluable as a hepatic 
stimulant, tt^v-x of tincture from the fresh root twice daily (P). Glycerin, 
locally at night when caustic lotions have been used (R). Electricity has cured 
obstinate cases (B). Milk-cure, when acid indigestion present (B). Water, 
locally is injurious, unless its sp. gr. approaches that of the blood serum. Rose- 
water with a little Glycerin and Sodium Chloride when ablution necessary 
in second stage, that of exudation and crusting (Pf ). Soaps, Petroleum, Cade 
or Carbolic (R) ; Sapo Viridis, to soften up infiltrated patches of chronic form, 
instead of the potash solutions mentioned above (Pf ). Diet should be largely 
vegetable, especially those which are eaten raw ; Cod-liver oil as a supplemental 
article of diet. Chaulmoogra Oil, in old cases is often of great benefit, as an 
ointment. The Oil i part to 2 or more of Vaselin (Wa). Oil of Cajuput, put up 
by mistake of druggist for Oil of Cade, made a remarkable cure in a case 
which had resisted treatment for some time (Claiborne). 



Prescriptions. 



R. Violae Tricolor, . . . . . ^j. 

Sennae, ^ss. 

M. Fiant chartulae no. iv. 
Sig. — Make an infusion with hot water 
from each paper, and take every night. 

{Piffard.) 



R. 



M. 
daily. 



Vini Ferri Amari, .... ^jss. 
Syrupi Tolutani, . . . . giij. 
Liq. Potass. Arsenit., . . . gj. 

Aquae Anethi, ^ ij. 

Sig. — Teasp. to dessertsp. thrice 
[Wilson.) 



R. Ferri et Ammon. Citrat., . gj. 

Potassii Citratis, gij. 

Liq. Potassii Arsenit., . . gj-ij. 

Tinct. Nucis Vom., . . . gij. 

Tinct. Cinchon. Comp., ad jfiv. 
M. Sig. — Teasp. in water, after meals, 
as tonic and alterative. (Bulkley.) 

37 



R . Emplas. Diachyli Simplicis, 

Emplas. Saponat., . . . aa p. xl. 

Petrolati, p. xv. 

Acidi Salicylici, p. v. 

Sig. — Emplas. Salicyl. Compos. (Pick.) 



R . Picis Liquidae, 

Pulv. Sem. Anisi, . . . aa gijss. 

Magnesiae Calcin., . . . . q. s. 
M. Ft. pil. no. c. Sig. — Two to ten 
pills daily. (Miguet.) 

R . Ung. Zinci Oxidi, . . . . ^ ss. 

Ung. Plumbi Subacet., . . jfss. 

Chloralis, Camphorae, . aa gr. xv. 
M. Sig. — Use as oint. 2 or 3 times 
daily after bathing with warm water. For 
local use in general eczema. (Gross.) 



. Hydrarg. Ammoniat. 

Glyceriti Amyli, 
M. Ft. unguentum. 



(Muller) 



578 



EMACIATION EMISSIONS EMPHYSEMA. 



R . Olei Cadini, 

Zinci Oxidi, aa % ss-j. 

Ung. Aquae Rosae, . . . . %]. 
M. Sig. — Ointment, antipruritic and 
mildly astringent. {Bulkley.) 



U . Aluminis, gr. xx. 

Zinci Sulphat., gr. x. 

Glycerini, gj. 

Aquae Rosa;, ^ iv. 

M. Sig. — Lotion. (B. 



&. Liq. Plumbi Subacet., . . %]. 

Glycerini, ^ss. 

Aq. Laurocerasi, .... ^ijss. 
M. Sig. — Lotion, when there is much 
weeping. (B.) 



R . 01. Cadini, g ss. 

Glycerini, gj. 

Ung. Diachyli, ^ ijss. 

M. Ft. unguentum. In squamous ec- 
zema with thickened skin. [Fox.) 



Emaciation. 

Calcium Phosphate, is especially useful in chronic wasting disease (R). 
Arsenic, is used by cattle-breeders to fatten oxen, etc., quickly (Tr). Iodine, 
improves the appetite and digestion, and gives strength and plumpness to the 
body (Wa). Cinchona, in small doses improves the appetite, and the general 
tone (Wa). Iron Salts, cause marked gain in flesh and color (Wa) ; remark- 
ably promote the appetite and digestion (B). Cod-liver Oil, internally and ex- 
ternally with friction, often very effective in the mal-nutrition and marasmus of 
children (P). Olive Oil, by friction daily ; inunctions are of value in many 
wasting diseases (P). Pepsin, to promote digestion of food (P). [Compare 
Tabes Mesenterica.] 



Emissions and Erections. 

Belladonna, when emissions, genitalia relaxed, atonic state (B) ; in gradu- 
ally increasing doses produces good results, even in extreme cases of emis- 
sions (Wa). Camphor, fails as often as it succeeds (P). Potassium Bromide, 
exercises special influence as a sedative in irritable states of the genito-urinary 
organs (Wa). Cimicifuga, as tonic to the nervous system removes irritation 
and melancholy, procures sound and refreshing sleep (Wa, P). Lupulin, 
useful to check emissions (P) ; gr. v-x, or xv, to keep penis at rest (Wa). 
Ruta, in small doses to limit discharge (P). Chloral, at bed-time, repeated 
every night until the habit is broken off (Wa). Iron, the tincture of the Chlo- 
ride in 3 doses at bed-time, sometimes conquers nocturnal emissions (Wa). 
Cocaine, a few drops of a 4 per cent, solution upon the glans penis, promptly 
controls an erection. [Compare Anaphrodisiacs, page 48, also Chordee, 
Spermatorrhoea.] 

Emphysema of the Lungs. 

Morphine, gr. y&, and Atropine, gr. y^, hypodermically for the asthmatic 
attacks : no remedy so efficient ; the disease being incurable, treatment must 
be chiefly palliative (B). Potassium Iodide, in full doses alone, or combined 
with the Bromide, affords most relief next to Morphine (B). Strychnine, is 
a valuable respiratory stimulant ; useful where there is constant dyspnoea with 
prolonged expiration (Wa). Stramonium, the leaves smoked for the asthma 
and dyspnoea before retiring, will often give a good night's rest (Wa). Am- 
monium Iodide, with Arsenic, for the bronchitis, with Copaiba, Turpentine or 
Eucalyptol, continued for some time (B). Digitalis, or hydragogue cathartics 
as Pulvis Jalapae Comp. for the dropsy (Da C). Arsenic, when connected with 
recession of a rash is esp. useful (R) ; long-continued it ameliorates (B). 
Terebene, gives good results upon the dyspnoea. Lobelia, allays the dyspnoea 
which accompanies capillary bronchitis in emphysema (R). Senega, often 
acts beneficially (P). Cod-liver Oil, continued for a long time (R). Hypo- 
phosphites, are useful (B). Chalybeates, the Phosphate of Iron, Quinine and 



EMPYEMA ENDOCARDITIS — ENDOMETRITIS. 579 

Strychnine (B). Grindelia, for asthmatic breathing and bronchitis (13) ; of 
great service (Wa). Chloral, for the short breath of such patients brought' on 
by catching cold ; if obstructed circulation, caution required (R). Bleeding 
and Purging, have been used with great success in many emphysematous con- 
ditions (R). Compressed Air, the only scientific remedy- yet brought forward 
for this disease ; affords much relief which is sometimes permanent (B) ; the 
apparatus of Waldenberg is the best for this purpose. [Compare Asthma, 
Bronchitis, Dyspncea.J 

Prescriptions. 

R- . Potassii Iodidi, 3 iij. 

Strychnine Sulph., . . . gr. j. 
Liq. Potassii Arsenit., . . ^ijss. 
Aquae Laurocerasi, . ad ^ iv. 
M. Sig. — Teasp. 4 times daily. For 
relief of dyspnoea, toning the cardiac ac- 
tion, removing the bronchial catarrh, and 
preventing the progress of the affection. 

{Hughes?) 



R. Potassii Chlorat., .... zjss. 
Tinct. Belladon., .... 2jss. 
Ext. Pruni Virgin. Fluidi, 
Tinct. Cinchonse Comp., aa^ij. 
M. Sig. — A dessertsp. 4 times a day. 
Where chronic bronchitis and anorexia. 
Dry cups also to chest night and morning. 
{Da Costa.) 



Empyema. 

Carbolic Acid, a weak solution to be injected after evacuating the pus (R). 
Carbolate of Iodine, has been injected with benefit (B). Iodine, in solution to 
be injected after tapping (R) ; the undiluted tincture may be thrown in without 
risk and with great benefit ; or the compound solution %] to ^xv aquae, as wash 
for the cavity to prevent re-formation of pus (B). Chlorine-Water, or solution 
of Quinine, to wash out the cavity (R). Salicylic Acid, in solution, answers 
well for the same purpose (P). Ammonium Acetate. The official Liquor 
Ferii et Ammonii Acetatis, with Quinine and stimulants, if the affection shows 
a tendency to linger (Da C). 

Endocarditis. 

Aconite, should be given early in all inflammations of serous membranes 
(Wa) ; gtt. y 2 or less, frequently (R) ; it is rare to meet with permanent organic 
heart disease as a result of rheumatic fever when the disorder is treated with 
Aconite from its commencement (P). Spigelia Anthelmia, is very useful in 
rheumatic endocarditis (P). Opium, in inflammation of serous membranes 
(B). Digitalis, to control the circulation, especially where irregular heart 
action (Da C). Veratrum Viride, has been used with remarkable effect on the 
pulse (Wa). Alkalies, as Potassium or Ammonium Carbonate, freely until 
urine is alkaline, to prevent permanent changes about the valves or orifices 
(Da C). Potassium Iodide, to promote absorption of the exuded lymph. 
Quinine, at the onset, may check the inflammation (B). Salicylic Acid, is use- 
ful in the rheumatic form (P). Rest for some days after active signs have 
abated, with agents to lower the blood-pressure within the heart and vessels 
(Fothergill). Leeching, in the acute inflammation is to be recommended if 
done early, later is useless ; use cups if no leeches are at hand (Da C). 
Poultices, give great relief and are of decided benefit (Da C). Stimulants, 
as Ammonium Carbonate, etc., freely, if signs of oppressed circulation appear 
(Da C). Iron, the tincture of the Chloride with alkalies, if pyaemic symptoms 
are manifested (Da C). [Compare Pericarditis.] 



Endometritis. 

Carbolic Acid, undiluted, on cotton-wrapped probe; no better method of 
treating uterine catarrh (B). Iodine, the most valuable of all local remedies 
(E) ; Churchill's tincture (Iod. gr. 75, Pot. Iod. gr. 90, Alcohol 3jj), one of tne 



5 So 



ENEMATA. 



most useful applications to the endometrium (Munde). Iodine Phenol (Iod. j 
Ac. Carbol. iv), on cotton-wound probes, applied to the uterine cavity, has 
given the best results of any agent used for 8 years past (Battey). Chromic 
Acid, as caustic, when slough is required ; should only be used after dilatation 
of cervical canal, and at the patient's house (Munde) ; a solution of gr. xv to 
5 j of hot water applied with success to the uterine cavity for catarrh (Wooster). 
Nitric Acid, fuming, to uterine cavity through intra-uterine speculum (Atthill) ; 
is considered by many the one agent for all forms of intra-uterine medication. 
Is efficient and comparatively safe, but produces too much cicatricial tissue 
(Munde). Iodoform, as suppository in rectum (B) ; in pencils to uterine canal. 
Iodo-tannin, locally in chronic cases (B). Ergot, or better Ergotin, gr. j, sub- 
cutaneously, for the train of uterine disorders depending on passive congestion 
of the organ (P). [See Hysteria for formula.] Glycerin, as a local applica- 
tion introduced by Sims, is of great value ; esp. as vehicle for impure Carbolic 
Acid or Iodine, on cotton, or oakum (E). Hot Water injections in large 
quantity about the os uteri, are of great value (E) ; as usually made are of no 
value ; must be applied by special syringe, in the dorsal recumbent posture 
with elevated hips, at a temperature of ioo° to 120 F. twice daily for at least 20 
minutes each time, and persevered in for months and years (Munde). [Com- 
pare Uterine Congestion and Hypertrophy.] 



Prescriptions. 



Ri . Potassii Iodidi, 

Potassii Bromidi, . . . aa gr. xx. 

Tinct. Iodi, 3 ss. 

Aquas, £ij. 

M. For hypodermic injection into cer- 
vix, in chronic cervical metritis. 

(Bennett.) 



R • Ergotini, , gr. xx. 

Tinct. Iodi, %]. 

Glycerini, . . . q. s. ad Jj. 
M. Sig. — Apply twice daily with cam- 
el's-hair brush, in cervical metritis. 

(Dabney.) 



Enemata. 

Enemata, for an infant, ^ss-j ; child 2 to 5 years, ^ij-vj ; 5 to 15 years, 
^vj-Oj ; adult, Oj-quart j. A simple domestic enema consists of soapsuds with 
a little common salt, or a pint of cold water (B). Simple warm water or gruel 
sometimes ; or, to one or the other of these add Soap, Turpentine or Castor 
Oil, with soap or gruel, to suspend the two latter. Very cold water may be 
used without inconvenience. Starch, boiled or raw, of cream consistence, tem- 
perature 100 , with a few drops of Tinct. Opii, in extreme cases of choleraic 
diarrhoea, or that of phthisis, or typhoid fever (R). Nutrient Enemata, should 
contain materials for artificial digestion, as the rectum is not an organ of diges- 
tion, and to secure rapid osmosis should have an acid reaction. A suitable 
formula is appended below. Inject slowly and not frequently; five times in 
twenty-four hours should be the maximum. Defibrinated blood has also been 
used as a rectal injection with good results, being completely absorbed (B). 
Should not exceed three or four ounces of bland material, injected slowly, after 
ascertaining that the rectum is not filled with faeces (R). [Compare Injectiones, 
ante, page 476.] 



Prescriptions. 



Nutrient Enema. 



£. Infusi Carnis (Beef-tea), . ^iv. 

Acidi Hydrochlorici, . . . tr^x. 

Glyceriti Pepsini (Scheffer),^ij. 
If rectum irritable add 10 to 20 drops of 
Laudanum. 



Enema Ricini et Terebinth. 

R. 01. Ricini, ,^j ss - 

01. Terebinth, J ss. 

Ovum, no. j. 

Decocti Hordei, -jel 

Aq. Fervid., ...,,. ^ xiv. 



ENTERITIS ENURESIS. 581 

Enteritis. 

Opium, to the point of tolerance, is the remedy, the deodorized tincture in 
10-drop doses every second or third hour, according to age (Da C) ; of great 
value to control inflammation and quiet the intestines (B) ; proves of signal 
use (Wa), Aconite, of great utility in acute inflammation with high tempera- 
ture, sthenic condition, resisting pulse (R, P). Arsenic, surprisingly curative ; 
small doses with Opium (B). Podophyllum, with occasional doses of Aconite, 
will often allay the vomiting and diarrhoea (P). Ricinus Communis, is em- 
ployed with great advantage (P). Turpentine, stupes, hot, over seat of disease, 
are of manifest advantage (Wa). Skim-milk, is of the highest value as sole 
diet in acute inflammation of digestive organs (B). Water, cold and hot, 
principally cold, or ice, of unquestionable advantage (B). Poultices, Linseed, 
large and hot (Wa) ; may be used or not, as the patient feels benefit from them 
or otherwise (Da C). Water, hot fomentations constantly, followed by a wet 
compress. Perfect quiet in bed. Ice or cold water freely swallowed. No food 
until inflammation subsides, then beef-tea, milk, gum-water, etc., the very 
mildest and most bland diet for four or five days (Da C). [Compare Diar- 
rhoea, Dysentery, Cholera, Peritonitis, Typhlitis.] 



. Enuresis. 

Belladonna, no single remedy so uniformly successful ; children require large 
doses ; a solution of Atropine, best, gr. y^ to -^ (B) ; the best remedy for 
children, gtt. x-xx of the tinct. three times a day ; if unsuccessful, and no 
worms or other irritation exist, try Strychnine, Cantharides, Turpentine, San- 
tonin or Galvanism (R) ; small doses are useless (P). Santonin", in over-doses 
produces incontinence of urine in children, but curiously will sometimes stay 
the habit, even when not dependent on worms, and in cases where Belladonna 
fails (R) ; in the enuresis from worms (P). Cantharides, one or two drops of 
the tinct. three or four times a day in middle-aged women or the aged, even 
when due to paralysis ; sometimes also in children, but for them Belladonna is 
generally better (R). Chloral Hydrate, enuresis in children (R) ; three-grain 
doses thrice daily for infantile incontinence (Da C). Strychnine, may succeed 
when above remedies fail (B) ; sometimes useful for old people with paralysis 
of bladder, also for children (R, P). Buchu, often successful in chronic 
enuresis (P). Turpentine, small doses sometimes remove the trouble (B). 
Lupulin, said to be useful ; Herzfelder used it with advantage. Rhus Aroma- 
tica, has proven curative in 7 5 per cent, of cases treated with it, and of great benefit 
in the other 25 per cent. ; the fluid extract, rr^x-xv four times daily in Glycerin 
and water (Stein). Scutellaria, remarkably efficient in many instances, Z 
doses of the fluid extract thrice daily for a child of 12 years old. Potassium 
Nitrate, has been recommended for children (R). Potassium Bromide, succeeds 
in some cases (Wa). Collodion, painted to form a cap over end of prepuce (R). 
Ergot, when from paralytic state of sphincter (B) ; said to be useful (R). Iron 
Iodide, the syrup rr^xv-xx, well diluted with water, ter die, in pale, delicate, 
strumous children (B) ; sometimes useful even when no worms (R). Habits, 
Children to be taught to retain water as long as possible during the day ; little 
salt to be eaten ; abstinence from fluids not necessary ; bland fluids diminish 
acridity of the urine. Stopping meat from the diet has cured several cases 
permanently, after all remedies had been tried without success. 



R. Strychninae Sulph., . . . gr. j. 

Pulv. Cantharidis, . . . . gr. ij. 

Morphinae Sulph., . . . gr. jss. 

Ferri Reducti, gr. xx. 

Ft. pil. no. xl. Sig. — One thrice daily 
to a child of 10 years. [Gross.) 



Prescriptions. 

R-. Tinct. Ferri Chloridi, . . . 31J. 

Ext. Ergotse Fluidi, . . . 3 v. 

Spt. Chloroformi, , . . . 3 ij. 

Tinct. Quassia?, . . q.s. ad ^iv. 
M. Sig. — A teasp. in a winegl. of water 
thrice daily for children. 



582 EPIDIDYMITIS EPILEPSY. 

Epididymitis. 

Aconite, alternately with Pulsatilla, the latter in very small doses, a few 
drops of tinct. in a glass of water, a teasp. every 2 or 3 hours produces the 
happiest effects (Pf, St). Belladonna, the extract, 3j-ij ad 3J of Glycerin and 
water, on lint, applied to the inflamed testicle (Bumstead). Tobacco, with Lin- 
seed meal, as poultice, cautiously (P). Mercury and Morphine, locally, a 20 
per cent, oleate by inunction, in cases of syphilitic origin (R). Silver Nitrate, 
gr. lxxx ad ^iv aq. destil. freely applied to the scrotum will sometimes abort an 
epididymitis (Wa). Strapping and suspensory bandage to support the testicle, 
and rest it in the recumbent posture from the beginning, with a saline cathartic 
to clear the bowels, are all measures of great importance (Bumstead). [Com- 
pare Orchitis.] 

Epilepsy. 

Bromides, should be first employed in all cases, there being no remedy equal 
to large doses of Bromine salts, which should be persistently continued for 
many months, and with short periods of rest may be kept up for years. The 
combination mixture of Bromides has been taken by patients for 8 to 10 years 
without harm (Brown-Sequard) ; taken for long periods without a physician's 
supervision, has caused profound muscular depression, mental alienation and 
death (Hammond). Potassium Bromide, gr. xl ter die before meals, double 
at bedtime, for two or more years after all epileptic indications have ceased ; is 
generally useful, especially in daytime seizures and grand mal of sexual origin; 
also for infantile convulsions (B) ; especially in convulsive form, but often 
powerless (R). Sodium Bromide, gr. xx ter die, will arrest epilepsy without 
producing the cerebral symptoms of bromism (Clymer). Lithium Bromide, 
£ss daily, acts in some cases after Pot. Brom. has failed, and is generally effici- 
ent in about one-half the dose of the latter salt (Weir Mitchell). Nickel 
Bromide, gr. v thrice daily, is remarkably efficient in the epilepsy occurring at 
the menstrual epoch, and those which have withstood the action of the other 
bromides (Da C). Ferrum Bromide, will often cure cases in weak and anaemic 
subjects ; also with Potassium Bromide to combat the anaemia and depression 
produced by the latter (B). Ammonium Bromide, preferred in petit mal by 
many authorities. Combined with other bromides, as in Brown-Sequard's 
mixture (see formula below), before meals, with a tonic of Strychnine or Arsenic 
and a vegetable bitter, after meals. Zinc Bromide, gr. v in water and glycerin 
four times daily ; may be combined with the other bromides. Strontium 
Bromide, in doses of gr. xx thrice daily, gradually increased ; has been bene- 
ficially used as an alternate, being much less liable to produce bromism (See). 
Both Strontium and Calcium Bromides may be used with benefit (Fere). 
Aurum and Arsenic Bromide, the solution (Barclay's), Tr^v thrice daily after 
meals, increased to tt\,x, gave very satisfactory results in a severe case in a boy 
aged 7^ years (W. F. Barclay). Digitalis, Belladonna or Physostigma, com- 
bined with Bromides give better results than bromides alone ; treatment must 
be continued for several months to a year (Poulet). 

Belladonna, in petit mal and nocturnal epilepsy, in pale and anaemic sub- 
jects, should be given for a year or more ; extract and leaves gr. ^ of each in 
pill, every day at same hour, one additional pill every month (Tr) ; useful, es- 
pecially when from fright (P). Atropine better, drop-doses of a 1 per cent, 
solution of the neutral sulphate in white brandy (Tr). Arsenic, in epileptiform 
vertigo from stomach disorder (B) ; sometimes useful (R). Aurum. The 
Bromide of Gold and Arsenic (see above). Sodium Borate, in doses of gr. 
xx 3 or 4 times a day, has produced very good results in nocturnal epilepsy : 
is of real value and better than Bromides in symptomatic epilepsy, also may 
be found useful in nervous forms after the bromides have failed (Mairet) ; if 
beginning with small doses may be gradually increased to 90 grains a day ; 
when dose exceeds 60 grains daily it is advisable to add Glycerin to the water 
and syrup used as excipients (Dijoud). Amylene Hydrate, in 10 per cent. 



EPILEPSY. 



583 



solution, of which a tablesp. or two (gr. 30 to 90) a day, of value in petit mal 
and nocturnal epilepsy, also when bromides have failed, and where the attacks 
are not only very frequent but severe (Nache). Acetanilid, is being tried with 
a view to moderating reflex excitability. Hydrastinine, has been used with 
benefit, in doses of gr. }{ to }4 of the Hydrochlorate, up to gr. ij daily, in- 
ternally. Picrotoxin, anaemic subjects, attacks occurring at night, fa to fa of 
a grain hypoderm., or fa to y 1 - by stomach (B) ; benefits cases resulting from 
onanism (P). Cannabis Indica, has given good results ; is suitable for petit 
mal, the nocturnal variety, and with Strychnine, Belladonna, or Picrotoxin, for 
cases characterized by anaemia and depression (B). Quinine, when of malarial 
origin (P) ; often useful in .intermittent epilepsy (Ros). Solanum Carolinense, 
(the Horse-nettle), in tincture of the berries, made by bruising them and steep- 
ing in whiskey, has quite a reputation among the negroes for epilepsy and 
other convulsive affections, and has rendered, good service in my hands 
(Napier). 

Amyl Nitrite, inhaled at the beginning of the aura will prevent an attack 
(B); or ttVij-v in mucilage, when fits are very frequent (R). Nitro-glycerin, 
^Itjjo"' slower in action than Amyl Nitrite, but more enduring (Pf ). Ignatia, 
convulsions unattended with cerebral congestion (P) ; is par excellence the 
controller of functional phenomena of the cerebro-spinal axis (Pf). Strychnine, 
is useful in idiopathic epilepsy, but injurious in symptomatic form ; benefits when 
Potas. Bromide fails; when cerebral anaemia, nocturnal attacks (S, Pf); if 
Bromides fail and case is anaemic, give Strychnine, gr. fa ter die, and push it 
(B). Silver Nitrate, is not without efficacy, and was formerly much used, but 
the danger of staining the skin has caused its disuse, especially as better agents 
have been found (Wa). Copper Salts, may be useful in cases originating from 
stomach ; were formerly much used (B) ; the Nitrate or Oxide often given with 
benefit (R) ; the Ammonio-sulphate, gr. ^ in pill, thrice daily to begin with ; 
should not be continued beyond 3 or 4 months at a time (Brown-Sequard). 
Zinc Salts, have been much used in place of silver and copper salts, not hav- 
ing the serious drawbacks attending the latter agents. Zinc Oxide, probably 
useful only in cases originating from the stomach ; much said for and against 
it (R). Chloroform, by inhalation during paroxysm and also in interval (Wa) ; 
is of high value especially in cases of an hysterical character (Brown-Sequard). 
Chloral, the most suitable remedy for the nocturnal variety, in full doses at 
bedtime (B). Digitalis, rrLx of the tincture, with gr. xx of Potas. Brom. thrice 
daily, in cases complicated with cardiac dilatation (Gowers). Turpentine, has 
long been used, when due to reflex impression of intestinal parasites (B). 
Conium, not equal to the Bromides (B) ; not of much value (P). Valerian, has 
been used with some advantage (R). Bryonia, has an ancient reputation (P). 
Rue, may benefit when seminal emissions (P). Anaesthetics, are rarely called 
for (W). Fats and Oils, especially cod-liver oil when faulty assimilation exists 
(B). Galvanism, only in idiopathic epilepsy (B). Meat Diet, in many cases 
must be prohibited entirely. Trephining the skull, has given good results in 
several cases where a distinct depression from injury existed ; and in others 
where apparently indicated has been of no service. [Compare Convulsions.] 



. Potassii Bromidi, . . . . ^j. 
Ferri Bromidi, gr. i 

A q U£e > §y- 

Syrupi Simplicis, . . . . :§ vj. 
M. Sig. — Tablesp. twice daily. 



Prescriptions. 



R- . Strychninae Sulphatis, . . gr. j. 

Acidi Sulphurici Dil., . . Tt\x. 

Aquae Destil., §iv. 

M. Sig. — Teasp. after each meal, gradu- 
ally increased to a dessertsp. 



Potassii Bromidi, 
Sodii Bromidi, 
Ammonii Bromidi, 
Potassii Iodidi, 
Ammonii Iodidi, . 
Ammonii Carbonat. 
Tinct. Calumbae, . 
Aquae, . 
M. Sig.— A 
each meal, and three teasp. at bed-time. 

(Brown-Sequard.) 



aa 311]. 
aa gjss. 

• si- 

.... 3jss. 
. . '. . q.s. ad 5 viij. 
teasp. and a half before 



584 



EPISTAXIS ERUPTIONS. 



R 



M. 

meal 



Potassii Bromidi, . . . . .^ss. 

Sodii Bromidi, ^ ss. 

Liq. Potas. Arsenitis, . . gss. 

Ext. Conii FL, mj. 

Aquae Cinnamomi, . . . % ij. 
Infas Gentian. Co., q. s. ad g viij. 
Sig. — Tablesp. two hours after each 



R • Potassii Bromidi, 

Ammonii Brom., . . . aa 5ij. 

Ext. Ergots FL, . . . . 'Jj. 

Aq. Cinnamomi, . q. s. ad ^viij. 
M. Sig. — Dessertsp. in water thrice 
daily. When maniacal excitement and 
danger of cerebral hemorrhage. {Smith.) 



Epistaxis. 

Aconite, has been used with the best results (P) ; small frequent doses 
quickly check epistaxis in children and plethoric people (R). Arnica, is of 
great service when from mechanical violence (P). Belladonna, when of con- 
gestive origin (P). Ipecacuanha, has been highly praised (R) ; acts upon the 
vessels (B) ; gr. j-ij every quarter hour until nausea is felt, but vomiting need 
not be excited (Wa). Hamamelis, venous hemorrhage (Pf, R). Ergot, 
3ss-5j of fresh powdered Ergot, or ^j-gij of flu. ext. every half hour or hour, 
necessary in urgent cases (B). Alum, injected or snuffed up in powder (R). 
Iron Spray, in obstinate cases Liq. Ferri Subsulph., Z] to Sviij aquas by spray 
or injection ; the Tinct. of the Chloride also useful (B) ; diluted 5ij in ^vj in- 
jected into the nostrils is often effectual (Wa). Tannin, finely powdered, blown 
into the nostrils through a quill (Wa) ; a strong solution, gij ad ^iv, by nasal 
syringe (B). Turpentine, may be given internally with advantage (Wa) ; 
especially in debilitated conditions (B). Lead Acetate, gr. ij-iv with Opium 
gr. ss-j, proves signally useful (Wa). Vinegar, on lint introduced into the 
nostrils, sometimes highly efficient (Wa). Digitalis, is of undoubted benefit 
(B) ; the infusion best (R). Transfusion, when death from exhaustion is ap- 
parently imminent (B). Facial Artery, compression of (R). Sundry. Keep 
head elevated and cool ; warm the feet and hands by plunging into hot water; 
apply ice over the nose ; resort at once to the tampon, if bleeding becomes 
alarming. [Compare Hemorrhage, for formulae.] 



Eruptions. 

The following-named Drugs produce the eruptions indicated respectively 
after each, viz. Aconite — vesicular exanthemata. Arsenic — erythema and 
papules, vesicles and pustules. Belladonna — as Quinine. Borax — papular, 
scarlatiniform. Potassium Bromide — papules, pustules, deep tubercles with 
ecchymoses, ulcers, pemphigus. Castor Oil — urticaria. Cinchona — as Quinine. 
Carbolic Acid — erythema. Chloral — erythema on face and neck, itching, des- 
quamation, eczema, purpura and petechias. Copaiba and Cubeb — pemphigus 
erythema, eczema ; the Copaiba rash has a preference for the ankles and 
wrist. Cod-liver Oil — acne. Digitalis — erythema after long usage. Potassium 
Iodide — papules, vesicles, pustules, eczema, ecthyma, ecchymoses and pur- 
pura ; the Iodide rash prefers the face and back of neck and shoulders. Mercury 
— erythema, eczema. Opium and Morphine — erythema, papular eruption with 
marked desquamation and itching. Phosphorus — purpura. Quinine — erythema, 
scarlatina, papular erythema, hemorrhagic purpura, pemphigus and prurigo. 
The prevailing type of the Quinine eruption is erythema, or exceptionally 
eczema or purpura, and is essentially ephemeral ; it is of a bright vivid hue, 
disappearing on pressure, and resembles scarlatinal rash, first appearing on face 
and neck, and thence spreads over the body. In some instances it comes in dis- 
tinct spots and resembles measles ; in others it is an urticaria, with some oedema, 
and distressing burning, tingling, and itching. Five cases of purpura are 
authentically reported. Rhus Toxicodendron (and other varieties of Sumac) — 
vesicles, perhaps pustules, with redness, swelling and intolerable itching. Sali- 
cylic Acid — purpura, pemphigus, vesicular angina. Santonin — pemphigus, 
vesicles. Stramonium — as Quinine. Strychnine — as Quinine. Turpentine — 
as Copaiba. 



ERYSIPELAS. 585 

Articles of Food producing eruptions are : Acid Fruits — may cause acute 
eczema. Strawberries — urticaria. Apples — acneform efflorescence about the 
mouth. Walnuts — inflammation of buccal mucous membrane. Shell-fish — 
urticaria. Roast Turkey — in one case caused great urticaria. Lager Beer — 
acne in some. Alcohol — aggravates cutaneous inflammations. Butter, Oat- 
meal, Buckwheat, Fish — are popularly credited with causing eruptions, but there 
is no evidence therefor. 

Erysipelas. 

Pilocarpine, to abort the disease, very efficient if used early, gr. l /e hypoder- 
mically, or fluid extract of Jaborandi internally ; when free diaphoresis occurs, 
the temperature and pulse fall to normal, and the disease is checked; not 
suitable to debilitated cases, or those with a weak heart (Da C). Aconite, a 
favorite remedy with Liston, if used at beginning, when fever high (Wa) ; no 
more useful agent in idiopathic erysipelas, especially facial, and cases of 
sthenic type (B) ; at onset, often cuts the attack short ; is very useful in the 
erysipelas following vaccination (R) ; very valuable in sthenic cases (P) ; espe- 
cially so in traumatic erysipelas (Tr). Belladonna, Tt^v of tincture in water 
every hour for five or six doses, also locally ; has astonishing power in super- 
ficial and non-vesicular forms, also when erysipelas attacks the brain, and in 
the phlegmonous type (P) ; for similar indications as noted under Aconite, also 
when adynamia ; if much fever, combine it with Digitalis or Aconite ; when 
much depression, give it with Quinine ; gr. % °f the extract with gr. ij of 
Ouininse Sulph. every 3 or 4 hours (B) ; the extract with Glycerin, equal parts, 
spread thickly over the surface (Ouain) ; should be used both internally and 
externally, and may be combined with Aconite (R). Iron, Tincture of the 
Chloride, the nearest to a specific yet discovered ; the remedy of most service, 
any man being decidedly to blame who neglects its use ; requires decided doses, 
gtt. xl every 4 hours (Da C) ; treatment by it very general, but questionable 
(B) ; should be given with shorter intervals than 4 hours (R) ; is very successful 
in this disease (P) ; ten-drop doses every hour, or n^xl every 4 hours (Quain) ; 
is jalso used locally with much success, being painted over the surface in full 
strength. Quinine, may be given with the Iron ; also alone if thoracic compli- 
cations, wherein Iron might be contra-indicated (Da C) ; if pulse soft and 
tremulous, or very rapid, low muttering delirium (D) ; a combination of Qui- 
nine and Tincture of the Chloride of Iron offers special advantages (Wa) ; in 
the more severe cases to sustain the vital powers, and prevent cerebral embol- 
ism ; but large doses, gr. xv-xx every 4 hours, are alone of any use (B). Am- 
monium Carbonate, when feeble circulation, cyanosis and delirium ; also when 
any signs of embolism appear (B) ; highly useful in debilitated subjects (Wa) ; 
after free purgation the continued use of this salt is all that is needed in most 
cases (Watson). Potassium Iodide, with agents to secure free action of the 
bowels, skin and kidneys, the most efficient treatment in erysipelas ambulans, 
in which Iron and Quinine are useless (Da C). Antipyrin, is particularly 
efficient when hyperpyrexia (Ernst). Rhus Tox, a very useful remedy in the 
vesicular form (P). Tartar Emetic, in doses of gr. -^ frequently repeated, 
renders incontestable service (B). Calomel and Jalap, as purgative at onset, 
followed in 4 or 5 hours by Magnesium Sulphate, ^ss (Da C). Chloral, is an 
admirable adjunct to give sleep at night (Da C). Turpentine, as a stimulant 
in traumatic erysipelas, more generally serviceable than Alcohol (B). 

Local Applications. Silver Nitrate, by Higginbotham's method in trau- 
matic form ; gr. lxxx of the brittle stick dissolved in 3iv of water and painted 
2 or 3 times over inflamed surface and beyond, after careful washing and dry- 
ing (R) ; no agent more useful in subduing external inflammation. Iodine, 
painted over affected and neighboring surface, to prevent spreading (R). 
Ichthyol, is very efficient as a 10 to 25 per cent, collodion : Ichthyol and Ether, 
of each 5, Collodion 10 parts, with or without the addition of Castor Oil ; has 
almost specific properties in this disease (Radcliffe). Thiol, dry, as a dusting 
powder, has given excellent results. Iodized Collodion, is very successful as a 



586 



ERYTHEMA. 



local application. [See formula below.] Collodion, a thick coating relieves 
(B). Digitalis, an infusion is of much service, applied as a lotion (R). Sulph- 
urous Acid, and Glycerin, equal parts, or a solution of Sodium Bisulphite 
(Dewar). Zinc, Benzoated, as ointment, or the Unguentum Zinci Oxidi, any- 
thing to exclude the air, and whichever one is most agreeable to the patient 
(Da C). Bismuth, the Ointment of the Oleate, a very certain application to 
allay itching and burning, lessen pain, etc. (Shoemaker). Oil, by inunction, is 
very grateful in simple erysipelas (B). Oil of Turpentine, painted over sur- 
face is said to be remarkably efficient. Vaselin, Lard or Mercurial Ointment, 
diluted, 3j to ^j of Vaselin ; the simplest applications are the best (B). Car- 
bolic Acid, one part, with 8 to 14 parts of Oleic Acid, locally by inunction for 3 
or 4 minutes every % hour, all around the edge of the diseased part until it 
ceases to spread (Jacobi). Cotton Wool, sprinkled with flour or a mixture of 
Starch and Zinc Oxide, is a good application (B). Earth, clean yellow clay, 
free from grit or sand, and powdered, applied directly to the skin in the form 
of a smooth paste, made by mixing it with water, the best of all applications, 
having properties of antiseptic, antiphlogistic, antipyretic, and antimorbific 
nature (Hewson). 

Tracheotomy, promptly if oedema of glottis occurs, the operation giving time 
for inflammation to subside (Da C). Incisions, may be necessary in traumatic 
erysipelas when limb is greatly swollen and inflamed; also in the phlegmonous 
variety (Da C). Diet, a milk-diet is generally suitable ; should be -light but 
nutritious (R) ; feed the patient well (Da C). [Compare Phlegmon.] 



Prescriptions. 



R . Quininae Sulphatis, . . . g ss. 

Ext. Belladonnae, . . . . gr. ijss. 
Ft. pil. no. xx. Sig. — Two pills every 
4 hours, where much depression. (B.) 



R. 



M 
hours. 



Eh 

q. s. 

P- 

5ss. 



Quininae Sulphatis, . 
Ac. Sulphurici Dil., . 

Aquae, 

Tincturae Ferri Chlor., 
Spt. Chloroformi, . . . . .^vj. 
Glycerini, . . . . q. s. ad % iv. 
Sig. — A teasp. in water every two 
(Loomis.) 



R. Tinct. Ferri Chloridi, . . £j.' 

Syrupi Tolutani, . . . . %]■ 

Liq. Potassii Citratis, . . ^iv. 

M. Sig. — Teasp. to tablesp. according 

to age, every 3 hours. 7 ) ) has TT^x, gij 

has rr^xx, 3 ss has r^xl. [Anderson.) 



R- . Tinct. Ferri Chlor., . 
Glycerini, Aquae, . . 
M. Sig. — Teasp. every 
children. 



2 hours for 
( Gibney. ) 



For Local Use. 
R . yEtheris, 

Alcoholis, aa 

Pyroxylini, .... 
Solve, et adde — 

Ammonii Iod., gr. xl. 

Cadmii Iod., 

Cadmii Brom., . . . aa gr. xx. 

M. Sig. — For local use with a camel's 

hair pencil. If the cadmium salts are not 

to be had use gj Ammon. Iod., and gr. xx 

of Pot. or Amm. Bromide. [Humphreys.') 



5y. 

3J- 



R. Plumbi Acetatis, 

Ammonii Carb., . . . aa £_j. 

Aquae Rosae, ^"j- 

Ft. lotio. Sig. — Apply on lint, to allay 
irritation. {Peart.) 

R. Acid Carbol., 

Alcoholis, aa ijij. 

01. Terebinth., £iv. 

Tinct. Iodi, gij. 

Glycerini, %x. 

M. Sig. — Brush over surface every 2 
hours, and cover with a thin layer of wad- 
ding. 



Erythema. 

Antipyrin, internally, for the itching, is efficient. Belladonna, useful in 
cases resisting ordinary treatment (B). Quinine, the most valued remedy 
in erythema nodosum (B). Rhus Toxicodendron, a valuable remedy (P). 
Zinc Sulphate, as lotion, with Alum and Glycerin [see Eczema, for formula] ; 



EXHAUSTION EXOPHTHALMOS EXOSTOSIS. 5 87 

or the Acetate, in ointment [See below]. Bismuth, dusted over erythema 
about genitals of infants soothes pain and promotes healing (B). Mineral 
Acids, Nitric and Nitro-hydrochloric, have been advantageously used when 
from imperfect digestion (B). Dusting Powders, of Starch, Lycopodium or 
Buckwheat flour are very useful. Thiol, the dry form, as a dusting powder. 



Prescriptions. 

R . Plumbi Carbonatis, 

Bismuthi Subnit., . . . aa ^j. 
Sodii Bicarbonat., . . . . 3 ss. 
Ung. Zinci Oxidi Benz., . Jij. 
Ft. unguentum. Sig. — Local use. 



1& . Zinci Acetatis, gr. ij. 

Aquae Rosae ^j. 

Ung. Aquae Rosse, . . . . ^j. 
M. Sig. — Ointment. 



Exhaustion. 

Arnica, a few drops internally for aching of the muscles (R) ; in nerve pros- 
tration with general aching from over-fatigue (P). Phosphorus, for physical 
or mental exhaustion ; also in depression from overwork (R). Calcium Phos- 
phate, combined with Calcium Carbonate and Ferric Phosphate, gr. j of each 
for a dose (R). Potassium Bromide, when insomnia, bad dreams and irrita- 
bility (R). Opium, gtt. j of Laudanum with 2 or 3 of the Tinctura Nucis Vomicse, 
3 or 4 times a day, for symptoms of exhaustion with headaches, flushing and 
dyspepsia (R). Ammonia, internally ; its influence is but brief (R). Coffee 
or Tea, in ''hot or cold climates (R). Castor, is serviceable, but seldom used 
(P). Musk, benefits all forms of nerve-exhaustion (P). Cimicifuga, for head- 
ache from over-study or excessive fatigue (R). Alcohol, of value in all condi- 
tions of fatigue (P). Coca, lessens the sense of fatigue under exertion, relieves 
thirst, and obviates the effects of a too rarefied atmosphere ; is suitable for 
weakly subjects easily fatigued, and to convalescents (P). Cocaine, has been 
used successfully in exhaustion from sunstroke, loss of blood, and diarrhoea 
(P). Wet Sheet, dripping, cold, as a restorative, and to prevent aching of mus- 
cles (R). Sea Bathing, is also valuable (R). Habits, change of occupation 
better than absolute rest. [Compare Adynamia, Convalescence, Insomnia, 
Myalgia, Neurasthenia.] 

Exophthalmos. 

Exalgin, has been used with some success in the treatment of exophthalmic 
goitre (Churton). Belladonna, rr\,v of tincture hourly, of great service (R) ; 
results recorded from its use are very remarkable, but Digitalis will usually 
answer better (P). Duboisine, gr. yi^ of the sulphate 2 or 3 times daily, has 
produced remarkable results in one case (Hunt). Opium, may be of use in 
some cases (P). Digitalis, to raise the arterial tension and slow the heart, de- 
cidedly ameliorative in young subjects (B) ; to tranquillize the heart is the main 
indication. Iron, with Digitalis, seems to do more good than any other medi- 
cines (Da C). Chalybeate Waters, are beneficial (B). Convallaria, ameliorates 
the painful palpitation (Wa.) Galvanism, of the cervical sympathetic and pneu- 
mogastric, and eyes and thyroid gland, is decidedly curative in uncomplicated 
cases (B.) 

Exostosis. 

Potassium Iodide, may promote absorption when recent ; also friction with 
ointment of Mercury or Iodine (D). Aconite, was used by Storck (P). Mer- 
cury, a moderate course of mercurials may be effectual, when exostoses due to 
a blow or from syphilis (D). Exostoses of clavicles in children almost always 
disappear themselves (D). Excision if required (MacCormac). 



588 EYE-DISEASES EYELI DS FACE. 

Eye-Diseases. 

Belladonna, locally and internally in iritis, conjunctivitis and other inflam- 
mations. Atropine, in iritis, locally ; hypodermically, in glaucoma (R) ; the 
best application in inflammatory conditions generally. Euphrasia, had an 
extended reputation in Germany, is a mild astringent, and of service in catar- 
rhal conjunctivitis (P). Pulsatilla, as lotion in inflammations and ophthalmic 
cases (P). Santonin, gives good results in inflammatory and atrophic condi- 
tions of the retina and optic nerve, and in the stage of effusion of many other 
inflammations (Wa). Ruta, minim doses, night and morning, in dimness of 
vision depending on functional amaurotic condition, produces good results (P). 
Physostigma, topically, to contract pupils ; to reduce excessive atropinization ; 
stimulates the third nerve (P). Strychnine, hypodermically in muscular 
asthenopia, amblyopia, amaurosis, and in progressive nerve-atrophy not de- 
pendent on intercranial diseases (R) ; increases the sensibility of the eye, the 
field of vision becoming extended, and the vision more acute (Br). Ergot, 
useful in many eye affections, especially disturbances of accommodation, acute 
and chronic inflammations, and the blepharitis and pustular conjunctivitis of 
children (Wa) : is myotic. Pilocarpus, is used with great benefit in many eye- 
affections, particularly amblyopia from alcohol and tobacco, detachment of the 
retina, chronic iritis, keratitis, hemorrhage into the vitreous, glaucoma, muscse, 
atrophic choroiditis, hemorrhages of the retina, white atrophy of the optic 
nerve, and inflammatory affections with effusion and exudation, to promote 
resolution and absorption (Wecker). Cocaine, as a local anaesthetic in oph- 
thalmic surgery, a 4 per cent, solution, by instillation, sometimes injection 
required, as into the muscles for squint operation ; is mydriatic, and in some 
cases panophthalmitis has resulted after operations under Cocaine (R). Chlo- 
roform, vapor, close to a photophobic eye, relieves (R). Oleate of Mercury 
and Morphine, outside the eye in palpebral conjunctivitis, and stye ; also in 
syphilitic iritis (R). Silver Nitrate, Copper and Zinc Salts, are much used 
(B). [See Conjunctivitis, etc. Compare Mydriatics, Myotics, pages 28, 
29; also in this section the titles Amaurosis, Asthenopia, Cataract, Con- 
junctivitis, Corneal Opacities, Glaucoma, Iritis, Keratitis, Myopia, 
Ophthalmia, Photophobia, Retina, Strabismus, etc.] 



Eyelids. 

Calomel, locally, or Brown Citrine Ointment, as an application in many dis- 
eases of the lids (B). Mercury and Morphine, the 20 per cent, ointment with 
Lard, outside lid, for stye (R). Pulsatilla, internally, and externally as wash, 
in ophthalmic cases and inflammations ; the so-called " stye " may often be 
aborted by this treatment (P). Cadmium, much esteemed as collyrium, gr. ij of 
sulphate to ^j aquae rosae (R). Zinc and Copper Sulphates, are esteemed ap- 
plications (B). [See Conjunctivitis for formulae.] Ergot, an aqueous infu- 
sion, as a collyrium, in ptosis and paralysis of the eyelids (Wa). Tannin, a 
strong solution (1 to 3 aquae), locally ; or a weaker solution (1 to 20, 30 or 50 
aquae), is much employed ; also used in pomade, or as fine powder (Wa). 
Veratrine, in solution, brushed over lids once daily in painful spasmodic con- 
traction of the orbicularis (Wa). Ammonium Chloride, in solution as lotion, 
for ecchymosis of eyelids, vulgarly known as " black eye." [See Ecchymosis, 
Blepharitis, Conjunctivitis, Ptosis, Ectropium, etc.] 



Face. 

Amyl Nitrite, r>L T V to ye, in 30 times its volume of spirits, for flushing of face, 
or sensation of flushing, with cold feet and hands, and great prostration, chiefly 
in women at change of life (R). Curare, effective in facial spasm, when other 
remedies failed (P). Blisters, behind the ear, in facial palsy, followed by warm 



FALSE PAINS FEET FEVER. 589 

covering to part (H). Strychnine, has improved some cases of facial palsy 
(P). [Compare Acne, Freckles, Neuralgia, Odontalgia, Parotitis, 

TlC-DOULOUREUX.] 

False Pains. 

Tartar Emetic, with small doses of Opium, and external fomentations, where 
evidence of congestion (L). Opiates, to allay uterine irritation, after rectifying 
any derangement of bowels (L). Opium, is valuable, having specific action 
on uterine muscular fibres, relaxing some, stimulating others (Wa). 



Feet. 

Arsenic, swelled feet of old or weak persons (R) ; cedema of feet and ankles 
in the old, from feebleness of the heart (B). Lead, as ointment of equal parts 
of Emplastrum Plumbi and Linseed Oil spread on linen, and wrapped round 
the feet when they sweat — to be renewed every third day for nine days (R). 
Potassium Permanganate, gr. j to ^j solution, as wash, will remove fetor of feet 
(B) ; temporarily discolors the skin. Boracic Acid, in strong solution, is used 
with good results. Chloral, I in 50 of water, as bath, efficient. Sodium Bicar- 
bonate, a solution freely applied will remove fetor (B). Belladonna, will check 
fetid secretions (R). Salicylic Acid, in solution with Borax, the most agreeable 
and efficient deodorant for fetid perspirations (B): 5jss-iij with ^iij of dried 
Alum, in powder, applied freely to feet after washing and drying. Acid. Sali- 
cyl. 3, Magnesium Silicate 87, is the composition of the powder used in the 
German army for sweating of the feet. Ice, to the spine, or heat and cold 
alternately, to equalize the circulation, has been strongly advocated (Wa). 
Stockings, should be changed every day, and dipped in a strong solution of 
Boracic Acid and dried, to effectually check fetid perspirations. Cold Foot- 
bath, and drying with friction, for cold feet (R). [Compare Chilblains.] 



Prescriptions, 

R- . Ac. Salicylici, gr. xv. 

Amyli, gr. cl. 

Talci, ... ^iij. 

M. et trit. Sig. — Locally for sweating 
feet. (JCohnhorri). 



R. Ac. Borici (pulv.), .... ^jss. 

Vaselini, . ^j. 

M. Sig. — Ointment for bromidrosis. 

( Championniere) . 



Fever. 

[See also the titles of the Fevers, in their alphabetical order.'] 

Aconite, has the highest value in the eruptive fevers, also in all hyperpyrexias 
(B) ; always indicated in early stage of simple inflammatory fevers, pneu- 
monia, and in most acute congestions (P) ; has marvellous power over sthenic 
fevers ; thermometer should go hand in hand with Aconite (R). Veratrum 
Viride, possesses considerable power as an antipyretic ; useful in rheumatism, 
pneumonia (P) ; in delirium ferox of fevers it is of value (B) ; strongly recom- 
mended in both sthenic and asthenic fevers (R). Belladonna, in the eruptive 
fevers, especially scarlatina (B) ; in typhus, with delirium, insomnia, painful 
sensitiveness to light and sound, and in all hyperaemic states of brain and 
spinal cord (P) ; is prophylactic often against scarlet fever (P, Pf) ; in delirium 
of fevers, also excellent in typhus (R). Gelsemium, in remittent and typho- 
malarial, of real benefit ; is antipyretic (B) ; in bilious remittent, of value (Pf). 
Arsenic, in prostrating acute fevers to strengthen pulse and invigorate patient ; 
except quinine, no drug subdues intermittents so well (R) ; in malarial, espe- 
cially typho-malarial, it is of great value (B). Cinchona. Quinine in the erup- 
tive and all malarial, remittent, and intermittent ; as apyretic, less effective and 
more dangerous than cold baths ; useless in typhus and typhoid, except for 



590 FEVER. 

hyperpyrexia (B) ; it is anti-miasmatic, antiseptic, and antiphlogistic ; and of 
great value in intermittent, septicemic, and hectic fevers (P) : large doses at 
night to reduce temperature in typhoid and other fevers, are strongly urged in 
Germany : Cinchonine best as prophylactic against ague (R). Antipyrin, the 
type, also the best of the new series of synthetical antipyretics, which includes 
Kairin, Phenacetin, Chinolin, Thallin, etc. (See pp. 58, 118, 195) ; is antipyretic 
and diaphoretic, moderates the intensity of the febrile movement, and is especi- 
ally indicated in self-limited diseases with persistent hyperpyrexia, especially 
pneumonia, typhoid, etc. Phenacetin, the favorite antipyretic among the new 
synthetical compounds ; is efficient and safe. Kairin, is an efficient antipyre- 
tic, but profusely diaphoretic, also a cardiac and nerve depressant of great 
power, and highly dangerous in pneumonia, and other fevers where the heart is 
weak ; it often produces nausea and vomiting with headache and tinnitus 
aurium (P). Resorcin, has been given in acute rheumatism, typhoid, typhus, 
pneumonia, erysipelas, etc., as'an antipyretic ; like Kairin, however, its action 
in lowering temperature is transient as compared with Quinine or Salicylic 
Acid (P) ; may be used hypodermically as it is not irritant (B). Salicylic Acid, 
or Sodium Salicylate, nearly equal to Quinine as antipyretic ; very useful in 
all forms with high temperature and in intermittents, especially in septicaemia, 
pyaemia, erysipelas, and surgical fevers (B, R). Digitalis, the German antipy- 
retic ; very useful in scarlet fever, rheumatic, and pneumonia (B) ; especially in 
typhoid (R). Cimicifuga, as substitute for Digitalis, but less effective ; good in 
hectic (B). Hydrastine, intermittents, typhoid with copious sweats (P). 
Arnica, is antipyretic, full doses in sthenic cases, small (rr^v of tincture) in 
asthenic ; large and small doses produce different results (B) ; in rheumatic 
fever and typhoid it is highly extolled (P). Camphor, subdues reflex excitabil- 
ity ; is praised as stimulant in adynamic fevers (P) ; in adynamic fevers and 
where there is delirium (R). Mercury, large doses of Calomel, the German 
" specific " treatment of typhoid (B) ; small doses in typhoid at commencement ; 
has marked effect on tonsils in scarlatina (R). Rhus Tox., in rheumatic fever 
after Aconite, and in scarlatina with typhoid symptoms, is invaluable (P). 
Opium, much less used than formerly ; useful in delirium, and with Quinine in 
remittents and intermittents (B) ; fevers characterized by prostration, insomnia 
and delirium, noisy or muttering, with picking of bed-clothes and twitching of 
the muscles, — in such cases Opium, judiciously given, may save an almost hope- 
less case (R) : Morphine, hypodermically, the best form in febrile diseases, 
being less disturbing to the stomach and digestive power (P). Turpentine, in 
typhoid, puerperal, and yellow, as a stimulant to vaso-motor nervous system 
(ntx-2>ss) (B) ; as enema (11^30-60 in starch mucilage with rr\,x of Tinct. Opii 
if pain) invaluable when in typhoid hemorrhage occurs with tympanites (P, R). 
Tartar Emetic, minute doses (gr. -^) frequently repeated, and with Opium, are 
of great value in many acute febrile diseases (B) ; as a diaphoretic ; in ague ; 
in large doses to abort specific fevers (R). Muriatic Acid, very useful in all 
forms, especially in typhoid and the exanthemata; relieving dryness of the 
mouth and fauces, increases digestion, and restrains the diarrhoea (B). Acid 
Drinks, such as raspberry vinegar, citric acid, etc., very grateful and useful (R, 
B) ; two sliced limes or lemons, with ^ij of sugar, in Oj of boiling water, cooled 
and strained, make an agreeable refrigerant beverage (Wa). Baptisia, useful 
in common continued fever, or in the first stage of typhoid ; drop doses of a 
fresh tincture every hour. Eucalyptus, has given varied results in malarial 
fevers, some observers praising it very highly (P). Valerian, has done much 
good in fevers of a nervous character (P). Sumbul, is used in Russia for low 
fevers of a typhoid type (P). Cocculus, for tympanites of typhoid (P). Ammo- 
nium Acetate, as a diaphoretic, and in simple forms, as catarrhal ; the Carbon- 
ate, in scarlet fever and measles (R). Purgation, by Castor Oil, Magnesium 
Sulphate, etc., before exhaustion (R). Mustard Bath, on recession of rash in 
eruptive fevers (R). Aliment, milk and beef-tea alternately, every 3 hours; 
milk only, in fevers and inflammations of the digestive tract (B). Alcohol, in 
low conditions is useful when causes improvement in symptoms, which may 
become worse (R) ; Coffee better than alcohol (P). Water, is a valuable ad- 



FEVER, SIMPLE FISTULA. 



591 



junct to remedies in the treatment of fevers. Warm baths, the wet pack, hot 
and cold compresses, fomentations, moist inhalations, etc., have great value 
[see various fever titlesj : a most important agent. Cold baths or cold wet 
pack to reduce temperature (B) ; cold affusion, baths, packing, ice, and ice-bag ; 
hot affusion and sponging, all of great value in every form (R). 



Prescriptions. 



R. Tinct. Aconiti, 3 S H- 

Spt. Etheris Nitrosi, . . . 3 i j . 
Glycerini, . . . . q. s. ad %'\). 
M. Sig. — A teasp. every hour to an 

adult, as a febrifuge. 



R . Antipyrini, 

Aquae Cinnam., 

M. Sig. — A teasp. every 2 
children, to control pyrexia. 



hours 



for 



Fever, Simple. 

Aconite, in small repeated doses, the best remedy for febricula, etc. (B) ; in 
ordinary febrile conditions, if given early, will abate fever and induce free 
perspiration ; may be administered in conjunction with any other remedy indi- 
cated (R). Veratrum Viride, in small doses, as antipyretic (P, R). Hyoscya- 
mus or Belladonna, very useful in febricula, especially for head symptoms and 
constipation (P). Gelsemium, when remittent or bilious symptoms (P). 
Arsenic, if typho-malarial symptoms (B). Phenacetin, in hourly doses of gr. 
iv or less, in the simple continued fever of children, as antipyretic. Hydro- 
chloric Acid, in the continued fever of childhood, has a beneficial influence 
(West). Valerian, when nervous excitability (P). Lemon-juice, as "lemon- 
ade," or with Potassium Bicarbonate as a mild diaphoretic and diuretic (P). 
Pomegranate-juice is very grateful if mixed with sugar or honey (P). Bromides, 
gr. ss-j every quarter-hour are excellent for the febrile disturbances of chil- 
dren (Smith). Baths, warm, in simple fevers of children (R). Aliment, milk 
and beef-tea alternately every 3 hours, the most useful (B). 



Prescriptions. 



R. Ac. Hydrochlor. Dil., . . gss. 
Spt. ^Etheris Co., . . . . gjss. 
Syr. Rosae, !fss. 

Aquae Camph., . . q. s. ad ^iv. 
M. Sig. — Teasp. to tablesp., according 
to age, every 6 hours. 

{Modified from West.) 



R. Potassii Acetatis, . . . . gij. 

Spt. ^Etheris Nitrosi, . . . 3 iv. 

Syr. Simplicis, 25 j. 

Liq. Ammonii Acetatis, . J^'i). 

Aquae Camphorae, . q. s. ad ^viij. 
M. Sig. — Teasp. to tablesp. doses, ac- 
cording to age. Diaphoretic and anti- 
febrile. 



Fistula. 

Piper Nigrum, the confection, as a gentle stimulant in anal fistula (P). 
Iodine, by injection, sometimes curative, but generally fails (Wa). Sanguinaria, 
as injection, has cured (P). Capsicum, the weak infusion, a useful stimulant 
in fistulous ulcerations (P). Glycozone, Z] in §j of lukewarm water, as enema 
once or twice daily, soon produces good effects in cases of fistula in ano (Ed- 
son). Surgical. Division of sphincter in anal fistula, by knife or ligature, the 
best treatment (D) ; in fistula lachrymalis, dilatation of passage by probing the 
canaliculus, or slitting the canaliculus up (D) ; in vesico-vaginal, or recto- 
vaginal, surgical methods best. Diet should be nourishing and digestible ; fresh 
air and general hygienic conditions are necessary (R). Bismuth Subiodide, 
dusted over the surface of the wound after washing, to stimulate granulations 
when healing process is indolent, is remarkably efficient. 



592 



FLATULENCE FLUSHING FOREIGN BODIES. 



Flatulence, 

Nux Vomica, will remove flatulence and intestinal indigestion (B) ; when 
constipation, heartburn, weight on head (R). Charcoal, gr. v or x, soon 
after or just before meals (R) ; mixed with Bismuth (R). Chloroform, pure, 
in drop doses, benefits (R) ; by far the best agent in flatulent dyspepsia to 
prevent flatulence, always given well diluted (Huchard). Carbolic Acid, 
when no acidity present (R). Turpentine, gtt. iij-v on sugar, will quickly 
relieve (B). Strontium Bromide, is excellent in flatulence from decomposition. 
Asafcetida or Valerian, quickly relieves the flatulence of hypochondriasis (P). 
Asaf. 3j of tinct. to 0%. water, dose 3) ; useful for children (R). Sodium 
Sulpho-carbolate, gr. xxx after eating, will be found very serviceable (R). 
Phosphoric Acid, dilute, is often promptly alleviative. Anise, the Oil, also 
Ether, or any other member of the carminative group, (See page 37), will 
promote the expulsion of gas from the stomach and intestines. Mercury, 
when with clayey stools (R). Calumba, an effective remedy for flatulent dis- 
position is an infusion of 3SS each of Calumba and Ginger, £j of Senna, hot 
water Oj, a wineglassful ter die (P). Potassium Permang., in flatulence at- 
tendant on obesity (B). Physostigma, flatulence of women at climacteric 
(B). Sulphurous Acid, in 5 to 10 minim doses, when flatulence due to fer- 
mentation (R). Diet. Abstain from sugar, starchy food and tea — especially 
sugar ; eat little, slowly and regularly , as a general rule abstain from alcoholic 
drinks and vegetables, especially cabbage. Pepsin or Ingluvin after meals, to 
promote digestion (R). [Compare Colic, Dyspepsia.] 



Prescriptions. 



R 



Tinct. Nucis Vomicae, 
Tinct. Physostigmatis, 
Tinct. Belladonnae, . . aa 5jj. 
M. Sig. — Fifteen drops twice daily in 
a little water. 

R . Tinct. Illicii Anisati, 

Tinct. Gentianse, 

Tinct. Nucis Vomicae, . aagj. 

Chloroformi, TT^xv-xxx. 

M. Sig. — 8 to 10 drops in a winegl. of 
water, before meals. 



JJ. Gummi Camphorae, 

Pulv. Zingiberis, 

Pulv. Capsici, . . . . aa gr. j. 
Ft. pil. no. vj. Sig. — One pfll as re- 
quired for gastric and intestinal flatulence. 



R- . Bismuthi Salicylatis, . . . g iv. 

Magnes. Calcinat., . . . giv. 

Pulv. Carb. Ligni, . . . . gvj. 

Olei Anisi, ^ij. 

Ft. pulv. Sig. — A teaspoonfui before 
each meal. [Huchard.) 



Flushing-heats. 

Nux Vomica, mjj of the tinct. with Try of Laudanum in hysterical flushings 
of the middle-aged, with flatulence, weight on head and perspirations (R). 
Amyl Nitrite, tt\, J^to l /e in thirty times its volume of rectified spirits, is effect- 
ive for flushing of face, or sensation of flushing, followed by coldness, with 
cold feet and hands and great prostration occurring at climacteric chiefly (R). 
Potassium Bromide, at climacteric, with mental depression (R). Zinc Vale- 
rianate, or Valerian, flushings at the climacteric (R). Eucalyptol, for the 
flushings, palpitations and flatulence incident to the change of life (R). 



Foreign Bodies. 

In the Eye, — Remove by bathing, or wiping towards the lower inner corner 
with a soft, moistened handkerchief, or a bent bristle, the two ends being held 
in the fingers. Use tepid solution of Vinegar (gss to 3J) for removing lime, 
tepid water for powder ; then apply a weak Zinc or Alum collyrium, or instil a 
solution of Atropine (gr. ij to the 3), or Cocaine, 4 per cent. In the Ear, — 
Examine carefully with speculum before removal ; first syringe with warm 
water, or a drop of sweet oil to drive out insects, before using the forceps ; 



FRACTURES FRECKLES GANGRENE. 



593 



apply equal parts of Laudanum and Olive Oil, a few drops on cotton, if much 
pain. In the Nose, — A current of tepid salt water, forced up one nostril, may- 
force down the body through the other, if the mouth be held open. In the 
Larynx or Pharynx, — if water can be swallowed, the obstruction is in the 
trachea. Never push a body down. Remove by curved forceps or blunt 
hook. If passed into the stomach use solid diet to imbed the article. If all 
fail and the case be urgent, resort to catheterism or tracheotomy. In the Flesh, 
— remove at once by forceps, or sponge and water. [Compare Asphyxia and 
Apncea.] 

Fractures and Dislocations. 

Arnica, internally is excellent to neutralize the ill effects of mechanical inju- 
ries, tt\,v-x in a wineglassful of water every 2 or 4 hours ; when used after 
amputations, it certainly has the power of promoting the rapid union of the 
surfaces : the infusion is better than an alcoholic preparation for external use 
(P). Aconite, quickly and repeatedly, if feverish symptoms ensue (P). Iodine, 
internally and by friction, occasionally useful in ununited fractures (Wa). 
Calcium Phosphate, promotes formation of callus (Wa). Opium, useless in 
surgical fever, and may do harm (CI) ; for nervousness or muscular spasms 
after dressing, gr. %. of Morphine hypodermically as anodyne (Ag). Benzoin, 
the tincture on lint, as a dressing for compound fractures and other severe 
injuries, leads to rapid and satisfactory healing (Bryant). Carbolic Acid, 1 to 
20 or 1 to 40 solutions, for irrigation and dressings in compound fractures, 
obviates pyaemia and most of the other preventable causes of death (P). 
Lead-water and Laudanum, on lint, or a Calendula lotion to the part, after re- 
duction of the injury, with Morphine hypodermically and perfect quiescence. 
Diet, should be very simple for a week or ten days. [Compare Wounds.] 



Freckles. 

Resorcin, as paste with Zinc Oxide, applied to the face, to promote peeling 
of the skin and removal of freckles and other superficial spots (Unna). [See 
under Acne.] Iodine, the tincture or glycerite, locally (B). Liquor Potassae, 
5j to ^ij aquas rosae, as a lotion (Todd). Benzoin, the compound tincture with 
water, as cosmetic to remove freckles (P). Sodium Borate, a saturated solution 
of Borax is a safe and often efficient lotion to remove freckles (B). Lime- 
water, and Olive Oil, equal parts, with a little Liq. Ammoniae, as liniment 
(Wa). Potassium Carbonate, makes a good lotion for freckles, sunburn and 
tan (B). Mercury, the Bichloride, with Alcohol and Glycerin, as a lotion, has 
been found effective: Donovan's solution, rr^lxxx to ^viij of water, of which 
^j every three hours, has been found highly successful (Wa). 



Prescriptions. 



R. Potassii Carbonatis, . . . £iij. 

Sodii Chloridi, ^ij. 

Aquae Aurantii Flor., . . ^ij. 

Aquae Rosae, J v 'ij- 

M. Sig. — Face-wash. (B.) 



R . Hydrarg. Chlor. Corr. , . . gr. vj. 

Ac. Hydrochlor. Dil., . . £j. 

Alcoholis, Aq. Rosae, . aa 5ij. 

Glycerini, ^j, Aquae, . ad ^ viij. 
M. Sig. — Apply at night, and wash off 
in the morning. 



Gangrene. 

Salicylic Acid, pure, in powder locally, to destroy fetor and change the 
character of the morbid action (B). Carbolic Acid, acts in the same way 
(B) ; a 1 per cent, solution as lotion in gangrenous ulcers (Wa). Sodium 
Sulphite, in solution, 1 to 5 or 10 of water, as lotion or applied on compresses, 
to destroy odor, soothe pain and restore healthy action (Wa). Ammonium 

38 



594 GASTRALGIA, GASTRODYNIA. 

Chloride, in solution as bath and fomentations, very successful in one case of 
senile gangrene (Wa). Cinchona, or better, Quinine, as the Hydrochlorate, has 
often proved of value (?) ; generally decoction of Cinchona best (Wa). Tur- 
pentine, locally, after removal of gangrenous part, a most efficient application 
(B) ; by stomach and inhalation from hot water in gangrene of lungs ; the 
oil locally in dry and chronic gangrene (P). Sanguinaria, has been recom- 
mended (P). Oxygen, as gaseous bath in senile gangrene (R). Charcoal, as 
poultice, value doubtful (R). Citric Acid, Lemon-juice dropped into wound, 
which is then covered with lint steeped in a solution of Chlorine ; very effec- 
tive for hospital gangrene, in Parisian hospitals \_Lancet, October, 1879]. Ferric 
Chloride, locally, is considered superior to the mineral acids (Wa). Nitric 
Acid, strong, applied carefully until the ulcer is converted into a firm, dry 
mass (Wa) ; is probably the best escharotic, next to Bromine, for gangrenous 
destruction (B). Bromine, is the best escharotic for hospital gangrene (B). 
Chromic Acid, is a very efficient caustic, penetrating deeply with but little pain 
(B). Opium, to soothe the pain, and diminish restlessness and irritability (Wa). 



Gastralgia, Gastrodynia. 

Resorcin, internally, acts exceedingly well. Opium, in some form necessary 
to relieve the pain in severe cases (Da C). Morphine, is of great value (P) ; 
subcutaneously in epigastrium very efficient, or in small doses with Bismuth and 
milk before meals (R). Belladonna, is useful in painful affections of the stomach 
(R). Atropine, often relieves promptly, and is excellent in neuralgic pain of 
the abdominal viscera (P). Nux Vomica, an excelfent stomachic, gtt. v-x of 
tincture before meals (B) ; gtt. j-ij every 2 hours in many forms of gastric de- 
rangement (R). Strychnine, hypodermically for gastralgia and gastrodynia 
(R) ; in very small doses, gr. \\q - ^ two or three times daily, a very successful 
remedy (P). Arsenic, sometimes dissipates the pain surprisingly (B) ; a drop 
of Liquor Arsenicalis before food in irritative dyspepsia and gastralgia with 
heartburn (R). Bismuth, when gastralgia due to irritation of mucous mem- 
brane, acts well alone, but is most efficient when given with aromatic powder 
and a little Morphine (R) ; or a combination of Bismuth and Arsenic in more 
chronic cases (B) ; Subcarbonate is especially adapted to gastralgia with labori- 
ous digestion and putrid or acid eructations (Wa). Manganese, the Black 
Oxide in gastrodynia and pyrosis (R). Zinc Oxide, an excellent remedy when 
gastralgia after food, gr. v-x with aromatic powder and Morphine, before meals 
(B). Silver Nitrate, in solution to check the pain of many stomachal disorders 
(R) ; a pill of gr. ss, with Extr. Hyoscyami gr. ij-iy (Wa). Hydrocyanic Acid, 
often cures rapidly when gastralgia from nervous derangement (B) ; may check 
vomiting as well as relieve pain (R) ; Cherry-laurel water a useful form (P). 
Nitro -hydrochloric Acid, gtt. ij-iij of the dilute acid, is serviceable (Da C). 
i*Ether, a few drops or the compound spirit rr\,x-xx, often relieves quickly (B). 
Chloroform, rr^ij-v on sugar, often relieves (B). Chloral, sometimes relieves 
pain in gastralgia (R). Pulsatilla, is efficient in many cases of painful dyspep- 
sia, with coated tongue, headache and nervous depression (P). Pepsin, when 
gastrodynia from indigestion (P). Creosote, checks pain after food (R). Alum, 
often affords relief (B). Ergot, of value in visceral neuralgias (P). Alkalies, 
for pain in stomach, Liquor Potassse generally employed (R). Quinine, in 
cases showing periodicity, and those of neuralgic type (P). Sodium Salicylate, 
for gastralgia with fermentation (R). Nitroglycerin allays the pain speedily 
(B). Carbonic Acid Water, in painful and irritable conditions ; may be mixed 
with milk (R). Milk-cure, very efficacious in obstinate cases (B). Galvanism 
■of the pneumogastric, and locally to the organ itself (B). Aquapuncture has 
given extraordinary relief (B). Diet is of the greatest importance ; food should 
be easily digestible, varied and plainly cooked ; sedentary livers should refrain 
from much animal food ; meals should be regular and frequent, eating little 
at a time, and that very slowly. Alcoholic beverages do harm as a rule, but 
may benefit particular cases. Eating should be done in as agreeable a frame 



GASTRIC DILATATION GASTRITIS. 



595 



of mind as possible, and the patient should rest for a time after a meal. 
pare Acidity, Dyspepsia, Neuralgia.] 

Prescriptions. 
R. Morphinae Sulph., . . . . gr. j. R 

Ac. Carbolici, Z ss. 

Aq. Menth. Pip., . . q. s. ad J iv. 
M. Sig. — Teasp. thrice daily. 

(Da Costa.) M 



[Com- 



R. Bismuthi Subnit., ^ij. 

Ac. Hydrocy. Dil., . . . . ^ss. 
Mucil. Acaciae, 

Aq. Menth. Pip., . . . . aaSjij. 
M. Sig. — Tablesp. thrice daily. 



R . Atropinse Sulph, gr. j. 

Zinci Sulph., £ss. 

Aquae Destill., J j. 

M. Sig. — 3 to 5 drops two or three 
times daily. (B.) 



Bismuthi Subnit., 

Magnesii Carb., . . . . aa gr. xvj. 

Ac. Hydrocy. Dil., . . . rr^x. 

Aquae, ^iv. 

Sig. — Dessertsp. for a child of 3 



years in flatulent gastrodynia and gastralgia. 

R. Ac. Hydrocy. Dil., . . . zij. 
Aq. Laurocerasi, . q.s. ad 3 iv. 
M. Sig. — Teasp. every 4 hours. 



R 



Pepsini, 3J. 

Ac. Hydrochlor. Dil., . . ^ ss. 
Glycerini, ^j ss ; 



M. et. filtra. Sig. — Tablespoonful doses 
for slow and feeble digestion. 



Gastric Dilatation. 

Carbolic Acid, internally to allay fermentation, with an occasional washing 
by the stomach pump (Da C). Strychnine, hypodermically or by the mouth, 
or Nux Vomica, the best remedy, conjointly with washing of the stomach and 
strict diet (Da C). Bismuth Subnitrate, with Magnesia or Soda, or Lime-water 
frequently, for the acidity, which is one of the most distressing symptoms (Fen- 
wick). Bismuth Salicylate, as an internal antiseptic, is highly praised. Salo- 
phen, relieves the fermentive disturbances. Diet, should be free from all starch 
and sugar, and from vegetables of any kind (Fenwick) ; milk not advisable, 
as much fluid will further dilate the organ ; solids better, as small quantities of 
dry, stale bread, or gluten bread, and underdone meat (Da C). 

Gastritis, Acute. 

Mercury, Calomel in broken doses, with ice, frequently swallowed, for the 
idiopathic form, which is occasionally seen and cannot be distinguished from 
that due to irritant poisons (Da C). Bismuth, Subnitrate or Subcarbonate in 
full doses after more acute symptoms have abated (Da C). Morphine, hypo- 
dermically for pain (B). Ice, internally and externally gives great relief (R). 
Aliment should be given per rectum ; no food, except milk and Lime-water, 
being admitted to the stomach for some time (Da C). Antidotes, in cases of 
irritant poisoning, as Alkalies to neutralize acids, Dialyzedlron or the Hydrated 
Sesquioxide for arsenic, Turpentine for phosphorus, etc. [See page 53, ante.~\ 
Then Oil, Albumen or milk, to protect the mucous membrane, stimulants, 
Opium, Ammonia, etc., to antagonize the depression of the vital powers. 



Gastritis, Chronic. 

Arsenic, sometimes surprisingly curative ; for the vomiting gtt. j-ij of Fowler's 
solution before meals (B). Pulsatilla, in subacute gastritis of phlegmatic tem- 
peraments, white tongue, heartburn, nausea, flatulency, little or no taste (P). 
Hydrastis, gtt. v-xv of tincture or fluid extract, daily before meals, especially 
for gastric catarrh of acute alcoholism (B). Nux Vomica, gtt. j of tincture 
every 5 to 10 minutes for 8 or 10 doses, in acute gastric catarrh, with headache 
or sick-headache ; also drop or 2-drop doses every 2 hours or oftener, when 
chronic gastric catarrh occurs in the course of chronic disease (R). Cinchona, 



596 



GASTRIC ULCER. 



to promote healthy state of mucous membrane, the infusion best with mineral 
acids, or Quinine ; the Red Bark in gastric catarrh of drunkards (B). Alkalies, 
either shortly before meals, to stimulate production of gastric juice ; or some 
hours after, to neutralize the acids of decomposition (Da C). Pepsin, gr. v 
immediately after a meal, to assist digestion (Da C). Podophyllum, in small 
doses at night, to act on upper bowel. Purgation as a method of treatment 
stands at the head (Da C). Ipecac, in small doses may prove highly useful, 
tt^v-x of the wine (P) ; for the nausea and vomiting (R). Tannic Acid, in 4- 
grain doses with a drop of Glycerin to make a pill (B). Bismuth Salicylate, as 
an internal antiseptic, is highly praised in chronic gastric affections. Strontium 
Bromide, gave successful results in 32 cases of gastric catarrh (See). Resorcin, 
acts exceedingly well. Glycozone, is one of the best remedies for the chronic 
gastric catarrh of alcoholism, and that from other causes (Edson). Hydrocyanic 
Acid, is much used (R) ; in subacute gastritis it often proves useful given in an 
ordinary effervescing draught (Wa). Silver Nitrate, in % or % -grain doses 
with Opium if pain, or preferably Belladonna, is extremely useful (Da C) ; to 
check pain and vomiting (R). Silver Oxide, is nearly as good as the nitrate, 
and not liable to produce staining (Da C). Opium, or Morphine, to quell pain 
in chronic gastritis from alcoholic excess (R). Eucalyptus, a most useful 
stomachic, not to be used in inflammatory states (B) ; is used with benefit (R). 
Mercury, the Yellow Oxide, in doses of gr. -^o~ru> m chronic form. [See under 
Dyspepsia.] Calumba, and other bitters are useful (B). Ammonium Chloride, 
in high repute in Germany (B). Caffeine, especially when associated with 
migraine (B). Bismuth, is very useful in chronic gastritis, especially that of 
drunkards, and the chronic gastric catarrh of children with vomiting (R) ; in- 
valuable for its sedative, alterative and astringent action; 10-15 grain doses 
several hours after meals (Da C). Lead Acetate, in chronic gastritis with 
gastralgia and pyrosis, may be combined with Morphine beneficially (B). 
Alum, when vomiting of glairy mucus (B). Aliment, such as will be digested 
in the small intestines ; requires careful attention ; the milk-cure has been very 
effective in bad cases ; malt liquors are harmful (B). Mineral waters of purga- 
tive type, to keep the portal system drained. Exercise is not beneficial ; better 
live quietly, and occasionally spend a day or two in bed (DaC). Kumyss very 
agreeable, and tolerant to stomach ; the milk-cure and buttermilk have been 
very efficient. The farinaceous vegetables, rice, tapioca, arrowroot, aerated 
bread. [Compare Dyspepsia, Gastralgia.] 



Prescriptions. 



R. 



Sodii Bicarbonat., . . . £jss. 

Tinct. Aurantii Cort., . . Jss. 

Infusi Calumbse, . q.s. ad 25 viij. 

M. Sig. — Two tablesp. before each 

meal. In chronic gastric catarrh. 



R . Aluminis, g ij. 

Ext. Gentianae, ^ss. 

M. Ft. pil. no. xxx. Sig. — Two twice 
daily. 

R . Argenti Oxidi, gr. xij. 

Ext. Belladonnae, . . . gr. iij. 
Olei Caryophylli, .... gtt. xx. 
M. Ft. pil. no. xxiv. Sig. — One pill 
twice daily. {Da Costa.) 



R. Magnesii Sulphatis, . . . ^j-ij. 
Sodii et Potassii Tart., . . 3 ss-j. 

Ac. Tartarici, gr. xx. 

Sig. — Dissolve in a glass of water, and 
drink, an hour before breakfast. 



R . Sodii Bicarbonat., . . . . gr. Ixxx. 

Spt. Chloroformi, .... ,^jss. 

Tinct. Gentianae, . . . . J ss. 

Infusi Rhei, J;iv. 

Aq. Menth. Pip., q. s. ad ^ viij . 
M. Sig. — A tablesp. or two before each 
meal In chronic gastric catarrh, with flat- 
ulence. 



Gastric Ulcer. 

Arsenic, Fowler's solution in drop doses lessens the pain and relieves the 
vomiting remarkably (B) ; has given relief when commonly-used remedies 
failed (R) ; gives good results when used in very small doses (Da C). Bismuth. 



GLANDERS AND FARCY. 



597 



relieves pain and vomiting, and contributes to the cure (B). [See under Gas- 
tralgia for formulae.] Silver Nitrate, in solution, to check pain and relieve 
the vomiting (R) ; is next in value to Bismuth, promoting cicatrization and eas- 
ing the pain (B). Silver Oxide is equally efficient, and is not liable to produce 
staining (Da C). Atropine, often happily relieves the pain and vomiting even 
when given in very small quantity (B). Morphine, for the pain and vomiting 
(R) ; in full doses if perforation occurs, to localize peritonitis until adhesions take 
place (Da C). Ergotin, I part to 10 of water, of which gtt. xv hypodermically 
several times a day for the hemorrhage. Gallic Acid, in 5-grain pill every hour 
for hemorrhage. Lead Acetate, is sedative and hemostatic; gr. ss-ij in pill 
with Opium, very useful to check hemorrhage and allay pain (R). Turpentine, 
5 to 10 drops frequently repeated in hemorrhage (R). Resorcin, acts very well ; 
its analgesic property herein is so marked that the stomach is enabled to tolerate 
food (Pope). Glycozone, is the best of all known agents for the treatment of 
gastric ulcer (Edson) ; should be given on an empty stomach, one or twoteasp. 
in a wineglassful of water. Charcoal is said to ease the pain by preventing for- 
mation of acid products (R). Mercury, Corrosive Sublimate an effective 
remedy ; gr. aV ' So tnr i ce daily before meals (B). Pepsin, by facilitating diges- 
tion, is useful (B). Iron, for the anaemia; the Lactate or Ammonio-citrate if 
stomach irritable (Da C). Ice-bag, to the epigastrium, for pain and vomiting, etc. 
(R). Nutrient Enemata, to rest the stomach. [See under Enemata for for- 
mula.] Brandy may be added, also Laudanum, gtt. x-xx, if the rectum is 
irritable (B). Milk-cure, has succeeded admirably (B) ; a strictly skimmed 
milk diet with Lime-water, 2 parts of milk to 1 of Aqua Calcis (Da C). Diet, 
should be of non-irritating character, which, with cold or hot compresses to the 
epigastrium, leaves little room for medicine. In bad cases nourish per rectum, 
so as to give the stomach complete rest ; in any case such food as is chiefly 
digested in the small intestines, farinaceous vegetables, rice, arrowroot, etc. 
A nice change from milk diet is a warmed pancreas, chopped up with rare meat, 
being nutritious and well relished (Da C). Rest, in bed for several months is 
imperative (Da C). Defibrinated Blood, by injection into rectum, in doses of 
from ^iij-yj (A. H. Smith). [Compare Hematemesis.] 



R . Argenti Oxidi, 

Ext. Hyoscyami, . . . aa gr. x. 
Ft. pil. no. xx. Sig. — One pill thrice 
daily before meals. 



R 



Prescriptions. 

R- . Argenti Nitratis, . . . . gr. v. 

Ext. Opii, gr. iij. 

Ft. pil. no. xx. Sig. — One pill thrice 
daily. . 



Bismuthi Subcarb., . . . 3 iij. 
Morphinse Sulph., . . . . gr. j-ij. 

Pulv. Aromat., gj. 

Ft. pulv. no. xij. Sig. — One powder in 
milk before each meal. 



&. Argenti Oxidi, . 
vel Zinci Oxidi, 
Morphinse Sulph., 
Ft. pil. no. x. Sig. 
daily, before meals. 



-One 



• 3 SS - 
pill thrice 



Glanders and Farcy. 

Ammonium Carbonate, in water, hourly, as concentrated as can be swallowed, 
followed by an opiate, and preceded by an emetic of Ipecac, and an incision 
into each of Wharton's ducts ; proved successful in a case of acute glanders 
(Wa). Carbolic Acid, and the Sulphites, as Sodium Sulphite, are most worthy 
of trial. Creosote, or Carbolic Acid, in Glycerin, locally (Wa) ; or dilute Chlori- 
nated Soda, and Lime-water. Escharotics, to destroy the affected spot, if inocu- 
lation occurs. Iodine, internally, also Arsenic and Strychnine, have been 
recommended. Quinine, in large doses, and Ferric Chloride, may be useful. 
Potassium Iodide, grs. 150 daily, with baths in Hot Springs of Arkansas, con- 
quered the disease in me, probably the only man who ever survived it. (Dr. 
Paul Paquin, Univ. Mo.) No drug yet tried has any marked specific effect on 
the disease (Durham). 



598 GLANDS GLAUCOMA GLEET. 

Glandular Enlargements. 

Iodine and Iodides, no remedy more efficient, when simple hypertrophy; 
useless (with all other medicines) when caseation or suppuration has set in. 
Iodine injected into cystic and glandular growths of neck: Syrup of Ferrous 
Iodide occupies an important place (B). Potassium Iodide for mammae and 
testicles, but especially for thyroid (R). Iodoform is equal, if not superior to 
Iodine, in enlarged scrofulous glands, and other glandular swellings (Wa). 
Lead Iodide, as an ointment. Ung. Hydrarg. Iodidi Rubri, produces very 
striking effects in goitre, enlarged spleen, etc. (B). Sulphides, especially the 
Blue Lick water, are said to abort or to mature suppuration in glands (R). 
Calcium Sulphide, for hard, swollen glands behind the angle of the jaw, with 
deep-seated suppuration (R). Calcium Chloride, highly useful in strumous 
inflammation and suppuration (B). Pilocarpus, is curative in acute affections 
of parotid and submaxillary glands (B). Mercury, useful in acute inflamma- 
tory states, tonsillitis, parotitis, etc.; Hydr. Chlor. Corr. gr. ■£$ or Hydr. cum 
Creta, gr. \, every two hours (B). The Oleate of Mercury and Morphine in 
obstinate and painful tonsillitis, and inflammation of lymphatic glands (R). 
Aurum. The Bromide of Gold and Arsenic rendered good service in a case 
of adenitis with enormous enlargement of the left side of the neck (E. A. 
Wood). Belladonna, especially in tonsillitis (P). Valerian, with Guaiacum, 
in strumous enlargement (P). Hydrastis, frequently controls (P). Carbolic 
Acid Injections, a 2 per cent, solution injected into substance of gland (B). 
Electrolysis, used by me to remove a number of swollen and painful lymphatic 
glands in the neck (Remak). By the use of strong and often interrupted faradic 
currents multiple indurated lymphatic tumors have been removed or dimin- 
ished (Meyer). Enlarged glands have been repeatedly cured by electrolysis 
(B). [Compare Bubo, Wen, Goitre, Tabes Mesenterica, Parotitis, Ton- 
sillitis, etc.] 

Glaucoma. 

Atropine, gr. g 1 ^ hypodermically beneficial (Anstie) ; imprudently used has 
caused the disease (Graefe, Wells). Eserine, lowers intra-ocular tension, and 
is indicated with Quinine, in all cases of threatened glaucoma, to preserve the 
eye from the risk of consecutive glaucoma, and after iridectomy or sclerotomy 
(Wecker). Iridectomy, the only remedy for the disease, medicine being worse 
than useless ; the operation should be performed as soon as a state exists which 
can be called glaucomatous; even when vision is lost, the operation will best 
relieve the pain (C) : almost a certain cure in early stages ; in later nearly 
always palliative and often curative. Drainage of Eye, by gold wire or catgut, 
has had success (Wecker). 

Gleet. 

Cantharides, in drop doses, when frequent desire and pain in region of 
prostate (R) ; of benefit in subjects of relaxed fibre and feeble circulation (B). 
Blisters, to the perinseum, of undoubted benefit (R). Piper Methysticum, has 
cured obstinate gleet (Switzer). Bismuth, 1, Glycerin 1, water 6 parts, as an 
injection, often useful in gleet (R). Eucalyptol, is used with benefit in chronic 
catarrh of the genito-urinary tract (R). Iron, the Tincture of the Chloride, .^ss 
in Oss of water with £>j of Laudanum, makes a good injection for gleet (R) ; 
internally for anaemic subjects (St). Mercury, Yz grain of Corrosive Sublimate 
in ^ vj of water, is a good injection in gleet, used every 2, 3 or 4 hours (R) ; Don- 
ovan's Solution in doses of 10 minims thrice daily, so uniformly successful in 
controlling chronic urethral discharge as to be almost a specific for gleet. 
Zinc Salts, the Sulphate or Chloride, gr. ij of the latter to a pint of water, as 
injection every hour (R). Bougies, of gelatin, medicated with astringents, are 
extremely efficient. Turpentine, in moderate doses, when due to relaxed con- 
dition (R). Copper Sulphate, a solution as injection (R) ; astringent injections 



GLOSSITIS — GLOTTIS GOITRE. 599 

may be used with benefit (Wa). Copaiba, smeared on a bougie, and intro- 
duced into the urethra, will sometimes cause gleet to yield (Wa). Sandalwood 
Oil, tt\,xv ter die (R). Glycerite of Tannin, with equal quantity of Olive Oil 
or mucilage, as injection, gij enough; persevere 8 or 10 days after discharge 
ceased, and do not use at bedtime (R). Balsams of Peru and Tolu, Buchu, 
Canada Balsam, Copaiba, Mastic, and Tannin, are used with advantage 
(P. R). Gleet is often kept up by over-treatment, will some time or other come 
to an end (St). Diet and Habits important. Stimulants, both solid and liquid, 
should be rigidly avoided, also coffee. Frequent ablutions, fresh air, good 
nourishment. [Compare Gonorrhoea.] 

Prescriptions. 

R- . Tinct. Ferri Chlor., . . . £vj. $. Pulv. Cantharidis, .... gr. iij. 

Tinct. Cantharidis, . . . gij. 01. Terebinth, gj. 

M. Sig. — 15 drops in water three times M. Ft. pil. no xij. Sig. — One thrice 

daily. daily in obstinate gleet. If strangury 

occur, stop for a day or two. 

R- . Zinci Sulphatis, gr. iij. 

Ac. Carbol., rr\jj. 

Ext. Hydrastis, 

Ext. Belladonnas, . . aa . gr. vj. 

Gelatini, q. s. 

M. Ft. bougia no. vj. Sig. — One 
urethra at bedtime. 



R- . Ac. Tannici, gr. x. 

Bismuthi Subnit., . . . . 3 ij. 
Aq. Rosas, ^ vj. 

M. Sig. — Shake and use as an injection' 
thrice daily. (Maury. \ 



Glossitis. 

Bismuth, gr. xx of Subnitrate with ^j of Glycerin and ^vij of water, as 
lotion, for erythematous inflammation of tongue (A). Purgatives, with gargles, 
leeches, antiphlogistic regimen generally (D). Quinine and Iron, should be 
given internally, with dilute acid washes, and free purgation (CI). Alum, dry, 
powdered, may be dusted on tongue (CI). Leeches, applied beneath the jaw, 
if symptoms are urgent (CI). Abscess, should be opened, if any form. In- 
cisions, along superior surface, followed by vapor of hot water, may instantly 
relieve congestion (A). Tracheotomy or Laryngotomy, if suffocation is immi- 
ment (A). 

Glottis, CEdema of. 

Emetics, non-depressing when oedema slight (A). Inhalations, of steam 
with Benzoin, or Conium, of great service (A) ; or of Tannin, gr. viij or x to 
3J of water; or Alum, gr. x to the ^, or a saturated solution of Potassium 
Chlorate, all as spray (Walker). Ethyl Iodide, by inhalation, proved curative 
in one case in which it was repeated twelve times (See). Scarification, by 
laryngeal lancet, of paramount value (A). Tracheotomy, if the above fail 
(A). O'Dwyer's laryngeal tubation promises well. [Compare Croup, Laryn- 
gitis.] 

Goitre. 

Iodine, is curative in simple hypertrophy (ordinary goitre) used both inter- 
nally and externally : deep injection of the tincture is very successful in cystic 
degeneration of the gland (B) ; also in the fibrous and fibro-cystic varieties, 
if injection be made into the tumor ; dangerous, if into a vein or into the 
surrounding areolar tissue (Wa). Mercuric Iodide, as oint. assisted by the 
sun's rays, a piece the size of a large pea rubbed in daily, very successfully 
used in India for simple hypertrophy (R) : the official Unguent. Hydrarg. 
lodidi Rubri, 1 in 10 daily (B) ; is too strong (Gross) ; gr. xv to the ^ strong 
enough for the worst cases (Wa). Potassium Iodide, internally, also exter- 



600 GONORRHOEA. 

nally as ointment, in simple hypertrophy of the gland (R). Strychnine, 
gr. ^q thrice daily, has been successful in several cases (Holmes). Ferric 
Chloride, injections of the solution used in thirty-eight cases with curative 
results (Mackenzie). Ergotin, injected with benefit into the parenchyma of 
the goitre (P) ; also used hypodermically with good results (Wa). Ammon- 
ium Chloride, as an internal remedy has proved curative (Stevens). Electro- 
lysis, has sometimes cured in cases of simple hypertrophy and cystic gland 
(B) ; 6 out of 14 test cases of goitre were absolutely cured by electrolysis 
(Duncan). Spongia Usta, was formerly considered a sovereign remedy (Wa). 
Seton, has cured. Fluoric Acid, in doses of rr\,xv to £j thrice daily, largely 
diluted, cured seventeen cases out of twenty (Woakes). Excision, is a very 
difficult operation, only to be considered in extreme cases ; it has been per- 
formed successfully by Desault, Harris, Lane, Hedenus, Billroth and Greene. 
[Compare Exophthalmos.] 

Prescriptions . 



&. Ammonii Chloridi, . . . gyss. 
Syrupi Simplicis, . . . . ;f ss. 
Aq. Cmnamomi, . . . . |j iv. 
M. Sig. — Teasp. thrice daily. 



& . Unguenti Hydrargyri Iodidi 

Rubri, £j. 

Vaselini, 3 vl )- 

M. Sig. — Use as directed. (Gross.) 



Gonorrhoea. 

Aconite, a drop of tinct. each hour in the acute stage (R) ; when inflamma- 
tion (Pf, St). Gelsemium, serviceable, acute stage (Pf). Cannabis Sativa, 
after acute symptoms subside, a few drops 3 or 4 times a day, is fully as effect- 
ual as Copaiba or Sandal, and infinitely more pleasant to take (Pf ). Canna- 
bis Indica, relieves pain, diminishes discharge (P) ; occasionally useful (R). 
Mercury, excellent results from Corrosive Sublimate (Pf ) ; gr. %-Yz to ^viij 
aquae destill. in subacute and chronic stages, as injection thrice daily ; may have 
gr. ss-j of Zinc Chloride added with benefit; is often. effectual (Wa.) [See 
page 476 for formula.] Hydrastis, the infusion best for injection, gj of root to 
Jviij aquae (Pf) ; the fluid extract is one of the best injections, properly diluted ; 
or the Muriate of Berberine (Hydrastin) gj to ^iv of mucil. acaciae (B). Col- 
chicum, the wine of the seed has frequently cured gonorrhoea, and was used 
in thirty-minim doses nightly for the relief of chordee by Brodie (B). Ferric 
Chloride, when acute stage has passed and the discharge is degenerating into 
gleet, few remedies are more useful than this tincture, in doses of ttlxv-xx 
thrice daily (Wa). [See Erysipelas for formula.] Alkalies, Citrates or Bicar- 
bonates to render the urine alkaline (R); Lithium Carbonate in five-grain 
doses thrice daily, for the same purpose : Alkalies are the chief factor in Otis's 
treatment ; Potassium Bicarb., gr. x in a tumbler of water, or in Flaxseed tea, 
or Infusion of Triticum, with gr. xv of Potass. Bromide, if great pain present ; 
Vichy Water (Celestin's) freely (Otis.) Turpentine, in chronic stage, when 
parts are relaxed, moderate doses are of great benefit (B). Cantharides, drop- 
doses may be used (R) ; in the chronic stage (B). Pulsatilla, in subacute and 
gonorrhceal ophthalmia (P). Copaiba, especially adapted to gonorrhoea (B) ; 
pour it upon half a winegl. of water to which add some bitter tincture (Chap- 
man) ; if given too early in the disease it will aggravate the symptoms (P) ; 
should not be used until pain in urinating is nearly gone, chordee ceased, and 
the discharge is diminishing and of yellow color (Wa) ; is no good, but rather 
injurious, and prolongs the disease (Otis). [See page 471 for formula.] 
Sandalwood Oil, valuable in subacute (P) ; a good quality difficult to obtain 
(Pf); the best internal remedy, Copaiba next (St). Silver Nitrate, a weak 
solution (gr. j-v to %]) as injection ; in vaginal gonorrhoea a strong solution (£j 
to ^j) through speculum to every part of the canal (B) ; as abortive injection is 
useless and dangerous (St). Cubeb, unlike Copaiba, is given with good effect 
in acute stage ; best results from a mixture of both as in electuary [See 
formula below] ; is not irritating to the stomach, and agrees with some patients 
better than Copaiba (Wa). Zinc Salts, a weak injection of the Chloride, gr. j 



GONORRHOEA. 



60 1 



to ^vj or viij of Rose-water ; or the Sulphate gr. j to the J, frequently repeated, 
is probably the best treatment (B) ; the best injections are those of the Sul- 
phate or Acetate, gr. vj-xij to ^iv aquae, after the acute inflammation subsides 
(St). Bismuth, the oleate, smeared on a sound, and inserted for 5 minutes 
(Shoemaker); with mucilage as an injection, excellent in chronic gonorrhoea 
(Hill). Lead Acetate, the dilute solution of the Subacetate, as injection, may 
be employed at any stage (B). Chloral, a weak solution, gr. j-iv to the 3j, a 
very good injection (Hill). Resorcin, a 1 per cent, solution makes a useful 
injection (Wa). Injections, of Tannin, Copper Sulphate, Iron, Cadmium, 
Port-wine, Brandy-and-water, and 1000 other agents (R) ; injections are very 
bad, especially in the acute stage ; should never be used until the 5th week and 
then only if the case is not progressing (Otis). True gonorrhoea is never cured 
in less than four weeks (Van Buren and Keyes) ; urethritis is a different disease 
entirely (Otis). Balsams of Peru and Tolu, also Buchu, Uva Ursi, Chimaphila, 
Pareira, etc., are among the numerous remedies used for gonorrhoea (R). 
Alcohol, as a beverage, or any other stimulant, must be avoided entirely (R). 
Soluble Bougies made of Iodoform, Eucalyptus and Cacao-butter, are highly 
recommended to cut the disease short (Wa) ; a series of similar preparations, 
having a basis of Gelatin and Glycerin, medicated with the usual astringent 
and sedative drugs, is manufactured by C. L. Mitchell, of Philadelphia, and 
may be obtained of the drug trade. Wrappings of several folds of cotton are 
heating and uncomfortable, also dirty and productive of balanitis, etc. Pin a 
false front to shirt for covering (St). Rest, in bed is an absolute desideratum, 
especially during the inflammatory stage. Hot water, ioo° F., to the penis 
during urination, extreme cleanliness, milk diet ; water freely as a beverage ; 
flavored with a few drops of Oil of Gaultheria, or Flaxseed tea, or Infusion of 
Triticum with Potassium Bicarbonate. Sexual thoughts to be entirely avoided 
(Otis). [Compare Chordee, Gleet, Orchitis, Rheumatism Gonorrhceal, 
Urethritis, Urethral Stricture, Vaginitis.] 



Prescriptions. 



For Internal Use. 

R. Potassii Citratis, ^ ss- j- 

Spt. Limonis, 3 SS - 

Syr. Simplicis, ^ ij. 

Aquae, '%]. 

M. Sig. — Dessertsp. largely diluted, 3 
or 4 times daily. As alkali for the increas- 
ing stage. ( Otis.) 

The Black Paste* 

R • Pulv. Cubebse, Jf iij. 

Copaibae, ,1J SS - 

Aluminis, .^ij. 

Sacchari Albi, . . . . . %)■ 

Magnesias, .5Jss. 

Olei Cubebae, 5J. 

Olei Gaultherias, . . . 3]. 

M. fiat electuarium Sig. — A piece the 

size of a walnut after each meal. (Otis.) 



R 



M 



Oleoresinae Cubebae, . . . % iv. 
Potassii Bromidi, .... ^j. 

Olei Sassafras, Tl\x. 

Syr. Acaciae, t ^ij. 

Aquae, q. s. ad ^v). 

Sig. — Dessertsp. 3 or 4 times daily. 
(/. Wm. White.) 



[For Alkaline Emulsion of Copail 
ante, page 471.] 



R 



M 



For Local Use. 

Resorcini, gj. 

Ac. Borici, gr. x: 

Zinci Acetatis, gr. % 

Aquae Destil, ^iv. 

Sig. — Dessertsp. as injection. 



R . Pulv. Iodoformi, . . . . Jj ss. 
Ac. Carbolici, . . . . . . "Z, ij. 

Glycerini, ^ ij. 

Aquae Destil., . . q. s. ad ^ viij. 
M. Sig. — Teasp. as injection. 



R. 



Zinci Sulphatis, gr. vj. 

Plumbi Acetatis, . . . . gr. viij. 

Ammonii Chloridi, . . . gr. iv. 

Aluminis, gr. v. 

Aquae Rosae, ^j. 

M. Sig. — Injection to be used after 
acute symptoms subside. 



R. Zinci Sulphatis, gr. viij. 

Liq. Plumbi Subacet. Dil., ^ iv. 
M. Sig. — Use as an injection. 



R. Zinci Chloridi, gr. j. 

Aquae Rosae, ^ vj — viij. 

M. Sig. — Use as injection. 



[For Injection Brou and others, see ante 
page 476.] 



602 



GOUT. 



Gout. 

Piperazin, the best solvent for uric acid ; promptly reduces the redness and 
swelling of the joints in acute gout ; remarkably relieves the paroxysm, and 
promotes elimination of uric acid and urates ; should be given in doses of 15 
grains daily, dissolved in a pint or more of carbonated water. Phenocoll, the 
Hydrochloride, when much pain and fever ; combined with Piperazin, gr. xv 
of each daily in a pint or more of carbonated water, is very efficient treatment. 
Morphine, hypodermically, as close to the affected joint as possible outside of 
the red areola, is miraculous in giving immediate relief. Antipyrin, remarkably 
efficient for relieving the pain as well as prophylactic against future attacks 
(Marshall). Aconite, may certainly relieve pain (P). Belladonna, the best 
remedy to effectually and speedily soothe pain ; also in gout; of the stomach, 
5-rr^ doses efficacious (P). Potassium Iodide, especially when pain is worse at 
night (R). Colchicum is merely palliative ; a large dose (gj) of the wine often 
removes the severest pain in an hour or two, and soon after the swelling and 
heat subside (R) ; it is especially useful in acute and rheumatic gout (B) ; is not 
specific, nor a lasting or final remedy for gout, but acts very directly on the 
pain and inflammation of acute attacks. Laville's tincture is a Colchicum prepa- 
ration, though Colocynth is also a constituent (P) ; Colchicum is useful in the 
bronchitis, asthma, dyspepsia, urticaria, etc., of gouty subjects (R). Veratrine, 
as ointment to painful joints (R). Sulphides, as baths in chronic gout,, or fumi- 
gation with Sulphurous Acid, and bed-clothes exposed to strong fumes (R) ; 
Sulphur waters certainly benefit (B). Iodine, painted round joints in chronic 
gout (R). Strychnine, hypodermically for later stage of gout paralysis (R). 
Arsenic, very serviceable in a form of chronic arthritis allied to neuralgia (B). 
Lithium, the Bromide internally and a strong solution of Lithia to the joints 
(B) ; the Bromide is the most efficient agent in combating the disease (Aulde) ; 
the Carbonate (gr. v to the %) on lint around gouty enlargements, joints, etc. 
(R). Sodium Salicylate, gr. x internally every 2 hours, also £>ij to ^vij of warm 
water, as lotion on lint covered with oiled silk. Guaiacum, has long had high 
repute, and may be given for a long time without injury (Wa). Rhubarb with 
an alkali, regularly during intervals, very serviceable (Halford). Manganese, 
Syrup. Ferri et Mang. Iodidi (rr\,x-,5ss) for the cachectic state (B). Alkalies, to 
relieve indigestion, especially Lithium Salts ; Alkaline mineral waters have 
long had a deserved reputation (B) ; Magnesia and its Carbonates often of great 
service ; the latter dissolved in excess of C0 2 an elegant form of administra- 
tion (Wa). Alkaline Poultice, 9 of Linseed meal to one of Sodium Bicarb, is 
a useful application (R). Turkish Baths, are useful in chronic gout (R). 
Aliment. Farinaceous vegetables and acid fruits ; avoid animal or saccharine 
food. Milk-cure has improved' cases, and apparently removed the diathesis 
(B). Cod-liver oil in chronic gout (B, R). Entire abstinence from alcoholic 
beverages is best; the worst wines are port, sherry and maderia. Local 
Measures. The affected limb should be raised, and surrounded by hot, moist 
flannels ; wrap the hands in flannel dripping with water, and cover with water- 
proof bag, to dissolve gouty deposits. [Compare Arthritis, Lith^emia.] 



Prescriptions. 



Scuc/amore's Mixture {Modified). 



R . Vini Colchici Radicis, 




• .1 J- 




Magnesii Sulphatis, . 




• %)■ 




Magnesia Optimae, . 




- 3 ij- 




Aquae Menth. Pip., . 




5 X. 




M. Sig. — Tablesp. every 


hour until it 


operates on the bowels. 




g r - J 




R- . Colchicinae, .... 




Ext. Colocynthidis Co., 




. 3ss. 




Quininae Sulphat., 




Z"h 




Ft. pil. no. lx. Sig. — One 


every 


four 


hours. 






(B-) 



R-. Vini Colchici Sem., . . . 5SS. 

Tinct. Digitalis, . . . . ^ij. 

Liq. Potassii Citratis, . . ^ ijss. 
M. Sig. — A teasp. in water every six 
hours. 

Lallemand' 's Specific. 
R . Ext. Colchici Acet. (B. P.), 

Ext. Opii Aquosi, . . aa gr. xv. 

Potass. Iodidi, t ^iv. 

Potass. Acetatis, .... £ij. 

Aquae Destill. , ^ iijss. 

Vini Albi, \ ss. 

M. Sig. — 20 drops thrice daily. 



GUMS HAIR. 



603 



& . Lithii Citratis, 

Magnesii Carbonat., . aa ^j. 

M. et div. in pulv. no. 1. (50). 

Sig. — One in water thrice daily, 
chronic gout. 



In 



R . Lithii Bromidi, ?j. 

Liq. Potas. Citrat., . . . Miv. 

Syr. Tolutan., . . . . . x\]. 
M. Sig. — A teasp. in plenty of water 
after each meal. {Aulde.) 



Gums. 

Myrrh, the tincture for spongy and ulcerated gums (P) ; 3ij-iv in ^iv of 
water or Infusion of Cinchona, is highly serviceable as a gargle or mouth-wash 
(Wa). Alum, for spongy and ill-conditioned gums, tending to recede from the 
teeth, whether of mercurial or scorbutic origin (Wa). Catechu, a piece dis- 
solved slowly in the mouth is often of service in similar conditions (Wa). 
Rhatany, the powder as a dentifrice, keeps gums in good order (P). Potassium 
Chlorate, gr. ij every four hours for a child of one year, for inflammation of 
gums in teething (Wa). Carbolic Acid, gr. iij ad ^j aquae, as lotion in diseases 
of the gums (Hilditch). Pomegranate, the bark an excellent basis for gargles 
in relaxed gums (P). Potassium Iodide, gr. x thrice daily, for periostitis of 
alveolar processes, marked by looseness of teeth, pain and swelling of gums 
(Graves). Iodine, gr. j ad ^j aquae, applied by a camel's-hair brush, after each 
meal, for retraction of gums with loosening of the teeth (Stille). Tannin, the 
glycerite, for spongy and bleeding gums (B). Carbolate of Iodine, when fetor, 
(B). Benzoin, the tincture a good application (B). [Compare Scurvy, 
Teeth.] 

Prescriptions. 



R . Aluminis, 3 ss. 

Tinct. Myrrhae, 5jj. 

Tinct. Cinchonae, ^iv. 

Mel. Rosae, 3}. 

Vini Albi ^ viij. 

M. Sig. — Mouth-wash. 



R . Tinct. Orris, 
Spt. Rosae, 

Alcoholis, aa ^iv. 

01. Amygd. Amar., .... gtt. ij. 
M. Sig. — Violet Mouth- wash. 

(Piesse. 



Hair. 

Rosemary, encourages the growth of hair, mitigates baldness, and is supposed 
to prevent uncurling in a damp atmosphere (P). Hydrogen Dioxide, and 
other preparations of oxygen, are used to "blonde " the hair, for purposes of 
fashion (Wilson). Hair-dyes, comprise Potassium Permanganate, Pyrogallic 
Acid, Black Oxide of Lead, which are temporary, and the Black Oxide of Silver, 
which is permanent in its action (Wilson). Depilatories usually consist of 
powders containing Quicklime 3 parts, Sodium Sulphide 1, and Starch 4. A 
powerful depilatory is Barium Sulphide made into a thin paste with Starch 
(Wilson). Another contains Yellow Sulphide of Arsenic, gr. xx, Quicklime, ^ss, 
Starch, gij. A very effective one is Barium Sulphide and Zinc Oxide (B). 
Sarsaparilla is stated by Teste to possess the curious property of changing red 
hair to a light flaxen color, when taken internally for three months. [Compare 
Alopecia, Syphilis, Tinea Tonsurans, etc.] 



. Sodii Boratis, 3 

Aq. Ammoniae, . . . . . t ^ 

Spt. Myrciae, ^ 

Aq. Rosae, ^ 

M. Sig. — Shampoo Hair Wash. 



Prescriptions. 



R 



R 



. Ac. Salicylici, . . . 
Tinct. Benzoini, 
Alcoholis, Glycerini, 

M. Sig.- Hair Wash. 



. gr. xl. 

. 5JSS. 

aa 3; viij. 



M. 



01. Ricini, ^J ss - 

01. Bergamottae, 3J SS - 

01. Cinnamomi, 

01. Caryophylli, .... aaTTLvij. 

01. Lavandulae, rr^xl. 

Tinct. Cantharidis, . . . .■ gj. 

Aq. Ammoniac, ^ij. 

Alcoholis, q.s. ad Oj. 

Sig. — Hair Tonic. 



604 



HAY-FEVER. 



Hay-Fever. 

Arsenic, especially valuable when disease is more of catarrhal than of asth- 
matic type, 3-minim doses of Liquor Arsenicalis (Makenzie) ; as cigarettes, 2 
or 3 daily. [See Asthma for formula.] Belladonna, when nasal secretion is 
very profuse (B). Euphrasia, of decided benefit for the catarrhal symptoms 
(Pf ). Quinine, very useful after the more acute symptoms have subsided (R) ; 
injected into the nares checks catarrhal discharge and spasmodic symptoms 
(P) ; a solution of the Hydrochlorate, gr. iv-viij ad sjj aquae, applied locally to 
nasal mucous membrane by a spray-producer or a brush, will arrest the disease 
if confined to the nares and fauces (B). Ipecacuanha, in hay-asthma (R) ; 
is of great value, though the smallest doses cause similar effects (P). Aconite 
is better than Arsenic in true hay-fever (R) ; has been used with the best results 
(P). Grindelia benefits cases of asthmatic type (B). Iodides are very ser- 
viceable, locally and internally ; large doses until some iodism observed ; may 
be combined with Arsenic (B). Opium, especially as Morphine, of great value 
in any stage, but great danger of the opium-habit (B) ; the tincture in doses of 
rrvjj-iij every 2 hours for three doses, then rr\J every 2 hours until the discharge 
abates, has given excellent results (Wa). Black Coffee is highly recommended 
(P). Cocaine, a 5 to 20 per cent, solution of the Hydrochlorate, brushed over 
the nasal mucous membrane after drying it as far as possible, is the most effi- 
cient palliative yet obtained (R) ; a 4 per cent, solution dropped from a medi- 
cine-dropper well into anterior nares, the head being thrown well backward, or 
sprayed up the nostrils from a small atomizer ; gives immediate relief, and 
though not curative it prevents so much suffering and distress that in no case 
should it be left untried (DaC). Ignatia, the tincture has seemed to benefit 
some cases, and to favorably influence the course of the disorder (Da C). 
Lobelia, has been found an efficient remedy (Wa). Tobacco, smoking helps 
some and aggravates the symptoms in other instances ; internally ad nauseam 
it helps, but there are better and safer remedies (Wa). Removal to the sea- 
coast, or a barren, mountainous district, gives the only relief to some sub- 
jects; though many of the worst cases, hitherto unaffected by medicine, are 
now relieved by the local application of Cocaine. [Compare Asthma, 
Catarrh, Conjunctivitis, Influenza.] 



Prescriptions. 



R 



For Internal Use. 

Potassii Iodidi, ^j. 

Liq. Potass. Arsenit., . . sj.j. 

Aquae Cinnam., 25 iv. 

M. Sig. — Teasp. every 4 hours. 



R . Ext. Hyoscyami, . . . . gr. xij. 

Potassii Iodidi, £j. 

Potassii Bicarb., . . . . gij. 

Ext. Glycyrrhizae Pur., . . % iv. 

Aq. Anisi, % ivss. 

M. Sig. — Dessertsp. every 4 hours until 
relieved. ( Weber.) 

R. Liq. Potassii Arsenit., . . ^j. 
Tinct. Belladonnse, . . . gij. 
M. Sig. — 5 to 10 drops after meals, as 
a prophylactic. 



R. Tinct. Euphrasise, .... gjss. 
Aq. Camphorae, . q. s. ad J ij. 
M. Sig. — Teasp. four times daily, for 
the catarrh. 



For Local Use. 



R 



Tinct. Iodi, gj. 

Ac. Carbol., gtt. x. 

Aq. Destill., Jjiv. 

M. Sig. — For local use with atomizer 
or post-nasal syringe. 

R. Mentholi, gj. 

Ac. Carbol., £ss. 

Zinci Oxidi, £j. 

Ol. Amygd. Dulcis, . . . !§jss. 

Cerati Simplicis, . . . . ^ij. 
M. Sig. — Apply thoroughly to the nos- 
trils every few hours. 



R. Quininae Bisulph. , . . . giij. 

Aquae, ^iv. 

M. Sig. — Irrigate the nares, after 
cleansing with a weak alkaline solution. 



R. Cocainae Hydrochlor., . . gr. vj. 

Aquae Destill , £ij. 

M. Sig. — 5 per cent, solution. A few 
drops to be instilled into nares while head 
is lowered. {Da Costa.) 



HEADACHE. 



605 



Headache, Bilious-sick. 

Salol, is one of the most efficient remedies. Antipyrin, the most valuable 
single remedy for headaches ; an 8-grain dose in dyspeptic headache, in a little 
water, at commencement of attack, the patient lying down in a dark room ; a 
second dose one hour after is generally enough, but a third or fourth may be 
required : sleep generally follows, and there are no unpleasant after-effects. 
Acetanilid, in 4-gr. dose, equally effective. Nux Vomica, gtt. j of tinct. fre- 
quently, when acute gastric catarrh, with headache and nausea (R) ; gtt. j 
every 10 minutes, soon after meals, often gives marked relief in sick-headache 
not of neurotic origin (Smith). Strychnine, with Aloin and Belladonna, in 
minute granules, for bilious headache from obstinate constipation, effective if 
given several times a day for a week or ten days (Roy). Belladonna, the 
extract in doses of gr. -^"xo' m similar form. Iris, blinding headache in right 
supraorbital region, with nausea and vomiting, usually the result of hepatic 
derangement ; n\j every half-hour for three doses, usually relieves promptly 
(Pf). Bryonia, ordinary bilious sick headache with vomiting (P). Picrotoxin, 
gr. -^ by stomach, in periodical form (B). Chamomile, a popular remedy (R). 
Podophyllum, in sick headache, with dark bilious diarrhoea, or when consti- 
pation with dark evacuations (R). Sanguinaria, when due to stomach derange- 
ment, a few doses relieve (P). Hydrastis, from constipated bowels (P). Mer- 
cury, as Blue Pill, to prevent or mitigate ; or small doses (gr. y^) of Bi- 
chloride when with light-colored diarrhoea (R). Ammonium Chloride is an 
efficient remedy in most forms of headache (Wa). Sodium Phosphate, a 
useful laxative in so-called bilious-sick headache (B). Potassium Bromide, a 
large dose in ordinary or sick-headaches (R). Ginger, in paste, as counter- 
irritant (P). Water, as cold or hot affusion, or ice-bag to head ; hot sometimes 
best; the purgative waters (as Friedrichsha'll) before breakfast in a cup of hot 
water (R) ; a brisk saline purgative, or small doses of Epsom salts thrice 
daily, very effectual for frontal headache with constipation (Br). Nitro-muri- 
atic Acid, 10 drops of the dilute acid in a winegl. of water, before each meal, 
often an effectual remedy (Br). Charcoal, two teaspoonfuls stirred in half- 
glass of water, as a draught, is an efficient remedy for sick-headache with sour 
stomach and flatulence, etc. [Compare Hemicrania.] 



Prescriptions. 



R. 



Ammonii Chloridi, . . . 
Morphinae Acetatis, . . 
Caffeinae Citratis, .... 
Spt. Ammonii Aromat., . 
Elix. Guaranae, .... 

Aquae Rosae, 

M. Sig. — Dessertsp. every quarter-hour 
until relieved. {Carpenter.) 



R- . Podophylli Resinae, . , . gr. ij. 
Tinct. Zingiberis, . . . . 3 ij. 
Alcoholis, . . . . q. s. ad gj. 
M. Sig. — Teasp. in a winegl. of water 
every night at bed-time, or every second, 
third or fourth night as required. 

{Dob ell.) 



Headache, Congestive. 

Aconite, to reduce the circulation (R). Veratrum Viride, at menstrual 
periods (R). Belladonna, relieves cerebral congestion, and distress from light 
and sound (P) ; pain over brows and in eyeballs, often due to stomach or 
uterine derangements, especially in young women ; tt\,iij of tinct. every three 
hours (R). Potassium Bromide, a large dose (gr. xv-xx) in ordinary or sick- 
headaches (R); Bromides are useful when nervous system has been irritated, 
but when exhausted they do harm (Hammond). Calomel, gr. ^, every hour 
for ten or twelve doses, will relieve the headache of syphilis occurring at night 
(Tr). Cannabis Indica is given with uniformly good results in the headache 
of the climacteric. Potassium Iodide, throbbing, intolerance of light, pain 
passing from back of neck over vertex to brow, nocturnal, tender scalp, almost 
unbearable; ten-grain doses ter die will cure (R). Hydrastis, when consti- 



6o6 



HEADACHE. 



pated bowels (P). Amyl Nitrite, for headaches with severe flushing heats at 
menstruation or climacteric, "TCVs 1 ^ a sufficient dose (R). Mustard, in hot foot- 
bath, or as poultice to nape of neck in various forms of headache (R). Water, 
cold water poured gently over forehead, sometimes warm water better (R) ; a 
very hot foot-bath often effectually relieves (Wa). Purgatives are often bene- 
ficial, especially when congestive headache arises from suppression of hemor- 
rhoidal discharge, or in persons of phlegmatic habit ; Aloes best (Wa) ; or 
Colocynth, as derivative, when cerebral hyperaemia (Da C). 



Prescriptions. 



R 



Ext. Colocynthidis Co., . . gr. xij. 

Pulv. Capsici, gr. iv. 

Ext. Gentians, ...'.. gr. xxiv. 
Ft. pil. no. xij. Sig. — One pill thrice 
daily; also a 25-gr. dose of Sodium Bro- 
mide nightly, at bedtime. {Da Costa.) 



R- . Spt. Ammoniae, 5 j. 

Spt. Camphorae, gss. 

M. Sig. — For a quart of water, in which 
a handful of common salt has been dis- 
solved. Cork tightly and use locally on 
lint as an evaporating lotion. 



Headache, Nervous. 

Cannabis Indica, ten-minim doses of the tincture thrice daily in the intervals, 
often curative in bad cases of neuralgic headache; or % to ]/z -grain doses of 
the extract (P). [See under Hemicrania.] Belladonna, rr^iij of tinct. every 
3 hours, when pain over brows and in eyeballs, especially when at men- 
strual periods ; also when from over-study or fatigue (R). Nux Vomica, if with 
gastric symptoms (R) ; is better than Strychnine, and should be given in quarter- 
grain doses of the extract after meals, combined with Iron and Quinine if patient 
rs chlorotic (Hammond). Bromides, when the nervous system has been irritated 
are useful, but harmful when it is exhausted (.Hammond). Silver Nitrate, half- 
grain doses with minute doses of Pil. Coloc. Comp., invaluable in headaches of 
hysterical women and especially stomach headaches of delicate and literary 
men (Wa), Ignatia, removes clavus hystericus (Pf). Ammonia, the Aromatic 
Spirit (£>ss-3ij) or the Carbonate (gr. v-x) in nervous headache (B) ; the Hydro- 
chlorate (gr. x-xx) in bilious and hysterical headaches, especially in hard- 
worked and delicate young women (Wa). Amyl Nitrite, inhaled, when extreme 
pallor of face (B). Arsenic, throbbing supra-orbital (R) ; as a nerve tonic 
stands next in value to Zinc (Hammond). Cimicifuga, in nervous or hysterical 
women, especially at menstrual periods (R) ; in rheumatic headaches and 
menstrual (P). Coffee and Tea, when from nervousness or exhaustion (R) ; 
Coffee especially useful (P). Guarana, a very effective palliative, gr. xx every 
half-hour for three doses (P) ; rr^xv of the fluid extract every quarter-hour 
increased to rr\,xl will often relieve periodical headaches not of malarial origin 
(Smith). Sodium Salicylate, in small doses, gr. ij-iij every quarter-hour, is 
very efficient in neuralgic headache (Br). Caffeine Citrate, one to two-grain 
doses, in capsule, every half-hour, a very effectual remedy for nervous and sick- 
headache, but causes insomnia if used in the evening. Phosphorus, as dilute 
Phosphoric Acid, in doses of rr^xxx well diluted, thrice daily ; or Zinc Phos- 
phide, gr. T ^ in pill, ter die, very useful in most forms of nervous headache 
(Hammond). Cajuput Oil, well rubbed in twice daily (P). Menthol, locally 
to forehead in frontal headache (Wa). Potassium Cyanide, locally in reflex 
headaches, as gastric, cardiac, pulmonary, menstrual (B). Valerian is of great 
value in excitable persons (P). Camphor, a saturated solution in Eau-de-Co- 
logne rubbed on head, when of uterine origin (R) ; in hysterical females, inter- 
nally, with Magnesium Carbonate (P). Podophyllum, purgative doses often 
give relief when near menstrual periods, with constipation and dark stools (R). 
Zinc Oxide, two- to five-gr. doses useful (R) ; a remedy of great value (Ham- 
mond). Bismuth, the Subcarbonate, in two-grain doses after each meal, often 
better than Zinc, especially where gastric disturbance (Hammond). Ether 
Spray, for frontal headache, after acute illness or fatigue (R). Chloroform, 
rr^xv-xxx of the spirit internally, often effective (Wa). Galvanism, sometimes 



HEART AFFECTIONS. 



607 



valuable ; the constant current always, avoiding too great intensity lest amau- 
rosis ensue (Hammond). [Compare Hemicrania, Neuralgia.] 



Prescriptions. 



R . Potassii Cyanidi, . . . . gr. x-xx. 

Aquae Laurocerasi, . . . . ^ iv. 

M. Sig. — Apply locally on a compress 
for ]l to ]/ z an hour. (B.) 



R. 



Zinci Phosphidi, . . 

Ext. Nucis Vom., . . 

Confect. Rosge, . . . 
M. et div. in pil. no xxx. 
Sig. — One pill after each meal. 

{Fordyce Barker.) 



gr. nj. 
gr. x. 
q. s. 



R. Extracti Nucis Vom., . . . gr. iij. 

Ferri Reducti, gr. xij. 

Quininae Sulphatis, . . . . gr. vj. 
Ft. pil no. xij. Sig.— One after each 
meal. {Hammond.) 

R . Ext. Cann. Ind. Fl., . . . 3 ss. 

Pulv. Acacise, 'z v. 

Syr. Aurantii Cort., . . . ^ ij. 

Aquae, q. s. ad £ vj. 

M. Sig. — Teasp. every 3 hours. 



Heart Affections. 

Strychnine, in medicinal doses, is said to strengthen the heart-beats (R). 
Nux Vomica, gave speedy relief in several cases of heart-failure in which death 
was imminent ; small doses every )4, hour for four successive doses, then every 
hour (Bowie) ; in a case of cardiac hypertrophy and mitral insufficiency, in 
which death was imminent from heart-failure, one drop of the tincture in a 
teasp. of water every 5 minutes for 10 doses, then every 10 minutes for 3 doses, 
continuing at longer intervals, completely restored the cardiac force, and dis- 
pelled the accompanying cardiac asthma (Macfarlan). Digitalis, acts as a 
stimulant tonic (P) ; small doses of sedative action ; tonic or physiological 
doses to create hypertrophy in dilatation (Tr). ; irregularity of pulse is best 
indication (R) ; irritable heart (Da C) ; the tincture, given without water, is the 
best preparation ; especially indicated in weak heart acting rapidly because of 
its weakness, and in valvular disease (Wa). Convallaria Majalis, will usually 
succeed in all cases in which Digitalis is useful, acting similarly to that drug, 
but with less reliability ; is useful in aortic disease and in others where Digitalis 
cannot be used (Wa) ; valuable in all forms of heart disease where there is 
oedema of tissues (See). Morphine, next to Digitalis, is in general the most 
indispensable remedy in the treatment of severe heart disease, being by far the 
most efficient agent for the dyspnoea (Strumpell) ; hypodermically, is employed 
in many cardiac disorders with marked advantage, especially in dyspnoea and 
angina with diseased coronary arteries ; mitral regurgitation, with its dyspnoea 
and insomnia ; aortic disease, etc. Cimicifuga, safer than Digitalis in fatty 
heart (B) ; its action is strongly stimulating and tonic ; it relieves excessive 
dyspnoea when weak heart (P). Caffeine, an excellent cardiac stimulant, and 
diuretic, gr. ij-v of the Citrate every three hours (Da C). Arsenic, for dyspnoea 
from weak heart (R) ; in all cardiac neuroses it is especially valuable when 
combined with Iron and Strychnine, and is regarded as indispensable in all 
forms of weak heart accompanied by pain (Wa). Aconite, in the highest 
degree serviceable to diminish excitement or irritability ; it is more a remedy 
for functional derangement than for organic disease (Wa) ; in pericarditis (R) ; 
in nervous palpitations and hypertrophy (P) ; the heart seldom affected in 
rheumatic fever if Aconite be used from the start (P). Veratrum Viride, as 
cardiac depressant (B); in chronic cardiac diseases where excessive hyper- 
trophy, i. <?., when Digitalis is contraindicated (W). Iron, useful in various 
forms, especially anaemic disorders and palpitation ; also in dilatation and fatty 
heart, and mitral regurgitation (B). Hyoscyamus, in functional derangement 
from emotion, is specially indicated ; requires large doses (tt\,x1-1x), or gr. ¥ X g of 
Hyoscyaminae Sulph. hypodermically (Wa). Amyl Nitrite relieves heart- 
pains resisting all other treatment (W). Potassium Iodide, the true remedy for 
the heart ; especially applicable in non-compensatory mitral or myocardial 
diseases, and where there is cardiac debility ; restoring energy and vascular 



608 HEART AFFECTIONS. 

tension at first ; then by dilating, later on, all the arterioles, it frees the heart 
from resistance, and enables it to recover its contractile power ; also dilating 
the coronary arteries it furnishes nutrition to the heart itself (See). Blisters, 
flying, over precordial region, to stimulate action in extreme weakness (R). 
Alcohol, as Brandy when heart suddenly enfeebled by fright, loss of blood, etc. 
(R). Ether, ir^xx hypodermically, repeated soon, is a very promptly-acting 
stimulant in sudden heart-failure ; the compound spirit in gj doses for less 
urgent cases. [Compare Angina Pectoris, Dropsy, Endocarditis, Peri- 
carditis, Syncope, and the five following articles.J 



R- . Ext. Ergotse Fl., .... 3 njss. 

Tinct. Digitalis, J;ss. 

M. Sig. — Teasp. thrice daily in enlarged 
heart without valvular lesion. 



Prescriptions. 

R. Spt. yEtheris Comp., 
Liq. Morphinse Sulph. 

(U.S. P., 1870), aa gj. 
M. Sig. — Teasp. as required for the 



dyspnoea. 



Heart, Dilated. 

Digitalis, where much dilatation, and hypertrophy of left ventricle without 
valvular disease ; is not contraindicated when aortic disease (R) ; use in physio- 
logical doses (Tr) ; in simple dilatation gives most favorable results (W) ; very 
useful in mitral disease, with dilatation of the left ventricle (P) ; gives miracu- 
lous relief, is not sufficiently appreciated, but requires skilful administration ; 
use the infusion in preference to other preparations, a tablespoonful thrice daily, 
watching its effects (Da C). Scoparius, the infusion (Broom-tea), to maintain 
the kidney action if Digitalis is not sufficient (Da C). Purgation, brisk, free, 
watery stools, next to Digitalis are the best treatment (Da C). Morphine, hy- 
poderm. gr. yi~ l /6 two or three times a week in dilated heart with dyspnoea 
(B). Amyl Nitrite, dyspnoea from dilatation (R) ; is useful when great dysp- 
noea (cardiac asthma) (P). Ether, the Compound Spirit an excellent remedy 
for the dyspnoea (Da C). Mercury, a classical pill and a very efficient one as 
a diuretic in dropsy from cardiac disease is the combination of gr. j each of 
Pulv. Digitalis, Pulv. Scillae and Hydrarg. cum Creta (Foster). 



Heart, Fatty. 

Iron, the Tinct. Ferri Chloridi in small doses for a long time, has been of 
remarkable benefit (Wa). Cimicifuga, safer than Digitalis (B) ; the latter should 
not be used (Wa) : Digitalis of no value except for very temporary use and for 
some special indication (Da C). Strychnine, often the first remedy to do good ; 
unduly pushed will produce nervous worry and be injurious (P) ; is the remedy 
with Iron, nourishing but not fat-making diet, and wine to keep up the tone of 
the blood (Da C). Ergot, occasional doses have been given with apparent 
benefit (Wa). Ether, the Compound Spirit for sudden attacks of pain or 
dyspnoea (Da C). Amyl Nitrite, for the same, but Chloral must be entirely 
debarred (Da C). Stimulants, freely, in an acute attack of any kind, afford 
the only chance (Da C). 

Heart, Hypertrophied. 

Aconite, often better than Digitalis (R) ; dangerous in hypertrophy of left 
side, with diseased valves, but useful in simple hypertrophy (P) ; for over- 
action, with hypertrophy (B) : the one remedy which can be depended on ; 
small doses for months, say gtt. j of a good tincture ter die, to lower the heart 
gradually and keep it low (Da C). Digitalis, very useful in pure hypertrophy due 
to valvular disease or excessive muscular exertion (R) : the primary action 
(small doses) required, as it creates hypertrophy when given in physiological 



HEART AFFECTIONS. 



609 



or tonic doses (Tr). Veratrum Viride, as a cardiac depressant (gtt. v ter die) 
will relieve in simple hypertrophy, and irritable heart from abuse of tobacco, 
inadmissible when valvular lesions exist (B) ; gives the best results, next after 
Aconite (Da C). Lead Acetate, for violent palpitations, in some instances 
(Wa). Amyl Nitrite, in dyspnoea, syncope (R). Ergot, in enlarged heart 
without valvular lesion ; may be combined with Digitalis (B). Potassium 
Iodide, small doses long continued, benefit some cases (Wa). Camphor, in 
doses of gr. iij-xij daily for tumultuous palpitations, and dyspnoea of hyper- 
trophy with dilatation (Wa). Iron is necessary where anaemia exists (Da C). 
Quiet Life of great importance, no stair-climbing, no long walks ; rest in bed 
often of service for days at a time, moderate diet, avoiding fattening foods, 
meat, and stimulants (Da C). 



Heart, Palpitation of. 

Aconite, for "fluttering" of nervous persons, and nervous palpitations (R) ; 
for over-action, with hypertrophy (B) ; for palpitation with simple hypertrophy 
(P). Hydrocyanic Acid, when from dyspepsia (P). Iron, when due to anae- 
mia, a very frequent cause. Other causes are tobacco, coffee, tea, etc., to excess, 
dyspepsia, venery, excessive exercise (Da C). Spigelia Anthelmia, when due 
to mitral and aortic disease, with much dyspnoea (P). Digitalis, in small doses 
as sedative (Tr) ; combined with Iron in palpitations with valvular disease, or 
alone in very severe cases (Wa) ; suits a large number of cases, especially for 
temporary purposes (Da C) ; the only remedy of positive service for the actual 
palpitation (Richardson). Camphor, recommended in nervous palpitations 
(R). Veratrine, as ointment to chest, when rapid, irregular pulse, hurried 
breathing, dropsy and lividity, palpitation, inability to lie down (R). Nux 
Vomica, of great value in nervous palpitation. Bromides, in "fluttering" 
heart (B) ; are useful when tolerated by the stomach (Da C). Hyoscyamus, 
in nervous, and violent palpitations from excited state of the brain (P) ; in 
large doses, for functional disturbance arising from emotion (Wa). Belladonna, 
in small doses, may also be applied externally, when irregularity of rhythm 
(Da C). Valerian, nervous palpitation, with dyspnoea (P). Eucalyptus, palpi- 
tation and weak heart (B). Galvanization, of cervical sympathetic and pneu- 
mogastric, for palpitation (B). Hot Foot-bath relieves palpitations (R). Milk- 
cure, has been beneficial in irregular action (B). Ice, to the cardiac region, 
has benefited many cases ; is of chief value when patient can be kept in bed, 
which sometimes becomes necessary (Da C). 



Prescriptions. 



R . Pulv. Digitalis, gr. xx. 

Pulv. Colchici Sem., . . . gr. xl. 

Sodii Bicarb., gr. lx. 

M. et div. in chart, no. xl. Sig. — One 
powder at first 3 or 4 times daily, gradually 
reduced to one at bedtime. For irregular 
cardiac action. (Bowditch.) 



R. Tinct. Digitalis, zij. 

Spt. Etfieris Nitrosi, . . . j§j. 
Liq. Ammonii Acet., . . ad ^ iv. 
M. Sig. — A dessertsp. every 4 hours. 
If prolonged insomnia with palpitation add 
of Morph. Sulph. gr. T a T to each dose. 

(Richardson.} 



Heart, Valvular Disease. 

Nux Vomica, the tincture in one-drop doses every 5 minutes, remarkably 
efficient in heart-failure, even with death impending (Bowie) ; also for the 
asthma (Macfarlan). [See under Heart Affections, ante!\ Digitalis, in 
aortic regurgitation (R) ; most effective in mitral insufficiency (P) ; in rapid 
action with low arterial tension ; and in mitral disease : Infusion best, tablesp. 
doses twice daily (B) ; TTg of tinct. every ^ hour or hour, often gives more 
relief than larger doses (Smith) ; when heart is weak and struggling (Da C). 

39 



6lO HECTIC FEVER HEMATEMESIS. 

Morphine, hypodermically for dyspnoea, better in mitral than in aortic disease 
(R) ; the agent above all others in aortic insufficiency, combating the two great 
symptoms therein, the cerebral anaemia and the dyspnoea ; is to aortic regur- 
gitation what Digitalis is to mitral (Dujardin-Beaumetz). Aconite, useful for 
the palpitation, but dangerous in hypertrophy of left side with diseased valves 
(P) ; for cases presenting excessive growth and strong action, diminishes the 
blood-pressure in the arterial system, and gives great relief (Da C). Veratrum 
Viride, has similar applicability, but is more apt to nauseate. An admirable 
sedative, and one which does not sicken is a mixture of Tinct. Aconiti, try, 
Tinct. Verat. Vir., ttijij, Tinct. Zingib., n\,vij (Da C). Strophantus, is a 
cardiac tonic like Digitalis, but does not contract the vessels nearly as 
much (Br). Nitroglycerin, is the best of all remedies when actual cardiac 
pain ; it lessens blood-pressure and diminishes the resistance the heart has to. 
overcome (Da C). Caffeine, as a tonic and diuretic, of especial value in cases 
where urine is scanty, with cardiac pains, headache and dyspnoea, and weak 
heart ; gr. ij of the Citrate every three hours (Da C). Adonidine, in doses of 
gr. T^ to ^ thrice daily, acts excellently as a cardiac regulator (Da C). Barium 
Chloride, gr. -^ in pill three or four times daily, is diuretic, lessens cardiac 
pain, increases tone in the vessels, and is a good general and cardiac tonic 
(Da C). Purging, with Jalap, etc., in engorgement of right side of heart 
(R) ; occasionally useful (Da C). Treatment is directed chiefly to the dilata- 
tion or hypertrophy resulting from the valvular disease ; the simplest rule is to 
use judgment as to when the heart needs strengthening by Digitalis or reduc- 
ing by Aconite or Veratrum Viride (Da C). [Compare Endocarditis.] 



Hectic Fever. 

Quinine, large doses, gr. xv-xx daily, if stomach and intestines don't rebel 
(P) ; given before the paroxysm, to limit it (Roberts). Antipyrin, is better 
than Quinine, but must be used in much smaller dosage than ordinarily em- 
ployed, say gr. iv or v about l / z hour before fever rises, then doses of gr. ij 
hourly as long as temp, remains above 100.5 . This daily, will give excellent 
results in the hectic of phthisis (Pibram). Phenacetin, is safer and equally 
efficient. Phenocoll, as an antipyretic, is used with marked success. Aconite, 
in small doses, a remedy of much value in the irritative fever of phthisis (Da C). 
Morphine and other anodynes, are of especial value, given in full doses toward 
bed-time (Gross). Prunus Virginiana, the bark has been found useful, espe- 
cially when irritable cough (P). Calcium Phosphate, is especially useful (R). 
Calumba, excellent for tonic effects (P). Digitalis, the tincture, combined with 
Tinct. Ferri Chloridi, abates the temperature and diminishes the sweats (B). 
Iron, the Mistura Ferri Composita has obtained great celebrity, especially when 
much debility and anaemia (Wa) ; the Sulphate and Tincture of the Chloride 
of especial value in the treatment of hectic (Gross). Ipecacuanha, a few grains 
of Dover's powder at bed-time, will stop the profuse perspirations (Wa). 
Salicin, for profuse perspirations (Wa) ; as antipyretic. [Compare Perspira- 
tion, Phthisis.] 

Prescriptions. 



R • Tinct. Digitalis, 5 iij. 

Tinct. Ferri Chlor., . . . 3 v. 
M. Sig. — 15 drops 3 or 4 times a day. 

(B.) 



R-. Quininse Sulph., .... gjss. 

Elix. Taraxaci, ^>' xv - 

M. Sig. — Teaspoonful every hour for 
six hours. 



Hematemesis. 

Ipecacuanha, is decidedly effective in small doses, also when hematemesis 
is vicarious of menstruation (P, Wa). Hamamelis, tt\J— Ij of tinct. every 2 or 3 
hours (R) ; effective from its Tannin (B). Alum, serviceable in passive hemor- 



HEMATOCELE HEMATURIA. 6l I 

rhage ; Iron better (B). Turpentine, especially in passive hemorrhage with 
debility (R) ; and in hemorrhagic transudations on the free mucous surfaces, 
hematemesis, etc. (B). Ergot, has often cured when other means failed (P) ; 
most valuable ; in urgent cases Ergotin in 2- to 5-gr. doses hypodermically 
(R). Iron, the Subsulphate (Monsel's solution) or Pernitrate, the best remedies ; 
gtt. j-ij frequently, diluted with ice-water (B). Lead Acetate, especially in 
gastric ulcer, gr. ss-v (B). Tannic Acid, gr. x-xx, when from gastric ulcer or 
obstructive disease of liver (B). Gallic Acid, an extremely useful agent ; 
is best used in combination with dilute Sulphuric Acid (Wa). Ice, small pieces 
swallowed, a most useful agent, with perfect rest for stomach ; when hema- 
temesis from that organ, nutrient enemata must be employed ; iced cham- 
pagne to arrest faintness, if persistent ; when moderate need not give cause for 
alarm. 

Prescriptions. 

R. Olei Terebinth., giij. 

Ext. Digitalis Fluid., . . sjj. 
Mucil. Acaciae, Iss. 



Aq. Menth. Pip., . . . . ^j. 
M. Sig. — Teasp. every 3 hours. 



R . Ac. Gallici, 3J. 

Ext. Ergotae Aquosi, 

Digitalis, aa gr. xx. 

M. et div. in pil. no. xx. Sig. — One 
every 4 hours. 



Hematocele, Pelvic. 

Opium, or Morphine, if needed for pain, with absolute rest in bed, and a 
moderately tight abdominal bandage (E). Hemostatics, as Gallic Acid, Lead, 
Turpentine, etc., to arrest the hemorrhage, if it be still going on, combined with 
opiates, and the use of ice-bags or cold lotions to the abdomen or pervaginam. 
Tonics, as Iron and Quinine, while resolution of the extravasation is going on. 
Bromides and Iodides, to quiet the action of the ovaries, if the hemorrhage 
recurs at different periods. Potassium Iodide, as an absorbent, may be given 
with Quinine (Braxton Hicks). Iodized Cotton, an excellent application to the 
cervix uteri in cases of hematocele (Wa). Leeches, should be applied early 
in cases of peri-uterine hematocele; later, except to check inflammation, they 
are inadmissible (Wa). Mercury, gr. -^ of the Bichloride thrice daily, with 
Iron and Ergot, conjoined with vaginal injections of hot water morning and 
evening ; later in lieu of the mercurial the Syrup of Ferrous Iodide in 20-drop 
doses thrice daily, was thoroughly efficient treatment in one very bad case of 
retro-uterine hematocele (Hengst). Surgical interference has many advocates 
but is criminal in a large majority of the cases (E). If the case does not end 
in resolution it will terminate in pelvic abscess. 



Prescriptions. 



R. Iodi, gj. 

Potassii Iodidi, t ^ij. 

Glycerini, ........ ^ viij. 



Mix and saturate 8 oz. of cotton with the 
mixture ; then carefully dry, and label 
" Iodized Cotton." 



Hematuria. 

Turpentine, when with constitutional debility (B) ; in very small doses (R) ; 
often is very efficacious (P). [See under Hematemesis, for formula.] Hama- 
melis, has arrested severe cases (R). Chimaphila, controls hematuria (P). 
Gallic Acid, the most uniformly successful remedy (B) ; gr. x-xx every hour or 
two (Da C). Sulphuric Acid, alone or with Gallic Acid, is an efficient remedy 
(Da C). Acetic Acid, in a case of alarming hemorrhage from the bladder, 
which occurred after an operation for vesico-vaginal fistula, and resisted all 
other means, an injection of apple-vinegar and ice-water, equal parts, suc- 
ceeded in arresting it (Ghent). Quinine, large doses necessary ; cures when 
intermittent or from malarial infection (B) ; useful in some cases of intermittent 



6l2 



HEMERALOPIA HEMICRANIA. 



hematuria (R). Iron, the Tincture of the Chloride, tt^x-xx several times daily ; 
in this affection the best form of Iron for internal use (Wa). Ipecacuanha, 
exercises a powerful influence (Wa). [See under Hematemesis.J Ergot, by 
stomach or subcutaneously ; may be combined with Ipecac, Krameria, or other 
astringents (B). Ergotin, hypodermically, is far superior for efficacy and rapid- 
ity of operation (Wa). Matico, the infusion, in doses of ^ij every 2 or 3 hours, 
is fully equal to Gallic Acid, Lead, etc. (Thompson). Ammonium Benzoate, 
in 5-grain doses, for the albuminuria and hematuria of scarlatina (Hillier). 
Cannabis Indica, is especially indicated in dysuria and strangury when there 
is bloody urine (R). Camphor, in 2- to 5-grain doses is said to promptly 
remove the renal hyperaemia with bloody, coagulable urine, caused by Can- 
tharis, Turpentine, Oil of Mustard, Copaiba, etc. (R). Ice in rectum or to 
perineum, for vesical hemorrhage (Thompson). 



Prescriptions. 



R . Acidi Gallici, 5 ss. 

Ac. Sulphurici Dil., . . . gj. 

Tinct. Opii Deodor., . . . £j. 

Infusi Digitalis, ^ iv. 

M. Sig. — Tablesp. every 4 hours or 
oftener. In hematuria, menorrhagia, pur- 
pura hemorrhagica, and the hemorrhagic 
diathesis. (D.) 



R- . Ext. Ergotae Fluidi, 

Tinct. Krameriae, . . . aa ^j. 
M. Sig. — A teasp. every hour or two. 



R 



Ext. Ergotae (Squibb), . 

Aquae, 

M. Sig. — For hypodermic 
contain gr. j. 



3J- 

Si- 

use ; 



V 



Hemeralopia and Nyctalopia. 

Strychnine, night-blindness ; small doses, gradually increased, of service 
(Wa). Mercury, Hydrarg. Chlor. Corr. gr. ij ad aquae ^j, dropped into the eye 
twice daily, with blister on each temple, and mild aperients, has cured hemera- 
lopia (Smith). Quinine, in as large doses as can be borne, after cathartic and 
emetic, for night and day-blindness (Howard). Blisters, small, \]/ 2 inches in 
diameter, close to external canthus of the eye (Bampfield). Electricity, occa- 
sionally useful (Wa). Rest, protection of eyes from bright light, constitutional 
remedies, as indicated by state of general health, change of climate, speedily 
cure hemeralopia. It is sometimes merely a symptom of pigmentary degenera- 
tion of the retina, or a feature of scurvy. 



Hemicrania. 

Belladonna, when due to vaso-motor spasm, the face being pallid (B) ; the 
tincture in small and repeated doses if the disease be of reflex character (H). 
Iris, in blinding form, from hepatic trouble, right supra-orbital region ; rt\j 
every half-hour for 3 doses, usually relieves promptly (Pf ). Cannabis Indica, 
one of the most valuable remedies for megrim or sick headache, apparently 
acting on the nervous centre whence the disorder springs ; is most useful in 
the intervals to prevent the attacks, and especially when the paroxysms are 
becoming more frequent ; it may be combined in pill with either Iron or Aloes 
(K) ; of especial value in the congestive form, the tincture in repeated doses 
until physiological action is induced (H) ; gr. y 3 of the extract before each 
meal, increased gradually to y z or 2 /j, grain, in the intervals, kept up for 3 
months (Seguin) ; gr. *4 of the solid extract night and morning, very efficient 
in migraine, if used continuously for some time (Hare). Camphor, gr. iij-v, 
with xx or xxx-grain dose of Magnesium Carbonate, is very useful, especially in 
hysterical females (P). Croton- chloral, in milder forms without severe vomit- 
ing, headache being predominant; the Bromides are useful after it (R) ; rarely 
of any use, but if given it should be in 20-grain doses twice daily (H) ; Gua- 
rana, is useful (B), a very effective palliative ; gr. xx every }4 hour, for three 



HEMICRANIA. 



613 



hours (P) ; its efficacy diminishes by degrees, attacks usually becoming longer 
(Tr) ; Z'\] of fluid extract in course of an hour or two, to anticipate the attack 
when expected (Seguin). Caffeine, in typical migraine ; gr. j ad tt^xxv-xxx 
aquae hypodermically (P) ; is especially adapted when chronic gastric catarrh, 
gr. j every half-hour (B) : the Citrate ingrain doses every hour for some time 
before a paroxysm (Wa) ; gr. j every half-hour often gives marked relief 
(Smith). Valerian, of especial value when in exciteable temperaments ; after 
profuse or painful menstruation (P). Ammonium Chloride, is exceptionally ser- 
viceable ; seldom fails to cut short an attack (Austin) ; x-xv gr. doses (R) ; as 
a diffusible stimulant is very efficient, gr. xx up to %] every hour during the 
attack (H). Sodium Chloride, in small doses, proved very efficient in six posi- 
tive cases attended by gastric distress (Rabon). Antipyrin, the most valuable 
single remedy for headache, especially in migraine and those cases of it for 
which Ergot and Amyl Nitrite are indicated ; 5 grains at beginning of the attack 
often sufficient (Birdsall) ; of great value in true migraine, employed in twenty 
cases with unfailing benefit ; less useful in the malarial or dyspeptic forms, and 
useless in uraemic (Thompson) ; one dose of gr. xx, or 2 doses of gr. x each, 
]/ 2 hour apart, given in the prodromal period, or at the very beginning of a 
paroxysm, will invariably cut it short within an hour (Sprimon, Ungar, etc.). 
Phenacetin, has been given with great benefit, in doses of 2 grains with % 
grain of Caffeine Citrate, for migraine. Podophyllin or Mercury, bilious origin 
(R). Bromides, for true migraine ; Raspail's Eau Sedative locally, gives great 
relief (B) ; when due to uterine disorder (R). Potassium Bromide, veryser- 
viceable in the paroxysm, also in continuous form (R). Eucalyptus, in cere- 
bral anaemia (B). Digitalin, granules (^ bis die), for congestive hemicrania 
(B). Ergot, if due to miliary aneurisms of intercranial arterioles ; also in con- 
gestive migraine, and in nearly all kinds (B). Menthol, locally in frontal 
headache due to migraine, is said to be very efficient (Wa). [See formula 
below.] Piscidia, is highly recommended (Wa) ; efficient in doses of £ij of 
the fluid extract (Ford). Arsenic, for cerebral congestion and hemicrania (B) ; 
for throbbing pain in one brow (R) ; often has the best effect. Watson believed 
that gtt. iv-vj of Liq. Arsenicalis, 3 or 4 times a day, with due attention to the 
bowels, would cure 9 out of every 10 cases (Wa). Aconitine or Veratrine, oint- 
ment over brow (R) ; Aconitine internally is of great service (Seguin). Phos- 
phorus, is strongly recommended (R). Amyl Nitrite, by inhalation, in migraine, 
with pallor of face (R). Sanguinaria, a few doses very successful, when 
migraine is due to gastric derangement (P). Ignatia, removes clavus hysteri- 
cus (Pf). Nux Vomica, when of gastric origin (R). Cimicifuga, is strongly 
recommended (P). Rubber Bandage, applied tightly from eyes up, protecting 
the temporal arteries by pads, or a dry muslin bandage wetted after being put 
on (Weir Mitchell). Acupuncture, the needle run down to the cranium will 
give relief in clavus hystericus, when nothing else will do so (Pancoast). 



Prescriptions. 



R. Quininae Sulph., . . . . £ss. 

Pulv. Belladon., gr. x. 

Ext. Digitalis, gr. xv. 

Ext. Valerianae, £ss. 

Mellis, q. s. 

Ft. pil. no. xl. Sig. — 2 to 10 pills daily, 
gradually increased, during 3 or four days 
before the expected attack. 



R-. Mentholi, gj. 

Alcoholis, ?j. 

01. Caryophylli, 

01. Cinnam., aa TT\xx. 

M. Sig. — Apply with finger over seat 
of pain. 



R- . Ammonii Chloridi, . . . 3 vj. 

Ammonii Bromidi, . . . giv. 

Spt. Etheris Nitrosi, . . . ^j. 

Syr. Pruni Virgin., . . . % iij. 

Aquae, q. s. ad J vj. 

M. Sig. — Dessertsp. 3 or 4 times daily, 
conjoined with the use of RaspaiV s Eau 
Sedative (see page 108), locally. 



g r - iV 



B . Aconitinae (Duquesnel), 
Alcoholis, 
Glycerini, . . . . . . aa gj. 

Aq. Menth. Pip., . q. s. ad gij. 
M. Sig. — Teasp. thrice daily. 

{Seguin. 



614 



HEMIOPIA HEMIPLEGIA HEMOPTYSIS. 



Hemiopia. 

When established, hemiopia offers little hope of cure, though it has no ten- 
dency to progress. In hemiopia scintillans, Potassium Bromide, gr. xl-lx 
daily, or band of such metal as idiosyncrasy of the patient may decide, with 
stimulants to ward off the aura ; Quinine, Iron, Hydropathy, when Potassium 
Bromide fails (De Wecker). 

Hemiplegia. 

Strychnine, is most useful when members are relaxed ; hypodermically, 
when paralysis incomplete, and the muscles flaccid but not wasted (B). [See 
Paralysis for formula.] Potassium Iodide, gr. x-xviij daily, occasionally 
proves effectual (Wa). Galvanism, constant current to the brain or cord, 
faradic to the muscles opposite those contracted (Hammond). Physostigma, 
prevents muscle wasting, and hence is given with benefit to hemiplegics ; gr. 
-g ^ - ^q of the extract repeated frequently (R). Massage, in hemiplegia and 
other forms of paralysis due to intercranial lesions, when cold and blue skin, 
wasting and contracted muscles, ulcerations, etc. (B). Cocculus, in hysterical, 
epileptic and choreic hemiplegia, acts well ; also in hemiplegia from cold (P). 
[Compare Paralysis, Facial.] 



Hemoptysis. 

Atropine, gr. y^- hypodermically, is remarkably efficient in stopping the 
bleeding in phthisical hemoptysis (Squibb). Gallic Acid, exceedingly effective 
(P) ; may be combined with Ergotin and Digitalis. [See Hematemesis and 
Hematuria for formulas.] Lead Acetate, with Opium (B) ; proves signally 
useful (Wa). Ergot, the fluid extract in 30- to 40-minim doses, every 3 or 4 
hours, or hourly in severe cases ; or Ergotin hypodermically for urgent cases, 
in 2- to 3-grain doses (R). Opium, should be freely used for the attendant 
excitement (W). Ipecacuanha, has been highly praised (R) ; in emetic doses 
arrests hemoptysis (Tr.), though in poisonous doses produces it (P). A well- 
founded case is recorded where Ergot and Gallic Acid utterly failed, and Ipe- 
cac was effectual ; but it must be pushed to the nauseating point, in order 
to effect the control (Squibb). Turpentine, in drachm doses every 3 hours, 
may cause unpleasant symptoms which soon disappear on its discontinuance 
(R) ; has proved very efficient (P) ; after other hemostatics fail it is worthy of 
trial (Wa). Alum is serviceable in purely atonic hemorrhages (Wa) ; in 10- 
grain doses every 2 hours (B). Oil of Erigeron, is very efficient when no 
fever or other signs of constitutional irritation (Wa). Hamamelis, tt\j— ij of 
tincture, every 2 or 3 hours (R) ; nyj-x of fresh tincture several times a day 
(Pf). Ferric Acetate, a little added to water so as to taste, this constantly 
sipped (R) : Iron spray will often arrest (B). Digitalis, has undoubted power 
over hemoptysis (B) ; small doses daily (P) : infusion in large doses (R). 
Arnica, of great service, if from violence (P). Aconite, employed with best 
results (P). Sodium Chloride, half a teaspoonful of common salt, taken dry, 
repeated till nausea (R). Sulphuric Acid, the dilute acid a useful adjunct to 
other treatment (Wa). Spinal Hot-water Bag, to cervical or upper dorsal 
vertebrae (R). Auxiliaries, — Cold externally, acidulated drinks, perfect rest, 
and antiphlogistic diet (Wa). 

Prescriptions. 



R. Ext. Ergotae Fl., ..... £jss. 
Ext. Ipecac. Fl., 
Tinct. Opii Deod., . . aa 3 ij. 
M. Sig. — Teasp. every ]/ 2 hour. 



B 



Plumbi Acetat., gr. xx. 

Pulv. Digitalis, gr. x. 

Pulv. Opii, . gr. v. 

M. ft. pil. no. x. Sig. — One every 4 
hours. (B.) 



R. Aluminis, gj. 

Sacch. Alb., ^ss. 

Pulv. Ipecac. Comp., . . . gr. xx. 
M. ft. pulv. no. vj. Sig. — One powder 
every 2 hours. [Skoda.) 



R. 



TTLXX. 



Liq. Ferri Subsulph., 

Aquae, §ij. 

M. Sig. — Use as spray by inhalation for 
5 minutes every hour. 



HEMORRHAGE. 



615 



Hemorrhage, Hemorrhagic Diathesis. 

Acids. Sulphuric sometimes very effective in uterine hemorrhage (B). 
Dilute Vinegar to leech-bites, piles, cuts, etc. (R). Apple-vinegar as injection 
for vesical hemorrhage. [See under Hematuria.] Iron, when hemorrhagic 
diathesis due to anaemia ; the Tincture of the Chloride preferred (B) ; the Tinc- 
ture of the Chloride as styptic (Wa) ; 1 or 2 teaspoonfuls of the concentrated 
solution in a glass of water an excellent hemostatic (Tr) ; the Acetate, just 
enough to make water taste, in hemorrhage of lungs and kidneys (R). Ergot, 
in uterine hemorrhage of any kind, and many forms of hemorrhage, Ergot or 
Ergotin of great value (P) ; not to be relied on alone (B). Alum, is sanctioned 
by high authority (B) ; dusted on in slight cases (R) ; in uterine and traumatic 
hemorrhage, when small vessels open (Tr). Hamamelis, rr\J — ij of tincture 
every 2 or 3 hours, effective in many forms (R). Ipecacuanha, produces hem- 
orrhage in poisonous doses, yet has great energy in arresting it (P) ; exercises 
a powerful influence on internal hemorrhage generally, and in exhaustion 
therefrom ; gr. j-ij every % hour (Wa) ; in emetic doses serviceable (Tr). 
Turpentine, few agents more useful in the passive forms (B) ; small doses in 
hematuria (R) ; for serious hemoptysis, and hemorrhage of typhoid (P). 
Belladonna, hemorrhage from rectal ulcers (P). Digitalis, in uterine, and many 
other forms, of great value (P) ; with restoratives has undoubted power in the 
hemorrhagic diathesis (B). [See Hemoptysis.] Chimaphila, controls hema- 
turia (P). Gallic and Tannic Acid, in all passive hemorrhages, especially in 
that of the bladder (P). Tannic Acid for local use, Gallic for systemic effects 
upon remote parts. When hemorrhage occurs in relaxed and debilitated con- 
stitutions, Gallic Acid may be combined with Ergot and Digitalis (B). Matico, 
proves useful in many cases, especially menorrhagia, hematuria, and hemopty- 
sis (Wa). Nux Vomica, in hemorrhagic diathesis, especially when occurring 
in anaemic subjects ; also the Syrup of Iron, Quinine, and Strychnine Phosph- 
ates ; no prescription more generally useful (B). Aconite, to reduce the circu- 
lation, in epistaxis, hemoptysis, etc. (P). Cinchona, internally very efficient in 
some forms of hemorrhage (Tr). Copper Sulphate, in stick, solution or oint- 
ment, to arrest hemorrhage from small vessels (R). Arnica, in hemorrhages 
(ecchymoses), from mechanical violence (P). Rhatany, the extract, one of the 
most powerful hemostatics (Tr). Grape-cure, as tonic for convalescents (P). 
Alcohol, in hemorrhagic diathesis, to elevate the arterial tension (B) ; Brandy, 
Wine, when heart suddenly enfeebled by hemorrhage (R). Venesection, will 
promptly arrest pulmonary hemorrhage (B). Styptics, are either needless or 
inefficient, hence practically useless in general surgery; hemorrhage should be 
controlled by either pressure or ligation (Roberts). Hot Water, sponged over 
a bleeding surface, the best agent to stop hemorrhage (Gross). Transfusion, 
when death imminent (B). Ice, internally in wounds or hemorrhage of lungs, 
or from stomach ; small pieces frequently. (R). Rest. Perfect rest often 
indispensable, especially in hematemesis, in which nutrient enemata may be 
required. [Compare Dysentery, Epistaxis, Hematemesis, Hemoptysis, 
Hemorrhoids, Hematuria, Hemorrhage Post-partum, Intestinal, 
Menorrhagia, Metrorrhagia, Purpura, Wounds, etc.] 

Prescriptions. 



PagliarPs Styptic, 

R. Tinct. Benzoini, ,l vn j- 

Aluminis, ft), j. 

Aquae, ft), x. 

Boil 6 hours in a glazed earthenware 
vessel, adding hot water in lieu of that 
vaporized, and keeping well stirred ; filter, 
and put up in stoppered bottles. 



ft. Infusi Digitalis, gij. 

Ext. Ergotae Fluidi, 

Tinct. Krameriae, . . .aa # ^j. 
M. Sig. — A tablesp. as required in 
hemorrhagic conditions generally. (B.) 



PancoasVs Styptic. 
R. Potassii Carbonat., . . . . gij. 

Saponis, 3J -r j- 

Alcoholis, ^iij. 

Mix and use as a styptic especially for 
operations about the face. {Jos. Pancoast.) 

R. Ext. 'Ipecac. Fl., 3 ij. 

Ext. Ergotae FL, giv. 

Ext. Digitalis Fl., . . . . ,^ij. 
M. Sig. — Half teasp. to a teasp. at a 
dose, repeated as required. An excellent 
anti-hemorrhagic combination. 

(B.) 



6l6 HEMORRHAGE HEMORRHOIDS. 

Hemorrhage, Intestinal. 

Turpentine, should be used (B) ; especially in typhoid (P). [See Hema- 
temesis, for formula.] Belladonna, for irritable and bleeding rectal ulcers 
(P). Iodine, in passive, gtt. j-ij of tinct. frequently repeated, of great service 
(B). Sulphuric Acid, is serviceable (B). Lead Acetate, often of great service, 
especially when used as an enema (Jenner). Tannin, one of the most ser- 
viceable remedies for the intestinal hemorrhage of typhoid fever (B). Ham- 
amelis, very effective in intestinal hemorrhage, owing to its large proportion 
of Tannin (B). Ergot is most valuable ; may be given hypodermically in 
urgent cases (R). Gallic Acid, gr. xv with gtt. iij-iv of Laudanum, in a winegl. 
of iced water, every 2 or 3 hours in the hemorrhage of typhoid (Jenner). 
Opium, a valuable adjunct to astringents, allaying the nervous excitement 
(Wa) ; is most useful (Da C). [Compare Hemorrhoids, Dysentery, Typhoid 
Fever.] 

Hemorrhage, Post-partum. 

Atropine, hypodermically, is remarkably efficient. [See under Abortion.] 
Hamamelis, for persistent oozing (R). Ipecacuanha, in flooding after delivery 
(R). Iron, Monsel's solution, j to iij of water, strong enough and safe as 
injection (B) ; the Perchloride diluted (R). Amyl Nitrite, n^v by inhalation, 
has stopped a hemorrhage promptly and permanently (Kerr). Ergot, a full 
dose of the fluid extract as soon as birth is completed, as a prophylactic (Play- 
fair) ; hypodermically in urgent cases, gr. ij of Bonjean's Ergotin deeply into 
the tissues of the arm (Wa) ; gss doses of the fluid extract every 2 to 4 hours 
in secondary hemorrhage. Cimicifuga, will check post-partum hemorrhage, 
especially when tediously prolonged (P). Digitalis, the infusion best ; a 
tablesp. bis die, or in urgent cases every half hour for 4 doses (B). Nux 
Vomica, gtt. xx ; Ext. Ergotse Fl. gtt. xxx ; each hour for 2 or 3 doses (B). 
Opium, the tincture 3j, with Brandy, in profuse flooding (R). Vinegar, a 
handkerchief soaked in vinegar and carried into the uterus, will often check 
a severe hemorrhage (Landis) ; is antiseptic, astringent and sufficiently irri- 
tating to produce contraction, yet not so irritating as to cause subsequent mis- 
chief, and always acts promptly (Penrose). Tamponade by absorbent cotton, 
plugs of linen, etc., is indicated in hemorrhage from abortion or placenta 
praevia (Parvin) ; never tampon after delivery ! you might as well hang the 
woman by the neck (Wallace). Auxiliary Measures of importance are firm 
pressure on the uterus, compression of the abdominal aorta, the plug, and if 
necessary intra-uterine injections (Wa). Hot Water, no° to 122 F., injected 
into uterus, extremely successful in checking post-partum hemorrhage (Att- 
hill) ; the most prompt and certain method, and the least unpleasant to the 
patient (Parrish). [See also Dr. Cameron in Canada Med. and Surg. Jour., 
March, 1878, with record of 16 cases so treated.] Ice, to abdomen or within 
the womb (B) ; into womb or rectum (R). As a prophylactic against hem- 
orrhage and to secure firm contraction of the uterus, a good method is to 
grasp the womb through the abdominal parietes with a hand kept cold by 
frequent immersion in a pan of broken ice, while waiting for the expulsion of 
the placenta ; while one hand is kept on the uterus the other may be immersed 
in the ice. Transfusion of milk into veins may be necessary in cases of col- 
lapse (Thomas). 

Hemorrhoids. 

Galls, as ointment, very useful ; the official Unguentum Gallas, or combined 
with Lead and Opium (R). [See formula below]. Iron, a solution of the Sub- 
sulphate as wash to bleeding piles, which should then be well oiled (B) ; or 
an ointment of the Subsulphate, gr. xv to the %, locally night and morning, 
with gr. j of the salt thrice daily by mouth ; gives excellent results. Hama- 
melis, by mouth, also as lotion or injection in bleeding piles (R) ; is employed 



HEMORRHOIDS. 



617 



with satisfaction ; ttUJ-x of tincture several times a day ; also as enema or 
suppository (Pf). Nux Vomica, emphatically beneficial (P). Sulphur, gr. 
v-x, with 3j Confec. Sennas, as laxative (R) ; exercises a most soothing in- 
fluence (Wa). Sulphides, especially Blue Lick waters (B). Podophyllum, 
as cathartic for hemorrhoids of recent formation, bleeding from stasis in portal 
circulation (B). Aloes, causes congestion of pelvic viscera, yet Fordyce 
Barker shows it to be curative in piles, especially in recent ones, as after de- 
livery (B) ; to greatly relieve bowels (R) ; cures by removing constipation 
(P). Hydrastis, as lotion or ointment to external piles, of great value ; TT\,v 
of tincture ter die internally at same time (P). Ergot, with or without Nux 
Vomica, in dilated hemorrhoidal veins without new tissue, given by the stomach 
and used locally will often cure (B). [See Diarrhcea for formula.] Stil- 
lingia, will remove permanently when due to constipation, and temporarily 
when from hepatic obstruction (B). Senna, to procure soft and easy evacu- 
ations use the Confectio Sennse at bedtime, gr. cxx in a bolus (B). Iodoform, 
the ointment, and in suppository (B). Nitric Acid, as caustic, followed by 
free use of Olive Oil (B, R) ; ^ss-:|j ad Oss of water as lotion for bleeding 
piles (R). Hyoscyamus or Stramonium, leaves bruised, or ointment, locally, 
for pain (P). Linseed Oil, boiled, in doses of ^ij twice daily, has quite a 
reputation as a remedy for piles (W). Alum, to painful bleeding piles, a 
crystal trimmed and passed into rectum, or as an ointment (B). Ice, to painful, 
bleeding piles, or cold water injected daily (B) ; locally, for pain after operation 
(R). Leeches, directly to swollen, irreducible, and painful piles (B). Alkaline 
Mineral Waters, excellent (B). Carbolic Acid, 3 parts to 1 of Olive Oil, a few 
drops injected into the tumor ; a favorite and successful treatment by itinerants 
(Andrews) ; uncertain in all cases and in many fraught with danger (Gross) : 
a good procedure ; use 4 drops each of pure Carbolic Acid and Glycerin, and 
inject one tumor at a time (Hunt). Grape-cure, is used with success (B). 
Saline Purgatives, notably Epsom salts, in bleeding piles, combined with 
Sulphuric Acid, will often stop the hemorrhage (B). [See Dysentery for 
formula.] Diet, etc. Avoid stimulants, indigestible food and over-eating; 
during an attack use little animal food. Petroleum soap when piles protrude, 
with cold or tepid water ablutions. Injections, Oj cold or tepid water, are 
very useful. Stool should be at night. Surgical Methods are — the ligature 
for internal hemorrhoids, excision for external ones. Ligation is the proper 
treatment for the former, all other methods of operating radically being now 
discarded as unsurgical, and dangerous to life (Gross). Thermo-Cautery is 
used by Smith of London and many other surgeons, but is apt to leave behind 
fissures and ulcers, which are with difficulty healed. Prevention. Soft seats 
favor the production of piles, as also of uterine disorders, by pressure on the 
arteries as they emerge from the pelvis, and so tending to drive the blood into 
the interior of that cavity (Holden). 



Prescriptions. 



R- . Iodoformi, ....... ^j. 

Balsam. Peruv., gij. 

Magnes. Calcin., .... ^j. 

Cetacei, 3 SS - 

01. Theobromae, . . . . q. s. 
M. et fiant suppositoria xij. Sig. — One 
twice daily. {Potter.) 

R* . Ext. Colocynth. Co., . . gr. xxx. 
Ext. Nucis Vom., . . . gr. vj. 
Hydr. Chlor. Mitis, 
Ext. Hyoscyami, . . . aa gr. xij. 
M. et div. in pil. no. xij. 
Sig. — One as required for sluggish bowels. 
[Barker.) 



R . Pulv. Gallse, gr. xx. 

Pulv. Opii, gr. x. 

Ung. Plumbi Subacet., . gr. xl. 
Ung. Simplicis, .... %]. 
M. et ft. unguentum. Sig. — Ointment 
for piles. {(Ester/en.) 

R- . Pulv. Gallse, 

Pulv. Opii, 

Plumbi Acetat., . . . . aa gr. xx. 

Ung. Picis Liquids, 

Cerati Simplicis, . . . aa ^ss. 
M. et ft. unguentum. Sig. — Apply night 
and morning after bathing parts with cold 
water. 



6l8 HEPATALGIA HEPATIC CONGESTION. 



R. Ext. Opii, gr. x. 

Pulv. Stramonii, . . . . £j. 

Pulv. Tabaci, gss. 

Ung. Simplicis, ^ss. 

M. Sig. — Ointment for piles. 

{Shoemaker.') 



$. Ac. Carbolici ^ij. 

Ac. Tannici, t ^j. 

Alcoholis, % iv. 

Glycerini, ^j. 

M. Sig. — Hypodermic injection for piles. 
{Girard.) 



Hepatalgia. 

Ammonium Chloride, grains xx-xxx, every 4 hours, is highly efficacious 
(Anstie). Bryonia, worthy of commendation in many liver affections (P). Nux 
Vomica, has been found of much benefit ; dose should be small, gr. yi^ to £$ 
twice or three times a day (P). Quinine, would naturally be thought of in 
malarial subjects, but does not afford any relief (Anstie). 



Hepatic Cirrhosis. 

Diuretin, for the dropsy. [See under Dropsy.] Nitric Acid, in long-stand- 
ing diseases, as this, will augment flow of bile after liver has struck work from 
mercury (R) ; the mineral acids do not benefit (B). Arsenic, small doses 
perseveringly, give good results in improving the nutrition of the organ (B). 
Bryonia, of great value in many liver complaints (P). Iodides, are the best 
remedies for the first stage (B) ; Potassium Iodide is highly recommended 
by some authorities (Da C) ; the great measures in the treatment of this affec- 
tion are Potassium Iodide, hydrotherapy, and a milk diet (Lanceraux). Stil- 
lingia and Alkaline Mineral Waters, are important in the first stage (B) ; 
Alkalies early, especially Carlsbad water, with total abstinence from alcoholic 
beverages (Legg). Mercury. Corrosive Sublimate in small doses, gr. -^ thrice 
daily, for a long time, does benefit the condition, and has possibly cured a few 
cases (Da C). Sodium Phosphate is said to produce good results (Da C) ; 
has power to retard the sclerosis, and may possibly arrest the changes and 
restore a state of comparatively normal function (B). Gold and Sodium 
Chloride, in doses of gr. -^, as an hepatic alterative, may be used conjointly 
with Sodium Phosphate (B). Tapping becomes necessary for the dropsy, 
though purgation and diuresis may help to lessen it (Da C). Diet, should be 
easily digested, especially milk, avoiding starches and fats, and quitting alcohol 
(DaC). 

Hepatic Congestion. 

Nitric Acid, in chronic congestion, will augment flow of bile after liver has 
struck work from excessive use of mercury (R). Nitro-muriatic Acid, is found 
useful in India, with the acid bath (^iij ad gall, j) to hypochondrium (B) ; 
formerly held high rank but is now superseded by Ammonium Chloride; the 
acid baths being now rarely employed (Fayrer). [See page 465 for formula.] 
Sulphur, as Sulphates in purgative natural waters, small doses often repeated ; 
Potassium Sulphate is occasionally poisonous (R). Chelidonium, as deob- 
struent (P) ; energetically affects the liver (Pf ). Iodine, tincture and unguent, 
locally for hepatic engorgement after malarial attack ; Ammonium Iodide in 
moderate frequent doses in functional derangement, from malarial disease (B). 
Sodium Phosphate, 3j-ij, 3 or 4 times daily, in plenty of water, as a purgative 
(B). Ammonium Chloride, in passive congestion, and chronic torpidity, is 
well worthy of attention ; gr. xx every 4 hours (Wa). an excellent remedy 
(Da C). Turpentine, epithems, hot, often found very beneficial (Wa). 
Quinine, gr. xv-xx with Morphine, gr. %-%, in the acute congestion due to 
climatic or malarial causes, no remedy so efficient (B). Bryonia, is worthy of 
commendation in liver affections of various kinds (P). Iris, really serviceable 
when stools clay-colored and skin jaundiced (B) ; is one of the best aperients 



HEPATIC DISEASES. 



619 



in hepatic derangement (P). Mercury, valuable only as a purgative ; its use 
restricted to cases where there is deficiency or excess of bile (B) ; a full Calo- 
mel purgative is of utility in cases of congestion (Wa). Podophyllum, the 
resin in congestion of the portal circulation, is especially useful (B) ; yk-yi g r - 
doses every six hours will speedily relieve symptoms (P). Sanguinaria, is 
useful in hepatic engorgement without organic disease (P). Colchicum, in 
hepatic congestion and dropsy ; an active remedy in congestion of the liver 
(B). Resin-bearing Purgatives, as Rhubarb, Podophyllum, Iris, Euonymus, 
etc., are all actively cholagogue. [See list on page 40.] Ipecacuanha, decidedly 
stimulant to the flow of bile (B) ; is the Indian treatment now for the local 
liver, given in large doses for a week or two (Da C). Taraxacum, has had a 
reputation, but I cannot recommend it (Da C). Aliment. No starches or fats; 
milk, eggs, oysters, beef broth, whitefish, etc. (B), Cold Water Belt around 
the abdomen, covered with oiled silk, gives great comfort in chronic cases 
(Da C). [Compare Biliousness, Jaundice, etc. J 



Prescriptions. 



R. Elaterii, 

Spt. ^Etheris Nitrosi, 
Tinct. Scillas, 
Tinct. Colchici, . . 
Syrupi Simplicis, 



• g r -J- 

aa ^ ss. 
§]'■ 



M. Sig. — Teaspoonful thrice daily. 



;bo 



R. Hydrarg. Chlor. Mitis, . . gr. vj. 

Pulv. Ipecac, gr. j. 

Sodii Bicarb., gr. x. 

Div. in pulv. no. ij. Sig. — One at bed- 
time, followed by the following: — 

R. Ac. Nitro-hydrochlor. Dil., 3 iij. 
Elix. Taraxaci Co., . . ad Jvj. 
M. Sig.— Dessertspoonful before meals, 
and a milk diet. 



R. Ext. 


Taraxaci 


, . . . 


• ST- 


lxxij. 


Ext. 


Aloes, 




• g r - 


XXIV. 


Ext. 


Colchici 


Rad., 






Pulv 


. Ipecac. 


. . . . 


aagr. 


Xlj. 


M. et d 


v. in pil. 


no. xxiv. 






Sig.— 2 


nightly 


n chronic 


enlargement 


and torpidity. 




{Martin.) 



R. Sanguinariae, gr. viij. 

Podophyllini, gr. iij. 

Ext. Hyoscyami, . . . . gr. iij. 

Saponis, gr. viij. 

M. et div. in pil. no. xx. 
Sig. — 2 to 4 pills daily. In hepatic tor- 
por without organic disease. {Phillips.) 



R 



. Pil. Hydrargyri, 

Pulv. Aloes Socot. 

Pulv. Rhei, 

Ext. Hyoscyami, 
M. et. div. in pil. no vj. 
Sig. — 2 pills every other night 



. aa gr. lv. 



aa gr. vj. 



R. Cinchonidinse Sulph., 

Euonymini, 

Leptandrini, 

Juglandini, 

Irisini, aa^j. 

Podophyllini, 

Ext. Belladonnae, 

Ext. Hyoscyami, . . . aa gr. x. 
M. et div. in pil. no. lx. 
Sig. — One pill thrice daily. In obstinate 
hepatic torpor. {Blackwood.) 



R. Euonymini, gr. xij. 

Ext. Hyoscyami, . . . . gr. vj. 

M. et. div. in pil. no. vj. 

Sig. — One at bedtime, followed next 
morning by a full dose of an aperient min- 
eral water. 

R. Potass. Bicarb., 

Potass. Citratis, . . . aa^j. 

Syrupi Simplicis, . . . Jvj. 

M. Sig. — A teaspoonful to a tablesp. 

with a similar quantity of lemon-juice, in 

y z glass of water; the whole to be drank 

while effervescing. ( Wood.) 



Hepatic Diseases. 

Ammonium Chloride is highly serviceable in all cases of liver disease, 
whether due to organic changes or to functional derangement ; especially indi- 
cated after the more acute symptoms have abated (Wa). Nitro-hydrochloric 
Acid, formerly held high rank, but is now superseded by Ammonium Chloride 
(Wa) ; even the acid baths, so long considered of great importance, are now 
but little, if ever, used in India (Fayrer). Nitric Acid acts in some way bene- 



620 HEPATITIS AND HEPATIC ABSCESS. 

ficially on long-standing liver- diseases, as in chronic congestion and cirrhosis 
(R) ; with vegetable bitters, long continued, useful in waxy liver (Wa). 
Podophyllum has a high reputation in a variety of liver diseases (P) ; is actively 
cholagogue (R). Mercury, mercurial purgatives are used for both deficiency 
and excess of bile ; harmful in many acute forms of hepatic disease, and gen- 
erally are of doubtful propriety in liver affections (B) ; in hepatic congestion a 
full Calomel purge is of great benefit (Wa). Red Mercuric Iodide, as oint- 
ment, gr. j to gv, gives best results in malarial enlargement of the liver (W). 
Calomel is used in inflammatory disorders of the liver, but is less suited to par- 
enchymatous than to serous inflammations (Da C). Ipecacuanha promotes the 
flow of bile (B) ; may be used in small doses with great advantage in func- 
tional derangement of the organ (Wa). Resinous Purgatives, as Leptandra, 
Iris, Euonymus, Rheum, etc., are decidedly cholagogue (B). Euonymin is of 
great value in torpid liver and its accompanying headache (W). Bryonia is 
worthy of commendation in liver affections of various kinds (P), Chelidonium 
powerfully affects the liver (Pf ). Taraxacum is highly recommended in all 
chronic affections of the liver, especially in indolent enlargement and incipient 
scirrhus (Watson). Sodium Phosphate is cholagogue, and extremely useful in 
liver affections, especially the jaundice of children and hepatic calculi (Thudi- 
cum). Phosphorus specifically affects the liver, and used early in acute yellow 
atrophy may have an action of antagonism upon the disease (B). Potassium 
Salts, as depuratives, are of decided value, especially the Citrate, in hepatic 
torpor and other affections (W). [See preceding article for formula.] Sulphur, 
the sulphurous mineral waters, prolonged, give excellent results in liver dis- 
orders (B). Alkaline Waters are very serviceable (B) ; especially the Sulphur 
waters ; Glauber's salt in their place (Da C). Chlorine Water has been em- 
ployed with benefit in chronic hepatic affections, in doses of 3ss-ij in ^iij or 
iv of water (W). Iron preparations, long continued, in amyloid degeneration 
(Da C). Gentian, and other bitter tonics, in functional disorder ; also Nux 
Vomica occasionally, but use Mercurials and Podophyllum sparingly (Da C). 
Iodine and Iodides in waxy enlargement, simple hypertrophy and chronic 
congestion, of great value (Wa) ; Potassium Iodide alternately with Ferrous 
Iodide in waxy liver (Frerichs) ; a few drops injected into hydatids (B). 
Sanguinaria is of great value in hysteria from chronic hepatitis, and in hepatic 
engorgement without organic disease (P). [See preceding article for formula.] 
Stillingia for torpid liver and jaundice following ague, in the first stage of cir- 
rhosis, and in ascites from hepatic changes (B). Malt Liquors are harmful in 
all chronic affections, especially in fatty liver (B). Galvano-puncture for hy- 
datids, the negative needle into the hydatid (B)„ [Compare Lists of Agents 
acting on the Liver, page 40, ante ; also, the articles in this section entitled 
Biliousness, Calculi, Cancer, Hepatalgia, Hepatic Congestion, He- 
patic Cirrhosis, Hepatitis, Jaundice.] 



Hepatitis and Hepatic Abscess. 

Ammonium Chloride, is almost a specific in hepatitis and abscess of the liver 
(Stewart) ; often preventing the latter disorder, and in many instances curing 
it (Wa). Quinine, in large doses for the acute parenchymatous inflammation 
(Da C). Tartar Emetic, gr. }(- l A, every two or three hours, with Opium or 
Calomel as indicated by symptoms ; of especial value early in the acute attack 
(Wa). Leeches to margin of the anus in the acute type (B) ; to unload the 
portal system (Wa). Mercury is used, but is better suited to serous inflamma- 
tions than to parenchymatous ones (W). Chelidonium has been used with 
benefit in both acute and chronic hepatitis (P). Alkalies and Colchicum, 
when the affection is of a gouty nature (Wa). Sulphites are recommended in 
chronic forms (Da C). Sinapisms and Linseed poultices over the hepatic 
region in acute hepatitis (Wa). Saline Purgatives, as the Sulphate of Sodium 
or Magnesium, to increase the watery exudation from the mucous membrane 
of the intestines, in acute hepatitis (Wa). Nitro-Hydrochloric Acid, for some 



HERNIA HERPES HERPES ZOSTER. 621 

time, in chronic form tending to abscess (Da C). Aspiration, when pus forms ; 
early operation the rule of practice ; has induced many recoveries (Da C). 
[Compare Jaundice.] 

Hernia. 

Opium, or Morphine hypoder. to narcotism, often obviates the necessity of 
an operation in strangulated hernia (Wa). Chloroform, of evident benefit 
(Wa) ; inhaled to assist reduction (R) ; has superseded the use of Tobacco and 
Lobelia in strangulated hernia (P). Coffee, large doses, has certainly a remark- 
able influence in aiding or causing reduction of strangulated hernia (Wa). 
Oak Bark extract, as injection into the tissues, for a radical cure by stimulating 
the occlusion of the rings (Heaton's radical cure). A similar operation was 
patented by a Dr. Gage in 1840, the Oil of Cloves being the injection used. 
Professor Pancoast injected Tinct. of Iodine for the same purpose. Operations 
for radical cure all unsatisfactory ; a properly adjusted truss is the best 
remedy for a reducible hernia, answering the purpose of a retentive apparatus, 
and often permanently curing the disease by the steady, gentle and uniform 
pressure of its block (Gross). Ice Poultice is of use if no strangulation of gut 
or omentum (Wa). Sternutatory, as snuff or Ipecac, to cause sneezing while 
patient lies on his shoulders with elevated hips and legs over the back of a 
chair, frequently successful after taxis has failed to effect reduction. 



Herpes. 

Ferrum Arsenate, in doses of gr. \ daily, will effect the cure of a herpetic 
affection in the adult, however extensive or long established (Duparc). Mer- 
cury, Calomel ointment, 3j to the ^, is one of the best mercurial preparations 
(Pereira). Potassium Carbonate, as lotion, gr. xxx to Oj, to allay irritation 
(Wa) ; or as ointment, gr. xx to ^j, smeared over eruption at night, and 
washed off in the morning with a solution, gr. xxx to Oj (Neligan). Glycerin, 
diluted, is a serviceable application in herpes labialis (Wa). Ergot, the Oil 
prepared by the action of Benzin upon Ergot, which, upon evaporation of the 
solvent, makes a valuable application in herpes genitalium and other skin 
affections (Shoemaker). Alum, in herpes prseputialis, a solution of Z) to ^j 
aquae, applied on lint to the glans penis, is generally effectual (Wa). Collo- 
dion, the flexible form, is applicable to various kinds of herpes (Wa). Mag- 
nesium Citrate, as a cooling laxative, with soothing and protective lotions and 
ointments, and the Liquor Picis Alkalinus, diluted 10 to 20 times for the itch- 
ing (Bulkley). Astringent Lotions, of Tannin or Zinc Sulphate, in herpes 
praeputialis, to render the parts less sensitive (Da C). [For Herpes Circinatus 
see Tinea Circinata.] 

Prescriptions. 

R. Ac. Carbolici, gtt. v-xv. 



& . Tragacanthae, 3 ij-iv. 

Liq. Calcis, Jiv. 

Glycerini, ^j. 

Aquae Rosae, ^iij. 

M. Sig. — A soft jelly for local use as 
ointment. 



Pulv. Calaminae Praep., 

Zinci Oxidi, .... aa sjss-j. 

Ung. Aq. Rosae, ^j. 

M. et ft. unguentum. 

A soothing and protective application. 



Herpes Zoster. 

Rhus Toxicodendron, very readily subdues, especially when burning or itch- 
ing (P). Aconite and Opium, locally for pain (Wa). Morphine, oleate ext., 
without friction (R) ; hypoder. to mitigate the pain (Anstie). Celandine has 
been recommended (P). Dulcamara, has an old reputation (P). Silver Nitrate, 
painted on the warning patch of erythema, before or as soon as vesicles begin 



622 



HICCOUGH HYDROCELE. 



to form (R) ; as a local application, reported on favorably (Wa). Veratrine, 
as ointment (gr. xx-xl ad %]), in neuralgia following shingles (R). Zinc Phos- 
phide, gr. Ys every 3 hours, is said to control the pain and abort the eruption 
(Hughes). Grindelia, is reputed to relieve the pain (Stille). Mercury, the Ung. 
Hydrarg. Ammoniat. is said to relieve the pain and irritation remarkably (Wa). 
Blisters, for subsequent neuralgia (R). Hot Fomentations will often disperse 
(R). Baths daily, exercise out of doors, abundant nutritious food. Flexible 
Collodion, constantly reapplied to exclude air (Anstie). Galvanization of the 
affected intercostal nerves, the positive pole over their points of emergence, the 
negative brushed over the terminal filaments of the skin (B). Starch, dusted 
over the eruption, and on a muslin band sewed tightly around the body to pro- 
tect it from the friction of the clothes, gives the greatest relief (Bulkley). Rest, 
absolute, when eruption is extensive (Fournier). 



Prescriptions. 



R 



g r - 



Zinci Phosphidi, 
Ext. Nucis Vomicae, 
M. et div. in pil. no. xxx. 
Sig. — One every 2 to 4 hours, as a nerve 
tonic. {Bulkley.) 



R. Liq. Sodii Hypochlorite . ^iv. 

A q U9S > 'Jij- 

M. Sig. — Wash for ulcerated vesicles. 



R. Bismuthi Subnit., . . . . ^iv. 

Hydr. Chlor, Mitis, 

Zinci Oxidi, aa 3]. 

M. ft. pulvis. Sig. — To be dusted on 
cotton-wool, and applied to the ulcerated 
vesicles, after washing with the solution of 
Sodium Hypochlorite. (Fournier.) 



Hiccough. 

Nux Vomica, in 5- or io-ff\, doses of tincture, with tt\,xv of dilute Nitric Acid ; 
a short course frequently curative (P). Chloroform, combined with Opium (R). 
Pepper gr. ij-x, to stop hiccough (P). Laurel-water, a useful remedy, rt\,v (P). 
Morphine, hypoderm., often arrests (R). Camphor, has been recommended 
(R). Mustard, £j infused in ^iv aq. fervid, has cured most obstinate cases 
(R). Pilocarpine, gr. -^ of the Muriate, has cured bad cases which resisted all 
other means (Ortille). Ether, as spray to the epigastrium for ten minutes, then 
to the site of the phrenic in the neck (Regoni) ; or the spirit, n\,xx-xxx in some 
aromatic water, given internally, will often arrest the spasm immediately (Wa). 
Zinc Valerianate, gr. % with a small portion of Extr. Belladonnas, cured a 
severe case of fifteen days duration (Danet). Nitro-glycerin, sometimes arrests 
(R). In mild cases deep inspirations, holding breath as long as possible, or a 
firm belt around epigastrium (T). 



Hydrocele. 

Iodine, injection of tincture 1, water 2, into the sac to excite obliterative 
inflammation, the usual procedure for radical cure after tapping the sac (Wa) ; 
may be used full strength, or with equal part of water ; the latter the safest 
method in ordinary cases, but relapses are not infrequent (Gross). Carbolic 
Acid, 3ss, with a minute quantity of water or Glycerin to render it fluid, injected 
into sac and manipulated to bring all portions under its action, after which 
rest in bed and support to scrotum (Levis) ; a very efficient method for radical 
cure, but may cause erosion of vessels and hemorrhage into sac (Gross). Am- 
monium Chloride, as discutient lotion to the scrotum in hydrocele of children 
(Wa). Galvano-puncture, a current of 20 to 40 elements, by two needle elec- 
trodes, will invariably cure (B). Operations for radical cure include that by 
iron-wire sutures to excite adhesive inflammation (Simpson) ; and the incision 
of the hydrocele under antiseptic precaution (Volkman) ; the same end may 
be obtained by the simpler methods of injection noted above (Gross). [Com- 
pare Dropsy, Orchitis.] 



HYDROCEPHALUS HYDROPHOBIA HYDROTHORAX. 623 

Hydrocephalus, Acute. 

Iodine, lotions to scalp, or inunction of Iodine ointment together with Ferrous 
Iodide and Cod-liver Oil internally, offer the best chance of success, although 
most remedies often fail (Wa). Tartar Emetic, the oint. as counter-irritant to 
scalp in tubercular meningitis (R) ; in large doses internally was formerly 
employed (Wa). Croton Oil, is said to have removed the excess of fluid from 
the ventricles (R). Mercury, Hydrarg. Chlor. Corr., in doses of gr. ^L to -^, has 
proved successful (Wa). Magnesium Carbonate, 3j-ij saturated with Lemon- 
juice, every 2 or 3 hours, a useful purgative in hydrocephalus (Wa). Turpen- 
tine, in doses of Tr\,v-x with n^xx-xl of Castor Oil, or terebinthinate enemas, in 
incipient hydrocephalus (Wa). Purgatives, in small doses, every 4 or 6 hours 
after having overcome the constipation, to maintain action for some days ; a 
single dose of Calomel, followed up by Magnesium Sulphate at short intervals ; 
their value can hardly be overrated (Wa). Leeches, on crown of head rather 
than on temples, when much febrile action ; inadmissible if patient is much 
debilitated ; sometimes serviceable (Wa). 



Hydrocephalus, Chronic. 

Mercury, holds a high place in the opinion of many. Calomel gr. %-}i 
twice daily, with mercurial inunction to the shaved head, or the latter alone ; 
child to wear a woollen cap ; this treatment for 30 or 40 days (Wa). Ferrous 
Iodide, with Cod-liver Oil, always gives good results among the poor (Wa). 
Iodine, lotions. [See Hydrocephalus, Acute.] Potassium Iodide, may 
arrest progress (Wa) ; is of value certainly ; appears to have power of promot- 
ing absorption (Wa). Cod-liver Oil, sometimes improves the condition, 
especially in scrofulous children (Wa). [Compare Dropsy.] 



Hydrophobia. 

Belladonna, in all hyperaemic states of the brain and spinal cord, is one of 
the very best remedies (P). Stramonium, is used by Brahmins in India with 
apparent success. Glonoin, may be of benefit (Wa). Nicotine, rightly used, 
will probably prove to be our best remedy (B). Amyl Nitrite, should be fairly 
tried (B). Hydrastinine, is used with benefit, in grain doses of the Hydro- 
chlorate, hypodermically. Curare, is encouraging, gr. % injected, 7 doses in 
^]/z hours, dispelled the symptoms, but replaced them by paralysis of the limbs 
continuing for over 2 months (Ros) ; has seemed to antagonize the convulsive 
phenomena (B). Calcium Chloride, a filtered solution injected into wound, 
very effective in snake bites (Binz). Morphine, chiefly palliative ; for deep 
injection into the tetanized muscles (B). [See Tetanus.] Confine, is indicated ; 
has not succeeded (B). Cauterization, with hot iron or Caustic Potash after 
cleansing wound, which should be kept open by Unguentum Basilicon for 5-6 
weeks (Ros) ; with Silver Nitrate sharpened to a point, and applied freely to 
every sinuosity of the wound as preventive (Wa). Excision, the safer practice 
(Wa). Baths, warm and hot, produce calm (Ros). Pasteur's Inoculation, 
with a "modified virus," is claimed to protect the person bitten from the dis- 
ease. A recent report of the Pasteur Institute in Paris, states that during the 
last 8 years there were 14,430 persons treated thereat, with 72 deaths, an average 
mortality of 0.5 per cent., and a yearly mortality which varied from 0.94 per 
cent, in 1886, to 0.22 per cent, in 1892, and 0.24 per cent, in 1893. 



Hydrothorax. 

Diuretin, has been employed with benefit. [See under Dropsy.] Digitalis, 
in purely dropsical form, also in passive pleuritic effusions ; used as a diuretic 
(5j-ij of infusion bis die, or oftener) of great value (R). Elaterium, unques- 



624 HYPOCHONDRIASIS HYSTERIA. 

tionably of value as a derivative, though many fear it (P). Jaborandi, pro- 
duces good results (B). Iodine, 3j of tincture injected in returning hydro- 
thorax (B). Sanguinaria, has been used with the best effects (Wa). Blisters, 
when effusion has taken place, certainly seem to stimulate the absorbents to 
action (Wa). Dry Cupping, over the chest, gives relief (Da C). Thoracentesis, 
if much distress. [Compare Dropsy.] 



Hypochondriasis. 

Arsenic, in the aged, gives great comfort, especially when combined with 
Opium (B). Ignatia, is useful, the Tincture is best (P). Cimicifuga, of singular 
value in puerperal hypochondria, and in that accompanying spermatorrhoea, 
etc. (P). Aurum, the Chloride, gr. -fa to ^ ter die gives excellent results, when 
depression, vertigo, cerebral anaemia (B). Valerian, quickly relieves flatulence 
(B). Asafcetida, especially indicated in cases marked by flatulence and gloom 
(B). Potassium Bromide, especially among female town-dwellers, but also in 
male (R) ; effects are variable, relieves some, not others (Wa). Hyoscyamus, 
when syphiliphobia (P). Opium, stimulant doses of the tincture are of great 
importance (B). Caffeine, the Citrate (gr. j-v) has been used as a cerebral 
stimulant with advantage (B). Alcohol, in hypochondriasis gives temporary 
relief ; should never be given for its narcotic or stimulant effects in these cases 
(W). Cocaine, especially useful in cases marked by debility and nervousness, 
and in mental affections accompanied by depression ; the fluid extract of Coca 
may be used, either alone or in wine (Br). Turkish Baths, are useful for town- 
dwellers, with soft, flabby tissues, and mental depression (R). [Compare 
Melancholia.] 

Hysteria. 

Ignatia, useful in many forms of hysteria, with feeling of suffocation, sensa- 
tion as of a ball rising to the throat, convulsive crying, flatulence, etc. (P). 
Camphor, in hysterical excitement (P). Musk, for many anomalous and dis- 
tressing symptoms (R). Chamomile Oil, in the spasmodic and pseudo-neuralgic 
affections of hysterical women, a very excellent remedy (P). Cimicifuga, in 
hysterical chorea, is rapidly curative (P) ; for the headache (R). Asafcetida, 
in hysterical convulsive affections, with flatulence and cough (P) ; arrests 
paroxysm, valuable for flatulence (B) ; removes headache, peculiar sensations 
in head, and flatulence (R). Valerian, has great value, £ss doses of fluid ex- 
tract (B) ; useful in most cases, especially those of hysterical dyspepsia (P). 
Zinc Valerianate, especially at the climacteric age, for hysterical symptoms 
which can be traced to no particular cause (R). Ergot, with Iron and other 
tonics (See formula below), in cases depending on sub-involution of the 
uterus, with indigestion and anaemia (B). Nux Vomica, of great use in middle- 
aged subjects, with flatulence, weight on head, flushings and perspirations (R). 
Atropine, for hysterical aphonia, gr. y^ to ^ morning and evening (B). Ether, 
for the flatulence, and for the hysterical paroxysm in sudden seizures (B). 
Ammonia, the aromatic spirit for the acidity and eructations (B) ; the fetid spirit 
for flatulent colic, etc., may be given with great advantage in doses of £>ss-j 
(Wa). Potassium Bromide, gives control, and prevents paroxysms ; when 
verging on nymphomania large doses required (R). Iron, a course often use- 
ful, especially when anaemia or uterine obstructions (R). Phosphorus, in 
hysterical paralysis (R). Arsenic, lessens mobility of nervous system, and 
improves nutrition (B). Opium, gtt. j of Laudanum with gtt. ij of Tinctura 
Nucis Vomicae 3 or 4 times a day, for flushings, weight on head, depression 
(R). Ovarian Compression, has in many cases relieved recent hysterical 
contractions, and many other similar phenomena (Bourneville). Electricity, 
for aphonia, paralysis and anaesthesia, and to educate the nervous control ; is 
the sworn enemy of hysteria. Accessory Measures. Occupation of mind and 
body ; removal from influence of friends ; complete abandonment of the use 



ICHTHYOSIS IMPETIGO — IMPOTENCE. 



625 



of alcohol ; the shower-bath or cold-bath, as an educator of the will, as well as 
to invigorate the body; excitement to be avoided. The word "Hysteria" 
should never be applied to the case in the patient's hearing. Disorders of 
vision are often found at the bottom of hysteria ; look for hypermetropia and 
astigmatism. 

Pi-escriplions. 

R. Ext.Ergotae, ...... ^j. 

Ferri Sulphatis, £ss. 

Ext. Nucis Vomicae, . . . gr. viij. 

Hydr. Chlor. Corros., . . gr. ss. 
M. Fiant pil. no. xxx. Sig. — One pill 
thrice daily. To improve digestion and 
anaemia. (B.) 



R • Tinct. Asafoetidae, 

Tinct. Valerianae Ammon., 
Tinct. Castorei, . . . . aa J^ij. 

Aquae Camph., g vij. 

M. Sig. — A tablespoonful or two every 

hour. 



Ichthyosis. 

Zinc, the ointment or glycerite of the Oxide, especially the latter with a little 
Camphor added to it, is a most useful application (Wa) ; an ointment of the 
Sulphate, Z] to gj, found very efficient (Wilson). Sodium Bicarbonate, as oint- 
ment, gr. xv-xxx to !|j, or lotion, 3ij -u J t0 Qj (Devergie). Copper Sulphate, 
gr. x ad ^j Unguentum Sambuci, a useful application (Wilson). Ulmus, in 
decoction, used internally, has cured the disease (Wa). Cod-liver Oil, applied 
locally with friction, has proved promptly curative. Warm Baths, may gener- 
ally be employed with benefit (R) ; alkaline and vapor baths, with Sapo Mollis ; 
and inunctions of oil or simple ointment, to prevent Assuring of the new skin 
(Duhring) ; frequent alkaline baths, with internal and external use of oily 
preparations, as Linseed and Cod-liver oils, yield the best results (Bulkley). 



Impetigo. 

Salol, locally, as an antiseptic and deodorant powder. Arsenic, is very use- 
ful [See Eczema] ; the Iodide in doses of gr. ^ has been employed with 
great success ; or Donovan's Solution, n\,v-x (Wa). Nitric Acid, internally, 
frequently benefits (Wa). Glycerite of Tannin, an excellent application (B) ; 
during day, with poultice at night to remove scabs (R). Quinine, Mineral 
Acids, when from imperfect digestion (R). Zinc, the ointment of the Oxide, 
after subsidence of inflammation (R). Sulphur, internally, serviceable (R). 
Calcium Chloride, gr. xv-xxx, daily, in some vegetable infusion, well spoken 
of (Wa). Mercury. Citrine Ointment dilute, locally, is an excellent applica- 
tion (Wa) ; a very weak White Precipitate Ointment answers best in impetigo 
contagiosa, with a little Carbolic Acid lotion (1 to 20) if it does not yield (Bulk- 
ley) : Calomel to cover the floor of the pustules, after opening, evacuating and 
washing them out (Da C). Laurel-water, relieves itching (P). Grape-cure, 
has proved excellent (P). Flexible Collodium, or Liquor Guttse-perchae, to 
cover the pustules, if located where they are liable to irritation (Da C). [Com- 
pare Eczema.] 

Impotence. 

Phosphorus, no remedy more efficient ; the pill of Zinc Phosphide the most 
convenient form (B) ; gr. -^ thrice daily. Phosphoric Acid, full doses, with gr. 
ss of Pulvis Cantharidis, an effective combination, especially in impotence of 
old age (B). Aurum Chloride, prevents decline of sexual power (B). Cantha- 
ris, with Iron is beneficial (B) ; in large doses (gtt. xx-xxx), with Iron and 
Phosphoric Acid or Nux Vomica (R) ; of doubtful efficacy (Wa). Cubeb, re- 
moves functional trouble (B). Nux Vomica, drop doses of tincture in atonic 
impotence (B) ; in large doses when spermatorrhoea (R). Sanguinaria, has 
decided aphrodisiac properties, but useful only in functional form (B). Ser- 
40 



626 



INFLAMMATION. 



pentaria, in relaxation and feeble erections, will often restore power ; ^ss doses 
of tincture bis in die (B). Ergotin, hypodermically about the dorsal vein of 
penis, when its enlargement and too rapid emptying is the cause of impotence 
(B). Cannabis Indica, is a useful remedy ; the best combination for functional 
impotence would be one of Cannabis, Nux Vomica and Ergot (B). Polygonum 
Hydropiperoides, is a useful remedy in the functional form, erections feeble, 
semen watery and testes soft (B). Ferrum Arsenate, acts as a tonic to the 
organs, and in full doses often benefits cases of functional form (B). Damiana, 
has been brought forward as a genital stimulant, and a remedy for impotence, 
but there is probably no ground for any confidence in such claims (Stille), 
[Compare Emissions, Spermatorrhoea, also List of Aphrodisiacs, ante, page 
47-] 

Prescriptions. 



R . Ferri Arsenatis, gr. v. 

Ext. Ergotse, gr. xxx. 

Ft. pil. no. xxx. Sig. — One twice daily. 

R. Ext. Cann. Indicae, . . . gr. x. 

Ext. Ergotse, gr. xl. 

Ext. Nucis Vom., . . . . gr. x. 
Ft. pil. no xx. Sig. — One pill night 
and morning. 



R. Quininae Sulph., . 

Strych. Sulph., . 

Ext. Ergotae, . . 

Mas. Ferri Carb., 
M. Ft. pil. no. xxx. 
or 3 times daily. 



. . . gr. xxx. 

. . . gr. ss. 

. . . gr. xv. 
,..-". gr. xlv. 
Sig. — One pill 2 



R . Sanguinarinae, . . 
Ext. Ergotae, . . . 
M. Ft. pil. no. xx. 
thrice daily. 



. . . gr. i]. 
. . . gr. xx. 
Sig. — One pill 



R. Tinct. Sanguinariae, . . . giij. 
Ext. Stillingiae Fl., . . s 3 v. 
M. Sig. — 15 to 20 drops in water, thrice 
daily. 



R . Phosphori, 


. gr. ss. 


Ext. Nucis Vom., . . . 


• g r - V J- 


Mas. Ferri Carbonat., . 


. gr. xl. 


Ext. Gentianae, .... 


. gr. xxx. 


M. Ft. pil. no. xxv. Sig.- 


—One 2 or 


3 times daily. 





Inflammation. 

Aconite, is especially indicated in inflammation of respiratory organs, eruptive 
fevers, and all inflammatory states of high temperature and sthenic reaction ; 
not in adynamic states, or continued fevers, except for hyperpyrexia ; may be 
advantageously combined with Opium (B) ; gives most brilliant results in many 
forms (R) : always indicated in early stages of simple inflammatory fevers, in all 
inflammation of serous membranes, pneumonia, tonsillitis, acute rheumatism,, 
erysipelas, etc. ; is especially adapted to the uses for which bleeding was form- 
erly employed (P). Arnica, is antipyretic, large doses (gss f tinct.) in sthenic, 
small doses (tt\,x) in asthenic inflammation (B) ; in inflammation of serous 
membranes it has given good results (P). Belladonna, in many forms no 
remedy more useful, notably scarlet fever, erysipelas, low fevers ; for inflam- 
mation of eyes, boils, carbuncles, etc., Atropine externally, Belladonna inter- 
nally; when much fever, may be combined with Aconite (B) ; both locally 
and internally in inflammation of the eye ; is effectual in inflammation which 
threatens to end in abscess (R) ; in erysipelas, inflammatory sore throat, 
encephalitis, gouty and rheumatic inflammation, cystitis, pneumonia, etc. (P). 
Gelsemium, especially for inflammation of lungs and pleurae, and in pneumonia 
(tt\,v-x of fl. extr. every two hours) (B) ; in acute stage of gonorrhoea is valuable 
(P). Bryonia, exceedingly valuable in pleurisy and other serous inflamma- 
tions, especially pericarditis ; after the aconite stage (P). Veratrum Viride, 
when much delirium and arterial excitement, useful at beginning only (B) ; in 
pneumonia, Veratrine is most valuable, also in acute rheumatism and generally 
as an antipyretic (P). Tartar Emetic in frequent minute doses, gr. y 1 ^, renders 
incontestable service (B) ; in pneumonia, tonsillitis, pleurisy, bronchitis, and 
other inflammatory affections (R) ; gr. ye, frequently repeated, has the power 
of completely dissipating early local inflammations (Spender) ; quite as useful 



INFLAMMATION. 627 

in arresting local inflammation as Quinine is in malarial fever (Lawrie). Pul- 
satilla, in acute and subacute inflammations with muco-purulent discharges, 
especially of eyes, ears, and nasal passages (P) ; also with Aconite in epididy- 
mitis (Pf). Mercury, in acute glandular inflammation of throat and neck, in 
ileo-colitis, iritis, syphilitic inflammations of serous membranes, laryngitis (R). 
Silver Nitrate, locally in strong solution, gr. clx to ^j of distilled water, painted 
over surface and beyond, after thorough cleansing and drying ; no agent so 
safe, powerful or efficacious in subduing external inflammation (Higginbotham); 
a strong solution in Nitrous Ether is a most efficient application to check in- 
flammation in superficial parts, as boils, felons, orchitis, synovitis, erysipelas, 
erythema, eczema, etc (B). Iodine, as liniment in vicinity of local inflamma- 
tion to produce vesication (R). Sulphides, especially that of Calcium (gr. ■^ u ) 
appear often to arrest suppuration ; after formation of pus they hasten matura- 
tion and circumscribe inflammation ; in boils, abscesses, and deep-seated sup- 
puration, they improve the condition and promote healing (R). Antipyrin, 
Kairin, and other antipyretics. [See under the title Fever.] Alkalies, especi- 
ally Ammonium and Potassium salts, are very valuable in the stage of exuda- 
tion (B). Astringents, locally in inflammations of mucous membranes (R). 
Lead, the Liquor Plumbi Subacetatis Dilutus as a soothing and astringent 
application to inflamed and erysipelatous surfaces (Wa) ; to eczema and other 
inflammatory diseases of the skin (Pf ). Digitalis, the German antipyretic, is 
especially useful in pneumonia, bronchitis, rheumatic fever and scarlet fever 
(B) ; Aconite safer and better (R) ; locally and internally Digitalis is useful in 
inflammations, especially those of joints, of breast, erysipelatous and varicose : 
a fomentation of a teasp. of the dried leaves in half a pint of boiling water, or 
3j of tincture to the same quantity of water, applied by flannels to the part, 
will quickly subdue (Fairbank). Quinine, in peritonitis (Tr) ; is indicated in 
most acute forms, unless objections occur (P) ; has power to arrest inflamma- 
tion in formative stage ; with Morphine and in full doses (gr. xv-xx) may sup- 
press many forms (B). Chloral, excellent when temperature is high, much 
delirium ; gr. v every 3 hours (B). Opium, is important in most inflammations, 
but especially those of serous membranes ; a full dose (gr. %■ of Morphine) at 
first, smaller doses after ; is especially curative in inflammation of intestines 
and peritoneum, and of cerebro-spinal meningitis, arachnitis, etc. (R). Saline 
Purgatives, valuable as part of the denutrition treatment, and to diminish 
arterial tension (B). Salicylic Acid is antipyretic, especially in septicaemic 
inflammation, and acute rheumatism, erysipelas, pneumonia (B) ; Sodium 
Salicylate more soluble (R). Colchicum often exercises a happy influence over 
certain acute inflammations, as bronchitis, conjunctivitis, etc., especially if 
occurring in gouty subjects (P). Cocaine, locally in commencing inflamma- 
tions of mucous surfaces, to constrict the blood-vessels of the part (R). Pilo- 
carpus gives good results in the exudative stage of pleuritis, iritis, keratitis, etc. 
(B). Cold, by Ice in bags, or cold water, a very useful agent. Heat, by hot 
water, fomentations, etc., often much better. Ice, in small pieces in a bladder 
applied to inflamed part (R). Water, cold and hot baths and packing very 
useful in all inflammations (B). Alcohol, is constantly prescribed, and is of 
value in low states, if symptoms after its administration are ameliorated (B). 
[See Fever.] Poultices, useful in many inflammatory states, but often abused 
(B) ; to check formation of pus and assist in maturation (R). Venesection, 
when pulse hard, strong, full and frequent, a plethoric state of the system and 
great intensity of morbid action ; if required, the earlier it is done the better 
(Gross) ; Leeches very useful in many forms where sthenic reaction and ple- 
thora; value of bloodletting probably due to derivative and counter-irritant 
effect (B) ; a remedy of great power for good or evil, now much neglected 
(Wa) ; local bleeding by leeches, cups, scarification, etc., should generally be 
preceded by some form of general depletion (Gross). Aliment, when no 
inflammation of the digestive tract, use milk and beef-tea alternately every 3 
hours; no starches or fats; in intestinal inflammation, milk, eggs, animal 
broths, oysters, fish, but all food must be used with great caution ; skim-milk 
treatment (B) ; Cod-liver oil in many chronic inflammations, as of heart, lungs, 



628 INFLUENZA. 



kidneys, etc. (R). [Compare the various titles, as Bronchitis, Pleuritis, etc., 
also the list of Antiphlogistics on page 43.] 



Prescriptions. 
[See pages 477 and 478 for Lotion and Liniment formulae.] 

R. Tinct. Aconiti, gj. 

Tinct. Belladon., gij. 

M. Sig. — Three or four drops in water 
every hour. (B.) 



R . Ammonii Chloridi, . . . . 3 v. 

Acidi Acetici, 

Alcoholis, aa ^x. 

Aquae, q. s. ad £ x. 

M. et fiat lotio. Evaporating and dis- j hours. Antimonial and Saline Mixture, 
cutient lotion. (Gross. 



R. Antim. et Pot. Tart., . . . gr. ijss. 

Magnes-ii Sulph., . . . . Jij. 

Morphinae Sulph., . . . . gr. ] 1 /. 

Ac. Sulph. Aromat., . . . gss. 

Tinct. Verat. Virid., . . . ^jss. 

Syr. Zingiberis, ?ij. 

Aquae Destill., ^x. 

M. Sig. — Tablesp. every 2, 4, or 



Influenza. 

Salol and Salipyrin, were highly extolled during the epidemic of 1891. 
Phenacetin, is used with great benefit, both as a prophylactic and a remedy. 
Phenocoll, the Hydrochloride has been used with marked success, in epidemic 
influenza, and for the neuralgic pains thereof. Acetanilid, 2, with Salicylic 
Acid and Ammonium Bromide, each 1 part, forming the mixture called Anti- 
nervin, was used with much success during the recent epidemic in Scotland. 
Strychnine, for the underlying weakness and depression, the real enemy to 
fight against in the grippe, Strychnine is the best remedy we have (Huchard). 
Digitalin, crystallized, in dose of gr. -^, in grippal pneumonia, in which, though 
the disease is in the lungs, the danger is in the heart (Idem). Sodium Benzo- 
ate, with Quinine and Caffeine [see formula below] in the simple form of the 
grippe (Idem). Quinine Hydrobromate in 8- to 16-grain doses, if the fever is 
high (Idem). Quinine has been used beneficially throughout the disease, espe- 
cially after the acute stage, for neuralgic pains (Wa). Ammonium, the Liquor 
Ammonii Acetatis, combined with Nitric or Chloric Ether, is often of great 
service (Wa). Sanguinaria, is used with much benefit (Wa). Cimicifuga has 
been given with much success (R). Camphor, in solution, hypodermically 
[see formula below], 2 to 4 injections daily, with 3 to 6 of Caffeine and 2 to 3 
of Ether, for grippal pneumonia (Huchard). Camphoric Acid, in one dose of 
gr. xx-xxx, dry on the tongue, not over 2 hours before the expected time for 
sweating, is remarkably efficient to prevent it. Agaricic Acid, gr. x^ - /^ by 
mouth, is efficient against the sweating of influenza. Bismuth Salicylate, or 
Naphtol, Betol, Salol, or Benzo-naphtol, as intestinal antiseptics, when such 
are required (Huchard). Sulphurous Acid, by fumigation or inhalation, a few 
drops on boiling water ; or as a spray, often controls influenza (R). Menthol, 
in 5 to 10 per cent, spray, is highly praised. Benzol vapor, is a reliable pul- 
monary antiseptic, and has been employed with very favorable results (Robert- 
son). Benzoin, the compound tincture, 3ss-j, inhaled from a pint of hot water 
frequently (Da C). Tartar Emetic has been recommended strongly, but is too 
depressant (Wa) ; has extraordinary power of aborting local inflammations, 
especially those of respiratory apparatus. [See under Inflammation.] Spir- 
itus Etheris Nitrosi, in doses of 3j-jss, in any convenient vehicle, is a popular 
and efficacious remedy (Wa). Cocaine, a 4 per cent, solution snuffed up nos- 
trils or applied by spray-producer, very efficacious in the early stage (R). 
Cubeb, 3ss or 3j doses of the tincture in % -glass of Linseed- tea thrice daily, 
for the subsequent cough, often curing like a charm (R). Opium, best avoided 
in early stage, but later for the cough, with Ipecac, gives great ease ; Dover's 
powder, with Nitre and Lobelia, is a good form (Wa). Potassium Nitrate, 
Nitre largely diluted, as lemonade, 3j-ij in the course of the day, proves highly 
useful (Wa). Turkish Baths have been employed with marked advantage 
(Wa). Hot Fomentations, for the headache (R). 



INSANITY INSOMNIA. 629 

Prescriptions. 

R. Quin. Hydrobromat., R. Ext. Cimicifugse Fl., . . ^ss. 

Sodii Benzoat., Tinct. Opii Deod., .... 3J. 

Caffeinae, aa gr. xxx. Syr. Tolutani, 3 xj. 

M. et ft. pil. no. xxx. M. Sig. — Teasp. every four hours. 

Sig. — One pill thrice daily. (Hue hard.) | . 

R. Camphorse # ^ ijss. 

R. Ammonii Chloridi, . . . ^jss. 01. Olivas (steriliz.), . . . giij. 

Morphinae Sulph., . . . . gr. ij. M. Sig. — 3 ss hypodermically twice or 

Tinct. Sanguinariae, ! thrice daily. (Huchard.*) 

Syr. Ipecac, aa ^iv. 

Mist. Glycyrrh. Co., R. Ext. Ipecac. Fl., . . . . 3 ij. 

Aquae, aa jfjss. Tinct. Opii Deodor., . . . giv. 

M. Sig. — Teasp. as required for the Tinct. Aconiti, 5jj. 

cough. Each dose has of Morph. Sulph. M. .Sig. — Five to ten drops every two 



g r ' 



To' 



hours, for the bronchitis. 



Insanity and Dementia. 

Hyoscine, has strong power as a mental alterative ; is particularly useful in 
that form of mental disturbance which renders the patient violent and abusive, 
restless and domineering, a nuisance to every one who has anything to do with 
him (Weatherly), Opium, Morphine the best form, especially for melanchol- 
ies, climacteric and senile cases, which improve under its use ; is hurtful in 
mania. Chloral, does as much harm as good, is best suited to wildly maniacal 
and erotic patients. Potassium Bromide, is almost discarded, except for epi- 
leptic cases. Conium, is useful, sparingly, for noisy patients, so also is Hyos- 
cyamine. Colchicum, for gouty cases, which are numerous ; cure the gout, 
and you may cure the insanity. Shower-bath, suitable for cases due to self- 
abuse ; the wet pack in the mania of hystero-epilepsy. Stimulants rank high, 
next to quiet and absence from home. 

Moral or Mental Treatment in recent times, is confided in greatly. With 
correct management from the start, nearly all cases of insanity unattended by 
paralysis or physical decay may be cured (Savage) ; this can be best admin- 
istered in a well-conducted asylum or hospital for the insane, where security 
and the prospect of recovery will be better than in the best home ; the total 
abolition of any one plan of treatment in favor of another would be a great 
mistake ; more than half of first attacks of insanity are recovered from under 
good management, which is best attained under the direction of persons trained 
in this specialty (H). Recently, efforts have been made at the improvement 
of the insane condition by requiring them to attend school daily, with remark- 
ably good result. Tonics and Hypnotics, should be used in cases requiring 
them. Food, of good quality is at the basis of treatment. Kumyss, a good 
food in hysterical dyspepsia and anorexia, being easily digested and prevent- 
ing waste (Savage). [Compare Delirium, Hypochondriasis, Mania, Mel- 
ancholia.] 

Insomnia. 

Chloral, in 20 to 30 grain doses, by far the best hypnotic for many forms of 
insomnia (R) ; cautiously in that of delirium tremens (B) ; acts best in cases of 
purely nervous type (Wa) ; in combination with alcoholic preparations, especi- 
ally if Bromides present, it is apt to separate and float on top as an alcoholate. 
(See ante, page 180). Croton-chloral, is feebler than Chloral and less toxic; 
as a hypnotic Z] may be given (R). Somnal, is a combination of Chloral, 
Alcohol and Urethan, and strikingly efficient in the insomnia of convalescence 
from acute disease (Myers). Paraldehyde, in doses of o\j-3ij, one of the most 
efficient and safe hypnotics, being free from depressant action on the heart 
and other unpleasant by-effects. Hypnal, gr. xv-xxx, is credited with simul- 



630 



INSOMNIA. 



taneous hypnotic and analgesic action. Hypnone, is of moderate power, but 
said to be especially useful in the insomnia of acute alcoholism. Urethan, a 
pure but mild and safe hypnotic, especially useful for children. Resorcin, 
produces quiet sleep in general nervous excitability, and in the insomnia of 
typhus fever and pulmonary tuberculosis. Chloralamid, gr. xxx in Z) of whiskey 
or brandy, in simple or idiopathic insomnia, or that from nervousness, hysteria, 
chronic alcoholism, but not when due to excitement or severe pain. Sulphonal, 
gr. xxx, in milk, 2 hours before effect is desired ; an admirable hypnotic in 
many cases, but its efficacy decreases with use, and it is of no value in insomnia 
due to pain. Trional, is markedly hypnotic and sedative, acts surely and 
promptly in the insomnia of neurasthenia and organic brain affections ; is 
better than Sulphonal or Chloral, in many respects (Schultze). Tetronal, is 
somewhat less hypnotic than Trional, but more of a sedative ; the sleep from 
either lasts 6 to 8 hours, and is generally dreamless. Neither are of any use 
when insomnia is due to pain. Potassium Bromide, when from cerebral over- 
action, gr. xv before each meal, and gr. xxx on retiring ; has cumulative effect 
(B) ; it increases hypnotic effect of Hyoscyamus, Belladonna, Cannabis Indica, 
Ether and Chloroform (R). Hyoscyamus, an effective substitute for Opium in 
children, &]-%} of tinct. necessary, and without danger (B) ; when Opium dis- 
agrees (R). Belladonna or Atropine, hypnotic in some morbid states, especially 
those marked by prostration, low. arterial tension, contracted pupils. Ignatia, 
for sleeplessness from nervous erethism, better than Morphine (Pf). Gel- 
semium, in simple wakefulness (B) ; and in that of drunkards, mania and 
over-excitement (R). Coffee, insomnia from lowering of nervous power, and 
chronic alcoholism (P). Opium, or Morphine, gr. yt>-gr. ss, when pain (B) ; 
Codeine and Narceine are also hypnotic; should be given to act at n aturaltime 
for sleeping (R). Sumbul, rr\,xxx-xl of tinct. with a little Chloric Ether, very 
efficient in the insomnia of chronic alcoholism (P). Tartar Emetic, and Opium, 
very effective when due to cerebral congestion, and when Opium stimulates (B). 
Ether or Chloroform in a full dose (R). Phosphorus, nutrition inactive ; in- 
somnia of the aged (B). Humulus, a hop-pillow effective (P) ; Tinct. Lupulinae, 
5ss-^ss,as cerebral sedative. Cocaine has been used with some success (Wa). 
Chamomilla, rt\j of the tinct. every quarter-hour, an excellent sedative for chil- 
dren (Smith). Cannabin Tannate, in 8-grain doses, a good hypnotic (Fron- 
miiller); very inefficient (W). Cannabis is very uncertain in its action (R). 
Alcohol, if from cerebral anaemia, a full dose of whisky or brandy ; or in some 
a glass of ale or beer answers better (B). Water, a tepid bath just before 
retiring often effective ; when head is hot apply cold to it, and a tepid bath to 
the body (B). [Compare Nervousness ; also the list of Hypnotics on page 27 ; 
also the Analogues of Chloral, page 180.] 



Prescriptions. 



R- . Paraldehyde % ijss. 

Alcoholis (99 per cent.), . ^ jss. 

Tinct. Vanillas, 3 ss. 

Aquae, . ^ £j. 

Syr. Simplicis, . . q.s. ad "f^ iv. 
M. Sig. — A teasp. or two every hour 
until sleep is obtained. 

( Yvon's Hypnotic Elixir.} 



R- . Potassii Bromidi, 

Chloralis Hydratis, . . aa ^ ss. 

Syr. Pruni Virgin., . . . . ^j. 

Aquae, q. s. ad 3* ij . 

M. Sig. — Teasp. in a winegl. of water. 
Repeat in one hour if necessary. 



R. Potassii Bromidi, . . . . £iv. 

Chloralis Hydratis, . . . 3 iij. 

Tinct. Asafcetidae, . . . . ^iv. 

Syrupi, gvj. 

Aquae, q. s. ad^ vj. 

M. Sig. — Tablesp. every 2 hours until 
sleep is induced. In the insomnia of hys- 
teria. 



R- . Chloralis Hydratis, 
Potassii Bromidi, . 
Tinct. Opii, . . . 
Syr. Aurantii Cort., 

Aquae, q 

M. Sig. — Teasp. dose 

peated if necessary. 



• 3U- 

• • 3h 

• • <5»J- 
ad%\). 

May be re- 



INTERMITTENT FEVER. 63 I 

Intermittent Fever. 

Quinine, as prophylactic, gr. v-x each morning in black coffee ; begin with 
gr. v, add gr. j each week (R) ; in ordinary intermittents give 6 or 10 grain doses 
up to 20 or 30 grains, so as to have it all in 4 or 5 hours before the expected 
paroxysm ; give the Sulphate and in solution to get its full action (Da C) ; for 
acute ague, gr. x in sweating stage, and same 5 hours before next paroxysm, 
and gr. x-xv at the septenary periods, until the third has passed ; in pernicious 
form, gr. xx-xl are required, by stomach, rectum or skin, to secure safety of 
patient ; best in combination with Morphine, and with continuous administra- 
tion of Arsenic during intermissions ; may be given in solution by rectum, or 
hypodermically (R) ; is almost specific in intermittents when uncomplicated, 
and of recent origin (Wa). Chinoidine may be used as a substitute for Quinine 
in doses twice as large (B). Cinchonine, Cinchonidine, Quinidine, the Sulphates 
of these alkaloids are scarcely, if at all, inferior to Quinine as therapeutical 
agents (Report of the Madras Commission, 1866); average dose of each, gr. 
x (Wa). Cinchonidine Salicylate, promises well as an antiperiodic (B). 

Arsenic, the best remedy next to Quinine, especially useful in long-standing 
agues, of quartan type (R) ; useful as adjunct to Quinine daily, to prevent 
relapse ; most important in chronic ague, with Iron ; also as prophylactic small 
doses of Fowler's solution (B). Hydrastine, stands next after Arsenic ; indica- 
tions same as for Quinine (B) ; in doses of gr. ij-ix is strongly recommended 
(P). Pilocarpine, gr. yi of the Muriate, in the cold stage, is strongly recom- 
mended by high authority, to excite profuse perspiration and thus lessen the 
attack (Da C). Apiol, when prejudice exists against Quinine ; gtt. xv during 
an hour, in divided doses, 4 hours before paroxysm (B) ; is one of the minor 
remedies which often prove successful in mild cases (Wa). Salicin, as substi- 
tute for Quinine, but inferior (B) ; grs. x-xl, in mild cases (P). Opium, as Mor- 
phine, gr. ]A-}i hypodermically, not only lessens the chill but aids the action 
of the antiperiodic ; is to be strongly urged (Da C) ; is useful in the pernicious 
variety, in combination with Quinine (B). Capsicum, the resins of black and 
red pepper, as adjuvants chiefly (B) ; promotes action of Quinine (Pf ). Nux 
Vomica, has been used with success, but is now used as adjunct to Quinine 
(B) ; good in convalescence (P) ; has antiperiodic value not inferior to that of 
Quinine ; Strychnine gr. ^, equals gr. j of Quinine Sulphate (Wa). Methylene 
Blue is efficient, and has many advantages over Quinine, especially for very 
young children (Ferreira). Chloroform, to prevent an impending paroxysm ; 
3j~3ij (of spt.) before the chill, or by inhalation (B). Narcotine, gr. ij-v ter 
die, is eminently antiperiodic ; no drug (except Quinine) cures intermittents so 
rapidly and surely, or with more freedom from disagreeable effects (Wa) ; said 
to be superior to Quinine (R). Nitric Acid, full doses every 4-6 hours (B). 
Sodium Chloride, in large doses during the apyrexia, gviij-xij, mav occasion- 
ally prove efficacious (Wa). Eucalyptus, during convalescence (B) ; has been 
successfully used in treatment of ague, o\j-ij of a tincture (Wa). Carbolic Acid, 
in 4-grain doses with Infusion of Ginger, cured a series of 8 cases which had 
resisted Quinine (Wa) ; its value established ; rr\,ss-ij in mint-water or gr. }£ m 
tt\,xx of water, hypodermically (Tessier) ; combined with Iodine is of great value 
in chronic malaria, and in acute cases after Quinine has stopped the paroxysm 
(B). Mercury, uncalled for in ordinary cases ; but Hydrarg. cum Creta, Qui- 
nine and Rhubarb of service in obstinate intermittents of children in tropical 
regions (Wa). Sodium Hyposulphite, gr. xv-xx every two hours is said to 
cure (R). Cascarilla, Chamomile, Quassia, are used (R). Gentian, is valued 
chiefly as vehicle (P). Ammonium Picrate, proved wonderfully effective in 
India, where 10,000 cases were treated therewith (Clark). Lemon, in decoc- 
tion, exceedingly efficient in preventing recurrence of the paroxysms after they 
have been broken up by the use of Quinine (Crudeli). Emetics, may cure 
many cases ; one each morning will assist the action of Quinine ; Ipecacuanha 
preferred to Antimony (R) ; only at commencement, inadmissible if gastric 
irritation (Wa). Antimony, at the onset and continuously in mild, uncompli- 
cated cases ; Tartar Emetic, gr. ]4,- l /6 every 2 hours, has been followed by 



632 



INTERTRIGO INTESTINAL OBSTRUCTION. 



complete cures (Moore). Antipyrin, is useless (Falkenheim). Resorcin, and 
similar agents, have no specific action, merely controlling the pyrexia (Wa). 
Warburg's Tincture is a remedy of great power, but produces such severe 
diaphoresis as to be dangerous to adynamic subjects (Maclean). Purgatives, 
in the intermission, before using the antiperiodic, is good practice; Podophyl- 
lum, Colocynth or Jalap (Da C). Iron, is valuable in chronic cases ; the 
system should be thoroughly saturated with it (Da C). Ergot, for the enlarged 
spleen (Da C). [Compare the title Malaria ; also the List of Antiperiodics 
on page 43.] 

Prescriptions. 



R . Quininae Sulph., . . . . gr. xxxij. 

Mucil. Acaciae, gij. 

Syr. Eriodyctii Aromat. 
(Parke, Davis & Co.), vel 

Mist. Glycyrrhizae Co., vel 

Velatine, . . . . q. s. ad %'\). 
M. Fiat emulsio. Sig. — A teasp. con- 
tains gr. ij of Quin. Sulph. Suspension of 
the Quinine without dissolving it makes the 
bitter taste less perceptible (Squire), and 
the Syrup of Yerba Santa covers the taste 
well. (Potter.) 

R. Quininae Sulphat., . . . . 3J. 

Ac. Hydrobrom. Dil., . . gij. 

Aquas, g xiv. 

M. Sig. — A teasp. contains gr. iij^f of 
Qum. Sulph. The acid directed prevents 
the unpleasant cerebral action. (B.) 



R- . Quininae Sulph., 

Pulv. Acacias, . . . . aa % ss. 

Syr. Zingiberis, Jiv. 

M. Sig. — A teasp. contains one grain of 
Quin. Sulph. A good formula for children, 
the quinine being suspended, not dissolved. 



R. Ac. Carbolici, gj. 

Tinct. Iodi Comp., . . . giij. 
M. Sig. — 4 drops every 4 hours in suf- 
ficient water. (B.) 

R. Massae Ferri Carb., . . . gj. 
Ac. Arsenosi, . . . . . . gr. j. 

M. Ft. pil. no. xx. Sig. — One thrice 
daily in chronic ague. (B.) 



R. Quininae Sulphat., . . . . gr. lxxx. 

Ac. Sulphurici Diluti, . . q. s. 

Spt. Etheris Nitrosi, . . . 2 iv. 

Syr. Tolu, Aquae, . q. s. ad Jij. 
M. Sig. — A teasp. contains gr. v of 
Quin. Sulph. (Da Costa.) 

R . Quininae Sulph. , . . . . gr. xl. 

Ferri Sulph. Exsic, . . . gr. xx. 

Ac. Arsenosi, gr. j. 

M. Ft. pil. no. xx. Sig.— One thrice 
daily. (B.) 



R. Quininae Sulph., 
Capsici, . . . . 
Opii Pulveris, . . 
M. Ft. pil. no. xx. 

pills as required. 



XXX. 
XV. 



. . . . gr. iij. 
Sig. — One to five 
(Piffard.) 



Intertrigo. 

Bismuth, the Nitrate or Carbonate, as dusting powder (R). Tannin, the 
glycerite, excellent (R, P). Camphor, added to dusting powders, to allay 
heat and itching (R). Lime-water, to obviate irritating urine (R). Soap, free 
ablution with, when caused by acid secretions ; use greasy applications after- 
wards (R). Boracic Acid, as ointment, 3jss to ^j of Vaselin, a very useful 
application (Wa). Glycerin, with Tragacanth, etc. [See under Herpes for 
formula.] Calomel, as ointment, 3j to ^j, is especially useful (Wa). Zinc 
Carbonate, as Calamine, a good dusting powder ; so also is the Oxide, or 
Fuller's Earth. 



Intestinal Obstruction. 

Opium, even % -grain doses every 4 hours, for 2-4 days, arrests dangerous 
symptoms, and brings a painless purgation (Brinton, P). Morphine, endermi- 
cally (Wa). Belladonna, often successfully employed (P) ; gr. %.~Yi every 
few hours, when from want of tone and partial spasm (Tr). Strychnine, occa- 
sionally beneficial ; cautiously in acute cases (Wa). Mercury, a full dose of 
Calomel, followed in a few hours by Castor Oil, and a Turpentine enema, af- 
fords relief (Wa). Caffeine acts upon the muscular tissue and often proves of 



INTUSSUSCEPTION IRRITABILITY IRITIS. 633 

the utmost value (Wa). Senna, the infusion, in doses of §j-iij, forms an ef- 
ficient purgative (Wa). Purgation to be refrained from (Bnnton). Enemata, 
insufflation and surgical measures are often necessary. [Compare Constipa- 
tion, Intussusception, Hernia.] 

Intussusception. 

Belladonna, gr. iv of extract in an enema, has been successfully used (Wa). 
Opium, in full doses carried to narcotism, has been successful in many cases 
(Wa) ; must be used freely to prevent inflammation (Macleod). Effervescent 
Enemata, have been employed with success (B). Tobacco Enema, may over- 
come, and has proved exceedingly effective, but is dangerous ; produces most 
depressing nausea ; not safe to use more than ^iv of an infusion of 3] to Oj 
(B). Inflation, of intestines with air {Hippocrates), seems a most reasonable 
mechanical remedy. Irrigation, by hydrostatic pressure is resorted to with 
success ; requires care and gentleness (B). Hot water (Wa) ; Ox-gall, gr. x-xxx 
in the solution used, is especially efficient in cases arising from partial paresis 
of the bowels (Hawkins). The knee-chest position is the best during irriga- 
tion or inflation. [Compare Hernia, Typhlitis.] 

Irritability. 

Ignatia, in small doses diminishes, in large doses excites irritability of cere- 
brospinal axis ; the remedy par excellence (Pf ). Chloral, gr. v, 2 or 3 times a 
day, in irritability with nervousness and restlessness (R). Chamomilla, is an 
excellent sedative for children, in doses of Tr\J of the tincture every ^ hour 
(Smith). Opium, gives calm to the nervous system if used in medium doses. 
Strychnine, in functional irritability of the nervous system. [Compare Insom- 
nia, Nervousness.] 

Iritis. 

Belladonna, locally and internally (R) ; rr\,v every 3 hours, also as lotion (£j 
of extract to %\v aquae), is of great value (P). Atropine, (solution gr. iv ad ^j) 
has a wide field of utility, as mydriatic (B) ; should never be omitted (C) ; is 
essential in the treatment of every form, should be applied early in the case 
and persevered in throughout its continuance (Lawson). Mercury, when of 
syphilitic origin, as it usually is (B) ; the Bichloride is of great service (R) ; in 
plastic iritis of original severity, or in cases aggravated by improper treatment, 
Mercury is imperative, gr. ij of Blue Pill twice a day, until blue line on gums 
(C). Aurum, the Bromide of Gold, Arsenic, and Mercury has been admin- 
istered with evident advantage (E. A. Wood). Duboisine, as substitute for 
Atropine, is more rapid for effecting dilatation, less irritating to the conjunctiva, 
and has less permanent after-effects (B). Turpentine, in so-called " rheumatic 
iritis " is very successfully used ; small repeated doses (P). Opium, when 
much pain, an indispensable adjuvant, or Morphine hypodermically (C). 
Copaiba, £ij in mucilage, thrice daily, gives excellent results in iritis and 
sclerotitis, diminishing pain in 24 to 48 hours, and restoring sight (Hall). Quinine 
and Iron, when the patient is feeble or anaemic. Irritants, or astringents 
should never be employed (C). Surgical. Paracentesis when increased ten- 
sion ; Corelysis when only one or two adjacent adhesions. Iridectomy. 
Complete functional rest to the eyes, by Atropine and a bandage with com- 
pression pad ; an absolute necessity during the whole period of treatment (C). 
[Compare Syphilis.] 

Prescriptions. 

I R. 01. Terebinth., giij. 

R. Hydr. Chlor. Corr., . . . gr. j. Syr. Acacise, t ^jss. 

Potassii Iodidi, 5jj. Aquae Cinnamomi, . . . . 3SS. 

Tinct. Calumbae, . . . . ^ij. M. Sig. — Teasp. 4 times daily. 
Aquae Destil , . . q. s. ad ^ vj. 

M. Sig — A dessertspoonful, in a wine- R . Extracti Belladon., . . . . 7,]. 
glass of water, 2 or 3 times daily. Ung. Hydrargyri, . . . . Jyj. 

[Lawson.) i M. Sig. — For inunction to brow. 



634 JAUNDICE JOINT AFFECTIONS. 

Jaundice. 

Salol, is one of the most efficient remedies in catarrhal jaundice. Mercury, 
in attacks with depression, sickness and coated tongue, gr. Yd-yi of Gray Pow- 
der taken at onset, and repeated three or four times a day, very valuable (R) ; 
as purgative in jaundice from both deficiency and excess of bile, singularly 
enough (B) ; Gray Powder with Ipecac, followed next morning by Castor Oil, 
is well adapted to the jaundice of infancy and childhood (Wa) ; Mercurials 
and Podophyllum are better avoided, especially in obstructive jaundice, unless 
very marked indications for them exist (Da C). Celandine, was formerly 
employed as deobstruent (P) ; energetically affects the liver (Pf). Hydrastis, 
useful if continued for some time, in jaundice from catarrh of ducts (B). 
Arsenic, has been used with success in jaundice from catarrh of bile ducts after 
catarrh of duodenum ; better for jaundice of malarial origin (B). Nitro- 
Hydrochloric Acid, internally, and acid bath to right hypochondrium ; tempera- 
ture of bath 96 , ^iij to gall, j (B) ; when jaundice depends on torpor of the 
liver, or is catarrhal in origin (W) ; during convalescence, rr^v-x of the dilute 
acid in Z] of a compound elixir of Taraxacum before each meal (Da C). 
Quinine, when due to malarial miasm, or when periodic (B). Euonymin, an 
hepatic stimulant of especial power (B). Podophyllum, in catarrhal and mala- 
rial jaundice (B) ; when stools exhibit no trace of bile, one dose has cured 
(Wa) ; is best avoided, unless markedly indicated (Da C). Sodium Phosphate, 
no remedy superior in jaundice from catarrh of gall-ducts ; Z] doses every four 
hours for adults : gr. x-xx for children (B). Manganese, in jaundice from 
malarial origin, or catarrh of biliary passages (B). Aloes, for simple jaundice 
of an atonic kind (B) ; when hypochondriasis (P). Rhubarb, for above mala- 
dies in children; white or clay-colored pasty stools; skin jaundiced (B). 
Saline Purgatives to depurate the upper bowel, as Rochelle salt; with alkaline 
baths, diaphoretics and diuretics (Da C). Ammonium Iodide, gr. j-iij in water 
every 2 or 3 hours in catarrh of bile ducts and jaundice ; — Also Ammonium 
Chloride, with fluid extract of Taraxacum (B) ; in 20-grain doses every 4 hours, 
produces a decided change (Wa). Stillingia, relieves jaundice and torpid liver 
following intermittent fever (B). Dulcamara, employed with advantage (P). 
Iris, in malarial jaundice and that from duodenal catarrh (B). Alkaline Min- 
eral Waters, especially in catarrh of duodenum or bile-ducts (B). Potassium 
Salts, the Chlorate in chronic or asthenic jaundice ; the Sulphate the most 
useful saline purgative in jaundice (Wa). Aliment. No starches or fats ; milk, 
eggs, oysters, beef broth, broiled or raw beefsteak, or whitefish (B) : plenty of 
green vegetables at each meal ; use cold water freely, avoid all high seasoning 
in food, and all liquors. [Compare Hepatic Cirrhosis, Hepatic Diseases, 
Calculi.] 

Joint Affections. 

Phenacetin, for the pyrexia of polyarthritis ; is efficiently antipyretic and safe. 
Aconite, for pains in inflamed joints (R) ; the liniment locally in chronic arthri- 
tic swellings (Wa). Mercury, the oleate in chronic inflammation of the knee 
(R) : Ung. Hydrarg. Ammoniat., diluted, Z) to £iv at first, then Z) to %], by 
gentle friction 2 or 3 times daily, in chronic articular inflammations, by far the 
best application (P). Rhus Toxicodendron, internally and as lotion, is invalu- 
able for subacute stiffness and aching of joints after acute rheumatic fever (P). 
Iodine, oiij-vj ad Glycerini ^iij, Aq. destil. ^iv, in numerous obstinate cases 
of joint affections consequent on rheumatism (Wa). Ferrous Iodide, with 
Iodine, locally, in scrofulous affections of the bones and joints (Wa). Iodoform 
has been used with satisfactory results in scrofulous affections of the joints and 
bones, by many continental authorities (Wa). Salicylic Acid, Z] with Zw of 
Lanolin, and 01. Olivae, q. s. to make a paste, applied locally and covered with 
cotton, or rubbed in once daily for 3 or 4 days, then omitted for a week, and 
again renewed, is of proven value in many obstinate cases of stiff knees, pains 
from so-called rheumatism, painful ankle- and wrist-joints, etc. (Aulde). 



KERATITIS — LABOR. 635 

Arsenic, often serviceable in rheumatoid arthritis and nodosity of joints; large 
doses continued, necessary (R). Alcohol, and water, equal parts, an excellent 
evaporating lotion (B). Silver Nitrate, a strong solution in Nitrous Ether is 
the most efficient application to check inflammation in small joints if applied 
early to adjacent vascular parts (B). Cod-liver Oil, in strumous subjects (R) : 
the remedy on which most reliance may be placed in scrofulous joint affections 
(Wa). Cold Douche, Galvanism, Turkish Baths, for stiff joints (R). Digitalis, 
as fomentation, Z] of tincture to 0% boiling water, applied on flannel, has 
proved very efficient in acute inflammations of joints (Fairbank). Turpentine, 
the liniment a serviceable application in chronic enlargement of the joints 
(Wa). Sulphuric Acid, as irritant ointment, 3j of acid to ^j of lard, very bene- 
ficial in chronic diseases of joints (Wa). [Compare Bursitis, Coxalgia, 
Gout, Arthritis, Rheumatism, Synovitis.] 



Keratitis. 

Atropine, renders great service by contracting vessels (B) ; by instillation, 
with enforced disuse, and a protective bandage, should be regarded as meas- 
ures of course (C). Mercuric and Ferric Chlorides, with Cod-liver Oil, will 
accomplish all that medicine can do for interstitial keratitis in syphilitic sub- 
jects (C). Calcium Sulphide, proves most useful in doses of gr. -^ to % , thrice 
daily, in sugar-of-milk trituration (Snell). Arsenic, Potassium Iodide or Bro- 
mide, Iron or Quinine, for constitutional effects in vascular keratitis ; also 
counter-irritation by Iodine painted on the temples until soreness (C). Ferric 
Perchloride, successfully employed in panniform keratitis ; a large drop of the 
solution dropped from a quill every second or third day (Wa). Eserine, lowers 
intra-ocular tension (B). Astringents or Irritants (as Alcohol in any form, 
Zinc Sulphate, Silver Nitrate, etc.), are entirely inadmissible (C). Iridectomy, 
is often beneficial in severe vascular keratitis (C). Pressure-Bandage, in 
severe suppurative forms, limits extent. Water, cold when inflammatory 
symptoms marked: hot (90-100 F.) in non-inflammatory form, to excite 
inflammatory reaction ; should be discontinued when marked injection. [Com- 
pare Corneal Opacities.] 

Prescription. 

Sig. — A teasp. in a winegl. of tepid 



1&. Hydrarg. Chlor. Corr., . . gr. j 

Ammonii Chloridi, . . . gr. vj. 

Tinct. Belladonnse, . . . gij. 

Aquae Destillatae, .... Jviij. 
M. et fiat, collyrium. 



water, to be applied frequently with a 
pledget of lint on the closed lids. In 
phlyctenular keratitis of children. 

(Turn-bull.) 



Labor. 



Ergot, only, when uterine inertia, and after the first stage has passed; is 
dangerous if any obstacle in front ; dangerous to child by paralysis of fcetal 
heart (B) ; is best given when head has passed the brim of pelvis (Wa). 
Anaesthetics, in protracted and painful labor; cautiously with primiparae (B) ; 
increase the risk of post-partum hemorrhage (W). Chloroform, not to com- 
plete anaesthesia, lest uterine action be interrupted ; usually begin when os is 
dilated (Simpson). Chloral, of great value to relieve pain ; does not interfere 
with the exhibition of chloroform ; should be given in 15-grain doses every %■- 
hour till effect produced (Wa) ; the best of all remedies for rigid, undilatable 
cervix, gr. xv every 20 minutes for 3 doses, perhaps a 4th after an hour's 
interval (Playfair). Ethyl Bromide, a rapid, sure and safe anaesthetic, particu- 
larly suited to labor cases (Levis). Opium, facilitates dilatation, promotes 
expulsive power of uterus, lessens hemorrhage, stimulates longitudinal and 
oblique fibres of the os (Wa) ; a full dose of Morphine, gr. % , in tedious labors, 
with severe pains, will aid patient greatly and promote progress of the child ; 
no bad results ensue ; for relief of pains and after-pains, or painful complica- 
tions (Wa) ; hypodermically in rigid os and cervix (R). Cimicifuga, exercises 
special action, similar to that of Ergot ; is less dangerous to life of child and 



636 



LACTATION. 



soft parts of mother (Wa) ; for mental disturbance and suppressed lochia (R) ; 
as partus accelerator in lieu of Ergot, also to allay nervous excitement after 
labor, and to check post-partum hemorrhage (P). Belladonna, topically to 
uterus, of great service in long-protracted labors from rigidity of os and cervix 
(H). Gelsemium, quiets the "nagging" pains of the first stage; requires 
physiological doses (B) ; relaxes spasm in rigidity of the os (Wa). Quinine, to 
strengthen uterine contractions ; used by many in place of Ergot (R). Can- 
nabis Indica, the tincture gtt. xxx, as stimulant to uterine contractions, more 
prompt, less lasting, than Ergot (Wa). Ipecacuanha, after delivery ; to pro- 
mote natural functions (R). Cotton-root, as excitant of uterine contractions 
may be more energetic than Ergot (P). Althaea, the decoction, as vaginal 
injection in difficult labor (P). Sodium Borate, excites activity of the uterus, 
and is well employed in tedious labor, where there is deficiency of uterine 
contraction (Rigby). Amyl Nitrite, has acted admirably in a case of hour- 
glass contraction of the uterus; seems to antagonize the action of Ergot 
(Barnes). Oil of Eucalyptus is very valuable in effecting antiseptic midwifery 
(Wa). Mercury, the Bichloride, gr. vijss to a quart of hot water gives a 20 1 00 
solution, probably the worst of all antiseptics for this purpose; is too danger- 
ous for obstetrical use (Fleischman). [Compare Abortion, After-pains, 
False Pains, Hemorrhage Post-partum, Lactation, Puerperal Con- 
vulsions — Mania — Fever — Disorders.] 



Lactation. 

Pilocarpine, as a galactagogue, gr. yi of the Muriate in brandy on retiring, 
the patient to be covered well in bed ; is efficient in direct proportion to its 
diaphoretic and sialogogue effects, these being evanescent, but its galactagogue 
power remains for weeks, an occasional dose only being required to spur up 
the secretion when flagging (Minges). Antipyrin, as an anti-galactagogue, 
4-grain doses every 2 hours have proven highly efficient. Belladonna, inter- 
nally or externally or both, in excessive lactation (R) ; Atropine gr. iv to ^j 
Aquae Rosse on lint around the breast to arrest secretion of milk ; remove when 
fauces become dry and pupils dilated (B). Camphor, locally to arrest the 
secretion; a saturated solution in Olive Oil or Glycerin, is more efficient than 
Belladonna (Wa). Potassium Iodide, in 25- to 30-grain doses internally, for 
the same purpose, is very effectual (Rousset). Calcium Phosphate and Hypo- 
phosphite, in debility from over-lactation (R, Wa). Ammonium Chloride, for 
the intercostal neuralgia of suckling women; gr. x-xx, every 3 or 4 hours (Wa). 
Quinine, Tannin, are used to arrest the secretion (R). Alcohol, as beer or 
porter, often useful in excessive lactation, not always (R). [Compare Abscess, 
Agalactia, Mastitis, Nipples, also the List of Galactagogues on page 49, 
ante.'] 

Excreted in the Milk, when taken by the nursing woman are — the Oils of 
Anise, Cumin, Dill, Wormwood and Garlic, — Turpentine, Copaiba, — the active 
principles of Rhubarb, Senna, Scammony, and Castor-oil, — Opium, Iodine, 
Indigo, Antimony, Arsenic, Bismuth, Iron, Lead, Mercury, and Zinc. Acids 
given to the mother cause griping in the child. Natural salts, as a rule, and the 
purgative agents above-named, act as purgatives to the child, and Potassium 
salts as diuretics. Turpentine, Copaiba and Potassium Iodide given to the 
mother, can be detected in the urine of the child. Opium given to the mother 
may narcotize the child, and Mercurials in the same manner may salivate it 
(Br). Atropine, Hyoscyamine, the Salicylates, and Potassium Sulphide, have 
also been found in the milk after their ingestion by the woman. 

Prescription for Milk Fever. 



M. 



Tinct. Aconiti, Y\ xx. 

Antim. et Potass. Tart., . gr. ij. 
Spt. Etheris Nitrosi, 

Syr. Simplicis, . . . . aa ^j. 

Aquae Aurantii Flor., . . ^ij. 



Sig. — A teaspoonful in a wineglassful of 
sweetened water, every two hours. 

(Foray ee Barker.) 



LARYNGISMUS STRIDULUS LARYNGITIS. 637 

Laryngismus Stridulus. 

Aconite, checks the spasm and relieves the croupous breathing (R). Bella- 
donna, promises to be of value (Wa) ; Atropine, gr. yi^ in a goblet of water 
(60 doses), of which a teasp. every hour or ^-hour, will give prompt relief 
(Smith). Bromides, when uncomplicated except with convulsions (R) ; full 
doses will suspend an attack, and moderate doses steadily continued will pre- 
vent recurrence (B). Ipecacuanha, an emetic dose to cut short an attack (B). 
Lobelia, has been employed (R). Chloroform, quickly cures the paroxysm, 
a few drops on a handkerchief sufficient (B) ; may often be used with advan- 
tage (W). Nitroglycerin, will speedily allay the spasm (B). Chloral, gr. v-xv 
to prevent or arrest (B). Quinine, given between attacks to prevent (B) ; a 
most valuable remedy, but in small, repeated doses (P). Emetics, Tartar 
Emetic ; Mercuric Sulphate (gr. iij-v) safer and better (R). Conium, is valuable, 
carried to a point of physiological effect (B). Water, wet pack to neck (B) ; 
cold sponging twice or thrice daily more successful than anything else, with 
out-of-door exercise ; cautiously if hoarse voice indicates laryngitis (R). [Com- 
pare Croup, Laryngitis.] 



Laryngitis, Acute Catarrhal. 

Aconite, very valuable (R) ; especially indicated in inflammatory states of 
respiratory parts ; gtt. ss-j every half-hour till an impression is made on the 
fever, then every hour or two (B). Antimony, Tartar Emetic, gr. ^, a very 
excellent remedy internally ; larger doses in cedematous laryngitis, gr. -^ with 
gr. iij of Dover's powder every 2 or 3 hours (Da C). Iodine, inhaled ; also as 
counter-irritant painted over neck (B). Morphine, small doses to allay cough 
(A). Sulphurous Acid as spray is vaunted (Wa), Leeches to throat are valu- 
able auxiliaries to general treatment in sthenic cases ; or cupping at the 
nape of the neck (Wa). Rumex, has selective action on the laryngeal mucous 
membrane. [See page 366.] Zinc or Copper Sulphates, .as emetics, in large 
quantities of warm water, where cedema slight (A) ; a solution of Zinc Sulphate, 
gr. xx to ^j on sponge to larynx with aid of the laryngoscope if possible to use 
it (Da C). Scarification, by Mackenzie's laryngeal lancet, of great service in 
the cedematous form (Da C). A Purgative and Diaphoretic, with mucilagi- 
nous drinks, if given at the start may be sufficient (Da C). Iron, Monsel's 
solution, 1 part to 2 or 3 of water and Glycerin, an excellent local application 
(Da C). Heat, by poultices or fomentations (A). Hot-water stupes may suc- 
ceed (Wa). Inhalations of hot steam, with Benzoin, the comp. tinct. gtt. x-xv 
to ^j, with gtt. x Tinct. Opii, or Hops, or Conium, of great service (Da C). 
Tracheotomy ought not to be delayed, if inhalations, leeches, and fomenta- 
tions fail (A, Wa) ; is especially indicated in sudden attacks of cedematous 
laryngitis, as those occurring in Bright's disease (Da C). Ice, steadily applied 
in bags over the larynx, if tracheotomy refused, has succeeded in bad cases ; 
small pieces may be slowly swallowed (Da C). [For Croupous Laryngitis, 
see Croup, Membranous ; for Spasmodic Laryngitis, see Croup, Catarrhal ; 
for (Edematous Laryngitis, see Glottis, (Edema. Compare also Laryngis- 
mus Stridulus, Pharyngitis.] 



Laryngitis, Chronic. 

Iodine, painted over neck as a counter-irritant, and inhalation of its vapor 
(B). Sulphur, Sulphurous Acid as spray in syphilitic or tubercular laryngitis, 
or a solution of Sodium Sulphite (£>j to the ^) in water (B) ; by inhalation, 
spray, or fumigation (R). Carbolic Acid, where long-standing hypersemia with 
diminished secretion, 3j-ij to the ^ of Glycerin is a most successful application 
(Mackenzie). Silver Nitrate, powdered or in solution to chronically inflamed 
larynx, as in phthisis (R) ; a solution of gr. x or xx to ^j, applied with a brush 



638 LARYNGOTOMY LEPROSY. 

by the aid of the laryngoscopic mirror (W) ; formerly much used, but is objec- 
tionable (B) ; should be used with great caution, and only when a particular 
point can be seen for it with the laryngoscope (Da C). Ferric Perchloride, 
solution gr. lx-cxx ad ^j Glycerini as local application (A). Zinc Chloride, gr. 
xx-xxx ad ^j, in Glycerin. Alternation of topical applications of great value 
(A). Copper Sulphate, gr. xx to gj of water, locally twice a week (Da C). 
Bismuth Subnitrate, by insufflation, is highly recommended in the worst forms 
of laryngitis, even in that accompanying phthisis (Tr, Wa). Menthol, in spray 
containing 5 to 10 per cent., is highly recommended in tubercular laryngitis. 
Resorcin, a strong solution locally, very beneficial in tuberculous and other 
ulcerations of the larynx (Tymowski). Guaiacum, as lozenges, very useful in 
mucous laryngitis (A). Althaea, as pectoral lozenges to relieve laryngeal irri- 
tation (P). Cubeb, the berries chewed are very efficient in relaxation of the 
larynx following a cold or long speaking (Wa). Cocaine, a 20 per cent, solu- 
tion of the Hydrochlorate by spray, mop, or brush, is very efficient in many 
laryngeal affections (James). Benzoin, in strumous laryngitis (Wa) ; in chronic, 
Benzoin on hot coals, or inhaled from boiling water, of great service (Tr). 
Tannin, in chronic catarrh and ulcerations, a solution (gr. x-xx to ^iv) applied 
by hand-ball or steam atomizer (A). Inhalations, or spray, of the best agents 
very grateful (B) ; air loaded with vapors of Ammonium Muriate by inhaler, 
said to be used successfully (W) ; vapors from boiling Tar, Turpentine, etc., 
placed on hot water, or better by steam atomizer (Da C) ; Chloroform, Hops, 
Benzoin, etc., by atomization (Walker). Insufflation, substances to be in small 
quantity, mixed with bland powder (B). Functional Rest of voice often requis- 
ite, especially in phthisical and syphilitic laryngeal ulceration (A). Chronic 
Laryngitis, includes many disorders of the larynx, which of late years have 
been differentiated as — thickened vocal cords (chronic laryngitis proper), 
laryngeal ulcers, polypi, cysts, cauliflower growths, tubercular and syphilitic 
laryngitis, etc., in all the voice being similarly affected. Dysphagia, as a con- 
comitant symptom is constantly indicative of tubercular laryngitis (Da C). 
[Compare Cough, Phthisis, Syphilis, Dysphagia.] 



Laryngotomy. 

Laryngotomy is more quickly and easily performed on the adult than trache- 
otomy, being farther from the lungs and less dangerous. It is usually directed 
to be performed by cutting longitudinally through the skin, then horizontally 
through the crico-thyroid membrane, which may be felt as a soft depression, 
an inch below the pomum Adami. In urgent cases, however, Professor Wood 
recommends a narrow-bladed knife to be passed horizontally through both 
skin and membrane at once, and then to enlarge the opening laterally to the 
required extent. The advantage of having a horizontal incision in the skin is 
the greater openness of the wound when the patient throws up his head under 
a sense of dyspnoea (D). In Laryngo-Tracheotomy, the deep incision is 
carried downwards from the crico-thyroid membrane, through the cricoid 
cartilage and one or two of the upper rings of the trachea (CI). 



Leprosy. 

Anacardium Orientale (Oil of Cashew), has been much lauded; investiga- 
tion established that much of its success was due to hygienic measures and 
use of fresh meat as food (P). Arsenic, with 5 or 6 times the quantity of black 
pepper, in esteem in India (Wa). Sarsaparilla, as tonic and alterative is valu- 
able (P). Gurjun (Wood Oil), as ointment and emulsion, has been used with 
success in alleviating the disease, by Dr. Dougall, Port Blair, Andaman Islands ; 
the ulcers of 24 lepers healed thereby. Ferri Arsenas, gr. A daily, is used 
with success (Wa). Mercury, the Oint. of the Red Iodide, diluted 1 to 10, or 
gr. j of the salt to £v of Unguentum, gives very good results (Wa). Diet, 



LEUCOCYTH.EMIA LEUCORRHCEA. 639 

nutritious food, cleanliness, bath, will do much to prevent the manifestations 
of the disease (R). Chaulmoogra Oil, [See page 177,] is credited with a few 
cures and many cases improved ; the oil is mixed with Psoralea corylifolia as a 
liniment, and is also used internally (Wa). Hoang Nan, is considered of 
utility by a number of writers on leprosy, and is given in combination with 
Alum 1, Realgar 2 or 1, and the drug 2 parts, the whole being made into 3- 
grain pills, one pill daily being given at first and gradually increased (Pf). 
Argenti Nitras, is said to act as a tonic and alterative, and to control leprosy 
for a limited period (Pf ). Ichthyol, used internally and externally, has given 
good results. 

Leucocythsemia. 

Alkaline Hypophosphites, have been used with more or less benefit (Wa). 
Digitalis, in young subjects (B). Nitro-muriatic Bath, should not be neglected, 
with tonics and nutrients (A). Iron, is of little value (B) ; large doses may do 
good in early stage, with careful diet, and Ergot to contract the spleen (Da C). 
Phosphorus, gr.'-^y increased to gr. ^, has proved successful in several cases 
(Wa). Arsenic, in as full doses as can be borne, may be of service, though 
hitherto ineffectual (Gowers). Galvanization of the spleen causes improvement 
of the blood, increasing the number of its red corpuscles (Gowers) ; is curative 
in uncomplicated cases (B). 

Leucorrhcea. 

Hydrastis, the fluid extract, undiluted topically-, quickly improves in uterine 
and vaginal leucorrhcea (B). Pulsatilla, 5-drop doses ter die for a few weeks ; 
also a teasp. of the tinct. in a pint of cold or tepid water, as vaginal enema 
daily, when pain in the loins, depression of spirits, loss of appetite, etc. (P). 
Silver Nitrate, in solution locally, also tampon saturated with 3j each of Alum 
and Bismuth, when leucorrhcea due to granular vaginitis (Parvin). Balsams 
of Peru and Tolu, internally (P). Glycerin, is largely employed for vaginal 
leucorrhcea, and for erosions and ulcerations of the cervix uteri (B) ; the best 
vehicle for other agents (E). Glycozone, applied on small rolls of lint, or 
absorbent cotton, after thorough washing of the vagina with solution of Hy- 
drogen Dioxide, 1 to 4 of water, and repeated twice daily (Edson). Borax, Z] 
to Oj of water, as vaginal wash for the leucorrhcea of pregnancy (Parvin). 
Cimicifuga, is said to be useful (P). Copaiba, has been used with success (P). 
Cocculus Indicus when sero-purulent discharge, pain in lumbar region (P). 
Carbolic Acid, diluted, as injection (B) ; for vaginal leucorrhcea (R). Bismuth, 
with mucilage, as injection ; or with Cacao-butter as suppository (B). Copper 
Sulphate, in solution, as injection (R). Tannic Acid, in chronic cases ser- 
viceable as injection 3ss in ^viij of claret wine (B) ; if os ulcerated, a sup- 
pository of Tannin and Cacao -butter to mouth of uterus (R). Iodo-Tannin, 
an excellent application, Z] of Iodine to ^j of Tannic Acid, a sufficient 
quantity to be packed dry around the cervix (B). Alum and Borax, make a 
useful injection in vaginal leucorrhcea (R). Belladonna, with Tannin as bolus 
where neuralgia or ulceration of os ; when disease due to over-secretion of 
mucous glands about the os, and much pain present, inject Sodii Bicarbonas, 
Z) ; Tincturse Belladonnae, ^ij ; Aquae Oj (R). Potassium or Sodium Bi- 
carbonate, Z) to Oj aquas as injection, especially when discharge alkaline and 
copious (R). Pareira, Uva Ursi, are successfully used (P). Sumbul, recom- 
mended in atonic form (P). Myrrh, with Iron or Aloes, beneficial (P). Ergot, 
said to be useful in some cases (R). Potassium Permanganate, has no special 
advantage ; is used in solution (gr. ij ad gj) (B). Potassium Chlorate, Z] to 
Oj of water as injection in simple cases (Parvin). Iron, the Iodide, internally 
and externally has proven serviceable ; the Mistura Ferri Composita, when 
anaemia and general debility (Wa) : the styptic preparations locally (R). 
Phosphates, for the cachexia (B) : Calcium Phosphate, gr. j-ij several times 
daily, of great value in checking profuse discharge (Wa). Injections, water 



64O LICHEN LITH^EMIA. 

at 6o° F. to prevent recurrence (R) ; hot water injections are the best tonic to 
pelvic vessels, to relieve venous congestion ; use with elevated hips (E). 
[Compare Endometritis, Uterine Ulceration, Vaginitis.] 



Prescriptions, 

R . Aluminis, £j. 

Zinci Sulph., 3 SS « 

Sodii Boratis, gr. iv. 

Aq. Rosse, ^ v "j- 

M. Sig. — Injection. (B.) 



R. Liq. Plumbi Subacet., . . ,^jss. 

Ac. Carbolici, ^ ss. 

M. Sig. — One-fourth to be added to 
pint of water and used as an injection. 



Lichen. 

Antipyrin, internally for the itching, is efficient. Aconite, sometimes useful 
(R). Mercury, Calomel and Mercuric Nitrate Oint. mixed (also Tar Oint. 
added), in patches of obstinate lichen (R). Silver Nitrate, the Nitrous Ether 
solution painted every day or two over patch (R). Baths, warm or of Sulphides 
(R) ; sponging with alkaline lotions, diluted Lead water, fluid extract of Grin- 
delia well diluted, or solution of Copper Sulphate, gr. x to the %, in miliaria, or 
prickly heat (lichen tropicus) ; with dusting powders of Lycopodium, Zinc 
Oxide or Starch, singly or combined (Hughes). Potassium Citrate, or some 
other refrigerant diuretic, and light, unstimulating food (Da C). [Compare 
Eczema.] 

Lithsemia. 

Piperazin, by far the best agent to promote elimination of uric acid and 
urates, with which it forms the most soluble of all known uric acid compounds : 
relieves the pruritus of the uric diathesis. Lithium Salts, especially the Citrate, 
gr. xx thrice daily, is very efficient (Da C) ; the Carbonate invaluable (Wa) ; 
the Bromide, in solution of Potassium Citrate given after stomach digestion is 
completed, one of the very best agents (Aulde.) Pichi, of great value in lithae- 
mia with cystitis (Wyman). Arsenic, in small doses, is also useful (Da C). 
Nitric Acid, 10 minim doses of the dilute acid in half-glass of water thrice 
daily, with an occasional dose of Pil. Rhei Compos, at bedtime, is the most 
efficient treatment for the class of patients who will not diet themselves (Hughes). 
Purgatives, especially alkaline mineral waters, to clear the portal system (Da 
C). Sodium Phosphate, in laxative doses, 3j thrice daily, gives good results. 
Alkalies, in biliousness ; also the continued use of alkaline waters rich in potas- 
sium salts, for solution of calculi (B). Acids, Hydrochloric often of great ser- 
vice ; also Lactic, when faulty digestion and assimilation (Br). Potassium 
Permanganate, prevents calculi by converting uric acid into urea (B). Buchu, 
combined with an alkali, has been a beneficial remedy (P). Colchicum, n^xv 
of the wine, twice or thrice daily ; is very useful (Wa). Chimaphila is believed 
to check the secretion of lithic acid (P). Aliment, farinaceous vegetables and 
acid fruits are suitable (B). Alcohol in any form is poison to a lithaemic (Da 
C) ; succulent vegetables and fruits, occasional abstinence from animal food ; 
high living, alcoholic liquors, and sedentary habits are injurious ; milk diet, 
and frequent draughts of pure water are recommended. Removal to a locality 
where pure soft water can be procured, is often curative. [Compare Calculi, 
Dyspepsia, Gout.] 

Prescriptions. 

R. Lithii Bromidi, % ss-j. 

Liq. Potas. Citrat., . . . ^iv. i R. Tinct. Belladon., .... n\xviij. 



Syrupi Simp., |j ij. 

M. Sig. — A teasp. in a wineglassful or 
more of water, 2 hours after each meal. 
Reduce after a week. 



Vini Colchici Rad., . . . gij. 
Liq. Potas. Citrat., . q. s. ad % iv. 
M. Sig. — A dessertsp. well diluted, 
every 3 hours. 



LOCOMOTOR ATAXIA LUMBAGO. 64 1 



R. Potas. Nitratis, ^j. 

Ext. Pichi Fl., |j. 

Elixir Simpl., 3 iij- 

M. Sig. — A teasp. every 2 hours. 



R. Vini Colchici Rad., . . . ^ ij 
Ext. Phytolacca? Fl., . . . zj. 



o ll J- 



Potas. Acetatis, 

Aquae, q. 

M. Sig. — A tablesp. four times daily. 



Locomotor Ataxia. 

Antipyrin or Phenacetin for the lancinating pains; the former relieves them 
remarkably : the use of Morphine for the pains should be avoided as long as 
possible (Osier). Belladonna and Ergot are highly efficient (Brown-Sequard). 
Silver Nitrate, when motor disturbances are very marked ; improved 1 in 20 
(R) ; gives the best results in doses of gr. % to gr. x / z thrice daily, withholding 
it after a few weeks to prevent argyria : the Oxide may be used instead of the 
nitrate, in half-grain doses (Da C). Aurum, is specially curative in all forms 
of sclerosis ; the Bromide of Gold and Arsenic has been of special service in 
this form (E. A. Wood). Potassium Iodide, Corrosive Sublimate, or Gold and 
Sodium Chloride, all in full doses, often retard the progress of the disease (Da 
C). Physostigma has proved beneficial (R). Phosphorus, useful, but may 
not cure (B). Hyoscyamine, ameliorative, gr. -£% gradually to gr. -^ (B). 
Electricity, galvanic, relieves pain ; faradic stops wasting of muscles (B) ; in 
stage of irritation the constant current (ascending) through spinal column (R). 
Water, one of the most efficient agents ; friction with a cloth dipped in water 
of 60-65 F., a cold compress to head; 4-8 minute bath of 70-75 gradually 
lowered to* - 6o°, then shower-bath frictions (R). Rest, as complete as possible, 
must be insisted on ; with good, nutritious diet, milk being desirable (Da C). 
Pilocarpine, produces general improvement if given in the incipiency, gr. j to 
3jj of water, of which rr\,xxx twice daily (B). Strychnine, gr. ■£$ in gj of Syr. 
Hypophosphitum, thrice daily, when the system is saturated with silver (Da C). 
Suspension daily, by head, has seemed to give relief to pain and improve con- 
dition : is known as Charcot's treatment, but discovered by Matchoukowsky, 
of Odessa, and carried out systematically by Hessing, of Pesth, before Charcot 
took it up : is now abandoned. Morphine, sooner or later becomes necessary 
for the lancinating pains. In one case, personally known to the author, which 
had been treated ineffectually by every known method, including suspension 
by Charcot himself, and was rapidly progressive, the abandonment of the 
hypodermic syringe for Morphine by mouth, gr. xv daily in divided doses, has 
seemed to result in complete cessation of progress, which has now lasted over 
four years. The patient is free from pain, eats and sleeps well, and attends to 
business, getting around by aid of a stick and some slight assistance from 
friends when crossing a crowded street. 



Lumbago. 

Cimicifuga, said to be more effectual than any other remedy (R) ; has some- 
times wonderful success; no indications can be given for it; 3 ss— ij of fluid 
extract (B); curative (P). Rhus Toxicodendron, in subacute muscular or ten- 
dinous rheumatism, worse at night; completely relieves some cases (Pf). 
Veratrum Viride, the tincture useful (R). Aconite in % TT\, doses of tincture 
every two hours, with Linim. Aconiti locally (Wa). Iodides, if referable to 
syphilis, mercury, copper, tin, or lead poisoning (B). Ammonium Muriate, is 
very efficient in myalgic lumbago, gr. xx thrice daily for 2 days or until signs 
of congestion of the nasal mucous membrane appear, — then to be replaced by 
Quinine, gr. v, thrice daily for a week (Waugh). Antipyrin, gr. vij, hypo- 
dermically, completely banished it in a very bad case at the Hotel Dieu, Paris. 
Morphine, hypodermically to relieve pain (R) ; gr. l /e with Atropine gr. ^, 
4i 



642 



LUNG DISEASES. 



hypodermically, will frequently cure lumbago in two or three hours (Da C). 
Capsicum, a strong infusion applied on lint, and covered with oiled silk, very 
efficient in recent lumbago (R) ; a Capsicum plaster is a very efficient applica- 
tion. Potassium Nitrate, in ten-grain doses hourly or every two hours, when 
urine scanty and high-colored (R). Belladonna, as plaster, very valuable for 
persistent lumbago remaining in a small spot (R). Turpentine, in doses of 
rr\,xx-xxx (carefully, lest strangury and nephritis), of greatest value when the 
bowels regular and urine clear and abundant (Wa). Ether Spray, externally 
as freezing mixture (R). Guarana, xv to xl-gr. doses removed severe chronic 
(Rawson). Chloroform Liniment, affords relief (Wa). Canada Balsam, gr. v- 
xx, is useful, or Burgundy Pitch, as plaster (P). Acupuncture, occasionally 
gives instant relief (B) ; not when high fever (R). Aquapuncture, has been 
employed with extraordinary success (B). Heat, by hot douche to seat of 
pain (B) ; or by very hot poultices for three hours, then the skin covered with 
flannel and oiled silk ; or a hot flat-iron (R). Galvanism, the constant current 
(B) ; is highly useful ; faradization almost as successful as acupuncture (R). 
Strapping from the thigh upwards with layers of adhesive plaster which overlap 
each other; nothing is so instantaneously beneficial. Diet, should be gener- 
ous and nutritive; Lemon-juice as a beverage. Absolute rest is of great 
importance. [Compare Myalgia, Rheumatism.] 



Prescriptions. 



R . Collodii, « 

Tinct. Iodi., 

Spt. Ammonise, . . . aa part. seq. 
Sig. — Paint over the part with a camel's- 
hair brush. {Burggraeve.) 



I&. Ammonii Chloridi, . . . . gj. 
Ext. Cimicifugse Fl., 
Syr. Simplicis, . . . . aa % j. 
Aq. Laurocerasi, q. s. ad £ vj. 
M. Sig. — A dessertsp. every four hours. 



Lung Diseases. 

Aconite, is indicated in most acute congestions (P) ; is especially indicated 
in inflammatory states of respiratory organs (R) ; Belladonna, in nt doses of 
the tincture frequently, is of great benefit in pulmonary oedema, to retard exu- 
dation of serum and to counteract the failure of the heart (Smith). Terebene, 
is very valuable in many conditions. Terpin Hydrate, is still more efficient 
and more easily administered. [See under Bronchitis.] Ammonium Acetate, 
serviceable not only in bronchitis, but in the whole range of acute pulmonary 
complaints as occurring in children (Dessau). [See under Bronchitis, for 
formula.] Veratrum Viride renders important service in acute parenchy- 
matous congestions (B) ; gr. ye of resin in pill when temperature and pulse 
are high ; it tends to induce prostration, collapse, etc. (A). Blisters, flying 
blisters to chest, and perhaps along pneumogastric nerves in hypostatic con- 
gestion (R). Copaiba, exercises a powerful influence over the pulmonary 
mucous membrane, and is beneficial in lung diseases generally, when attended 
with excessive secretion (Wa). Jaborandi, is serviceable for the attacks of 
breathlessness attendant on lung affections, but must be watched lest collapse 
ensue (Berkart). Liquor Potassae, in doses of TTLx-xv added to an ordinary 
expectorant mixture, is often attended with good results in congestions of 
bronchi and lungs, chronic bronchitis, plastic bronchitis, etc. (Walshe). Cimi- 
cifuga, is a useful sedative in many irritative affections of the lungs and bron- 
chial tubes, relieving cough, improving appetite, and ameliorating the general 
condition (Wood). Croton Oil, as liniment, is a highly useful counter-irritant 
in many chronic lung diseases, and even in the bronchitis of infancy (Park). 
Cubeb, in small and oft-repeated doses, is efficient in chronic bronchitis and 
other lung affections of old persons, checking the excessive secretion and 
gently stimulating the system (Wa). [Compare Bronchitis, Emphysema, 
Hemoptysis, Phthisis, Pleuritis, Pleurodynia, Pneumonia.] 



LUNGS LUPUS LYMPHANGEITIS. 



643 



Lungs, Gangrene of. 

Creosote, by inhalation, to obviate the fetor (R). Carbolic Acid inhalations, 
are used with marked benefit (Wa). Mineral Acids, especially Nitro-hydro- 
chloric, with Quinine, the main reliances in chronic pulmonary gangrene (A). 
Stimulants, as malt liquors, with general tonic treatment, are necessary (A). 
Ammonium Carbonate, one of the most reliable remedies ; is best given in 
Decoctum Cinchonas (Wa). Eucalyptus, the Oil with Alcohol, equal parts of 
each, of which 3j as inhalation by steam atomization, is useful (Wa). Turpen- 
tine, the spirit on boiling water inhaled for fifteen minutes every two hours, 
successfully employed (Skoda). [Compare Pneumonia, Phthisis.] 



Lupus. 

Aristol, as an application, has given excellent results. Arsenic, in chronic 
cases, not of syphilitic origin (B) ; Arsenous Acid, as caustic (R) ; the best 
remedy in lupus of head and face (Wa) ; the Oleate of Arsenic, in ulcerating 
forms, constantly applied, will destroy cell-infiltration in a mild and compara- 
tively painless manner ; is also well employed in the tubercular variety (Wa). 
Iodine, useful, whether syphilitic or scrofulous ; the tinct. or a glycerin solution 
(B) ; as tincture or liniment to edges and around (R). Strontium Iodide, has 
been used, with varied results, in lupus vulgaris. Mercury, as ointments in 
erythematous lupus, Calomel ointment in scrofulous and tubercular lupus of 
children (R) ; Calomel int. gr. j-ij increased to iv, will quickly check (Wa) : 
Emplastrum Hydrargyri very efficient in lupus erythematodes and allied affec- 
tions (Kohn). Cod-liver Oil, internally and locally (B). Lead, Liq. Plumbi, 
with one or two parts of Glycerin, applied warm after removal of crusts, in 
milder forms (R). Carbolic Acid, as a mild escharotic (B). Zinc Sulphate, 
dried, as caustic, freely dusted over surface, and a poultice to remove slough 
(B). Jequirity, a most useful application (Shoemaker). Sodium Ethylate on 
absorbent cotton, js the best of all caustics, followed by the Oleopalmitate of 
Bismuth, as a soothing and astringent application (Shoemaker). Chromic Acid, 
an efficient local application, gr. c to ^j aquas destil. (B). Phosphorus, as sub- 
stitute for Arsenic (B). Silver Nitrate, a weak solution gradually strengthened, 
in superficial forms (R). Cauterization, with the actual cautery at white heat, 
after scraping out as much as possible of the diseased parts, so as to destroy 
the lupus cell. Seek to replace the lesion by a cicatrix, to prevent relapse in 
situ, and the development of the disease elsewhere. Internal remedies only 
useful for the general health. 

Prescriptions. 



R . Iodi, 

Potassii Iodidi, . . . . aa ^ ss. 

Glycerini, . gj. 

M. Sig. — Locally in Lupus. 

{McCall Anderson.} 



R. Ung. Arsenici Oleat., . . . gij. 

Ung. Simplicis, 3J. 

M. ft. unguentum. Sig. — Use constantly 
over the affected surface. If pain sets in 
Opium may be added. {Shoemaker.) 



R. Hydrargyri Bromidi, . . . £jss. 

Adipis, 3 v. 

M. ft. unguentum. Sig. — To cover the 
part affected, using Cod-liver Oil freely, 
and the following solution internally. In 
tubercular lupus of the face. {Hardy.) 

R . Potassii Iodidi, gr. lxxv. 

Sodii Chloridi, % ss. 

Aq. Destil., gviijss. 

M. Sig. — Tablesp. before meals, night 
and morning. {Hardy.) 



Lymphangeitis . 

Belladonna, the extract softened with Glycerin, freely applied, is of great 
service ; when pain is severe, a poultice may be applied over the extract for a 
few hours only (Wa). Lead, Liq. Plumbi Subacet. Dil., as an external applica- 
tion, constantly applied, to soothe and restrain the inflammation (Wa). Iodine, 



644 



MALARIA MANIA. 



in strong tincture, around glands, to prevent suppuration (Roberts). Quinine, 
or Salicin, with alcoholic stimulants freely, in septic cases (Roberts). [Com- 
pare Bubo.] 

Malaria, Chronic. 

Quinine is less curative than when the infection is recent, but in periodical 
affections depending on the malarial cachexia it is of specific value, large dose«s 
being required (B). Salicylates, of Quinine and Cinchonidine are especially- 
effective in chronic malarial disease (B). Arsenic plays an important role in 
chronic malarial disease (B) ; diminishes splenic engorgement, and combined 
with Iron is rapidly curative of many affections due to the paludal miasm 
(Boudin) ; is a powerful prophylactic against malaria, and in chronic malarial 
poisoning, with frequent return of fever and neuralgia, the continued use of 
Arsenic is of great benefit (Fayrer). Iron, the Sulphate has decided anti- 
periodic power, and is particularly successful in anaemic subjects and in those 
with enlargement of the spleen (Wa) ; it improves the anaemia of chronic 
malaria, and should generally be combined with Arsenic (B). Iron and Man- 
ganese Iodide, the Syrup in doses of flbxx-xxx, is a successful remedy for 
chronic malarial infection, and Manganese Sulphate gives excellent results 
in jaundice of malarial origin (B). Cornus, Calumba, and other bitters, are 
highly efficient, especially the first named, in chronic malarial poisoning, and 
in convalescence after malarial fever (B). Carbolic Acid and Iodine com- 
bined are of great value in chronic malarial infection ; both are highly anti- 
periodic, and the latter is the best substitute for Quinine and the most active 
reducer of splenic enlargement (Gimwell). Eucalyptus is of high utility to 
reconstruct the damages in the organs of assimilation (B). Baths, the vapor- 
bath and Turkish baths are efficient aids to medicinal treatment in breaking up 
chronic cases, and may of themselves cure such by inducing profuse perspira- 
tion (Da C). [Compare Intermittent Fever, Remittent Fever.] 



Prescriptions. 



}£ . Cinchonidinae Salicylat., . . ,^ij. 

Ac. Arsenosi, g r -j- 

Ferri Sulph. Exsiccat., . . gr. xx. 
M. ft. pulv. no. xx. Sig. — One in wafer 

thrice daily. 



R- . Cornus, 

Calumbae, 

Liriodendri, 

Pruni Virgin., aa^vj. 

Eupatorii, 

Capsici, aa^ iv. 

Pulv. et misce. Sig. — A teasp. in cold 
or warm water, three or four times daily. 
A good tonic tincture may be made from 
the above combination. (B.) 



R-. Quininse Sulph., gr. xl. 

Ferri Sulph. Exsic, . . . gr. xx. 

Ac. Arsenosi, gr. j. 

M. ft. pil. no. xx. Sig. — One pill thrice 
daily. 

Be. Tinct. Iodi, gij. 

Ac. Carbolici, gj. 

M. Sig. — Two or three drops three or 
four times a day, in water. 



R- . Ac. Arsenosi, gr. j. 

Mass. Ferri Carb., .... gj. 
M. ft. pil. no. xx. Sig. — One pill thrice 
daily. 



Mania. 

Stramonium, of value ; allays irritation and induces tranquil sleep ; in wild 
and furious delirium, but intermittent ; also in nymphomania (P) ; many facts 
seem to confirm its reported value (Tr). Daturine, gr. T ^-^V hypodermically 
in acute mania, but is less useful than Atropine or Hyoscyamine (Wa). Duboi- 
sine, gr. -^ hypodermically in acute mania (Gubler). Belladonna is useful, 
especially in monomania, with fixed hallucinations, though a large dose causes 
a temporary insanity (Tr) ; one of the very best remedies in all hyperaemic 
conditions of the brain (P). Hyoscyamus, in violent intermittent forms, to 



MASTITIS. 645 

procure sleep and calm violent delirium (R) ; delirium with hallucinations but 
not congestion ; milder and less inflammatory forms ; also in hypochondriacal 
monomania (P). Hyoscine, finds its greatest and most useful application in 
the treatment of maniacal violence and noisiness, and is a drug for emergencies 
of this kind (Weatherly). [See under Insanity.] Veratrum Viride, success- 
fully combats the excitement in acute mania (B). Camphor, has been used 
successfully ; its action is uncertain (P). Opium, and Tartar Emetic are sat- 
isfactory for many cases ; also Morphine hypodermically to induce sleep (R) ; 
narcotic effect of doubtful utility ; better in insanity with depression (P) ; will 
not produce narcotism in many such cases, even in 2-grain doses. Cannabis 
Indica, 3j of tinct. with Z) of Potassium Bromide, is recommended (R). 
Bromides are used in puerperal mania, that of pregnancy, nymphomania and 
other forms (R) ; the combined use of Potassium Bromide and Tinct. of Can- 
nabis Indica, in equal parts, £j of each thrice daily for weeks and months, has 
proved very efficient in acute and periodical mania, senile mania, and other 
forms (Clouston). Chloral, as calmative, hypnotic, has induced mental im- 
provement, gr. v-xx (B). Coniine, most suitable to acute mania, quiets mus- 
cular action ; use in doses of rr^ss-iij, or the Hydrobromate hypodermically, 
beginning with gr. -^\ with Morphine conjointly injected, is very successful 
(R). Digitalis, 3ss-3j of tinct. valuable in acute and chronic mania, espe- 
cially when complicated with general paresis and epilepsy (Maudsley). — Cau- 
tion ! watch the pulse for any marked intermittence (B) ; a very valuable 
palliative in acute mania (Van der Kolk). Ergot, large doses, 3ss-j of fluid 
extract, to reduce excitement, shorten attacks, widen intervals between them, 
and prevent exhaustion, hence is very useful in recurrent and epileptic forms, 
and in chronic mania with lucid intervals (Crichton Browne). Iron, as a resto- 
rative, is frequently used in* chronic mania with benefit, the Tincture of the 
Chloride in 5-10 minim doses (B). Gelsemium, is more useful than Conium in 
mania with great motor excitement and wakefulness ; large doses required, 
rr^xv-xx of tincture. Croton Oil, as a purgative, WiX~K every hour, as revul- 
sive in mania from cerebral congestion (R). Cimicifuga, is often efficiently 
used in cases of mania occurring during the puerperal or pregnant condition 
(R). Galvanism, of the head and cervical sympathetic, has produced distinct 
improvement (B). Paraldehyde, as a hypnotic, in doses of S>ss-j, is often 
decidedly useful (R) : larger doses are necessary, an average one is £iss. 
Cold Douche, in maniacal delirium, the patient being in a warm bath during 
the application of the douche to the head (R). Removal from home, from 
sympathetic friends, and from surroundings connected with the origin of the 
malady, is a prime necessity to a cure. [Compare Delirium, Insanity, Puer- 
peral Mania.] 

Mastitis. 

Belladonna, Atropine locally (see Lactation), or combined with Morphine 
and Chloral, when much pain (B); especially as liniment to check secretion of 
milk when inflammation is imminent (R) ; or when breasts are distended by 
milk (P) : when inflammation has set in, continuous application of Belladonna 
for 24 hours often arrests it ; it is also useful when an abscess has formed ; 
fomentations useful in addition, but skin must be dried well before the Bella- 
donna is rubbed in (R) ; n^v-x of tinct. internally as well (P). Camphor, a 
saturated solution in Glycerin, locally, in mammary congestion threatening ab- 
scess (Wa). Phytolacca, has power to arrest inflammation of the mammae and 
to prevent suppuration ; the fluid extract in 10-minim doses internally, and the 
solid extract on a cloth to the inflamed breast (B). Conium, the extract in 
small doses several times a day, of striking benefit in mastitis and impending 
abscess of breast (Wa). Calcium Sulphide, internally in mammary abscess ; 
occasionally increases pain (R). Hyoscyamus, as plaster, to relieve painful 
distention from milk (P). Stramonium, fresh leaves as cataplasm to discuss 
indurated milk (P). Iodine, tinct. and ointments to remove indurations of 
breasts after inflammation (B). Mercury and Morphine, the Oleate locally in 
mammary abscess (R). Tobacco, leaves as poultice in abscess (R). Digitalis, 



646 MASTODYNIA MEASLES. 

the infusion locally as fomentation in severe inflammation of the breasts, causes 
it to yield speedily (Fairbank). Ammonium Chloride, Z] in Spt. Rosmarini Oj, 
as lotion on linen rags, kept constantly to the part, especially in induration 
after abscess has suppurated (Wa). Tartar Emetic, in small and frequent 
doses, given early, is beneficial (Wa). Oil frictions in first stage of inflamma- 
tion of breasts, from circumference toward the nipple (L). Rest, by supporting 
mammas with strips of plaster, and bandaging the arm to the side, to prevent 
motion (T). Sponging, with Alcohol (over proof) until part is cold ; renewed 
if heat return. Heat, applied by a basin lined with flannel saturated with hot 
water, to relieve pain and prevent suppuration. [Compare Abscess, Lacta- 
tion]. 

Mastodynia. 

Conium, has specific anodyne action on the mammas and generative organs. 
Cimicifuga, relieves infra-mammary pains of uterine origin in spinsters. Olive 
Oil, 2 parts, to 1 of Tinct. Opii, may be used by gentle friction to painful 
breasts after parturition (Parvin). Non-interference in simple cases of enlarge- 
ment and tenderness, which will spontaneously subside if let alone ; in severe 
cases support by strips or bandage, if breast pendulous; Belladonna ointment 
or liniments; amputation of mamma has been necessary (T). 

Measles. 

Aconite, for febrile symptoms, and especially to arrest the catarrhal pneu- 
monia (R) ; a valuable remedy (P) ; the best drug when fever is very high, 
^-drop doses of the tincture every 2 hours (Da C). Jaborandi, with a hot 
bath, as diaphoretics, in cases of delayed eruption (Da C). Asclepias, an 
infusion or decoction freely as a diaphoretic, to promote the eruption (W). 
Veratrum Viride, has been employed (R). Pulsatilla, for the catarrhal oph- 
thalmia, nasal and intestinal catarrh ; 3j-ij of tincture to ^iv water as wash 
(P). Ammonium Carbonate, dissolved in a solution of the Acetate, is much 
vaunted ; when feeble circulation, cyanosis, delirium, gr. v-x to ^ss-^j Liq. 
Ammonii Acetatis (B) ; gr. iij-vj or vij, every hour or two, in Cinnamon -water 
or milk ; one of the reliable remedies (W). Camphor, the water with Liq. 
Amnion. Acetatis, excellent when cough and catarrh the most urgent symp- 
toms (A). Ipecacuanha, for cough and catarrh, gr. j-ij every 4 or 6 hours (A). 
Antimony, preferred to Ipecac by some (A). Quinine, in small doses for the 
adynamia (gr. j-iij), or large (gr. xv) for hyperpyrexia, and catarrhal pneumo- 
nia, etc. (B). Carbolic Acid, has been employed in several hundred cases with 
decided advantage ; most useful at early stage (Wa). Cod-liver Oil and Iron, 
to scrofulous children, a long course of such medication after convalescence 
(Da C). Purgatives, must be given with caution (R) ; the milder purging salts, 
as Magnesium Sulphate, to be preferred (A). Mustard, as bath on sudden retro- 
cession of rash (R) ; often increases the fever without benefiting the pneumonia 
and other complications (A). Water, cold affusion at commencement ; pack- 
ing, especially when retrocedent (R) ; hot foot-baths for convulsions (A); tepid 
bath with cold douche to head, if cerebral symptoms are severe (Da C). Oil 
Inunctions, Cacao-butter very grateful, and reduces temperature ; also in the 
roseola (B) ; hands and feet to be rubbed with a firm fat to remove heat and 
tightness produced by rash (R). Aliment, low diet and slops ; no animal food 
during whole course (A). Hygiene, dark room, complete disuse of eyes, strict 
cleanliness (A). [For Sequelas see Bronchitis, Cough, Ophthalmia, Otor- 
rhcea, Pneumonia, etc.] 

# Prescriptions. 

R • Ac. Carbolici, 



Ac. Acetici, aa gj-^iss. 

Tinct. Opii Deod., . . . 5jj. 
Spt. Chloroformi, . . . . £j. 

Aquas, q. s. ad % viij. 

M. Sig. — A tablespoonful every 4 
hours, until fever abates. [Keith.) 



R. Tinct. Tolutanse, . . . . £ij. 

Syr. Senegae, Hj ss. 

Ac. Acetici, 3J SS - 

Syr. Pruni Virg., . q. s. ad % iv. 
M. Sig. — A teaspoonful as required for 

cough after convalescence. 



MELANCHOLIA MENINGITIS. 647 

Melancholia. 

Aurum, gives excellent results, gr. ^ to ^ of the Chloride thrice daily, 
especially when cerebral ansemia coexists (B). Bromides, sometimes afford 
relief which no other agent will ; no indications (B) ; Potassium Bromide for 
townspeople, especially women with unendurable despondency (R). Cocaine, 
a useful tonic, especially beneficial in nervous affections accompanied by de- 
pression (Br). Cimicifuga, in puerperal or uterine despondency, of singular 
value (P). Ignatia, has soothing effect in great mental depression (P). Arsenic, 
in melancholy of aged persons gives great comfort ; best with small doses of 
Opium ; Fowler's solution, gtt. ij ; Tinctura Opii, gtt. iij-v, ter die (B). Opium, 
in stimulant doses of tincture, gives good effects (B) ; especially when par- 
oxysms of acute anguish and despair, or when suicidal impulse (Wa) : Mor- 
phine hypodermically is of great benefit in some persons who have a peculiar 
idiosyncrasy therefor (R). Camphor has been highly recommended (R). Musk 
and Castoreum are employed in melancholia with benefit (R). Cannabis Indica, 
sometimes relieves (B). Phosphorus, depression from overwork (R). Chloral, 
as hypnotic, has been followed by marked amelioration and cure (Wa). 
Valerian, in hysterical or suicidal melancholia, is often beneficial (Wa). 
Caffeine has been useful (B). Iron, as restorative, the Tincture of Chloride (B). 
Water-cure, shower-bath, 15-20 seconds, or warm-bath, 95 Fah. for 30 min- 
utes ; the shower or cold douche may be usefully employed in certain cases 
where reaction takes place after it (Wa). [Compare Hypochondriasis, 
Hysteria, Insanity.] 

Meningitis, Cerebral. 

Aconite, is as serviceable in this as in the other acute inflammations ; during 
the stage of excitation, the tincture, gtt. ij with gtt. v of Deodorized Tincture 
of Opium, every 2 hours, gives admirable results (B). Belladonna, in all 
hypersemic conditions of brain and spinal cord one of the very best remedies, 
especially during the period of excitement (P). Hyoscyamus, valuable in sub- 
acute form (P) ; for nervous irritability during convalescence (A). Gelsemium, 
extremely useful ; rr^v of fluid extract every 2 hours (B). Mercury, as ointment 
gives good results in children (A) ; Calomel in small, frequent doses, so as to 
bring the system under it quickly, a most valuable remedy apart from its purga- 
tive effects (Wa). Potassium Iodide, has cured (Niemeyer) ; especially valuable 
in the tubercular form (B). Ergot; the fluid extract in gss doses, with £ss of 
Potassium Bromide, every 4 hours, to diminish the vascular excitement (B). 
Potassium Bromide, in the convulsions following simple meningitis (R). Opium, 
in small doses ; by clinical evidence proved to be the best treatment, especially 
for acute stage before exudation, or during the stage of excitation (B) : when 
collapse, may sustain powers of life ; with Tartar Emetic has proved most 
beneficial, but should be used with great caution, as it may do great harm 
(Wa). Bryonia, exceedingly valuable for serous inflammations in stage of 
effusion (P). Pulsatilla, valuable in the acute form (B). Purgatives, as soon 
as possible, unless exhaustion ; Calomel and Jalap the most active and search- 
ing (A) ; Croton Oil as a derivative and revulsive ; also locally to the shaven 
scalp, productive of the best results in tubercular meningitis (Wa). Venesection, 
or arteriotomy (temporal artery) gives good results (B) ; when high cerebral 
excitement and vascular action (A). Blisters, on nape of neck if coma, after 
active symptoms are subdued (A). Water, cold water for hyperpyrexia 
(C); pounded ice in bag or bladder, as a cap to the head (R). [Compare 
Hydrocephalus.] 

Meningitis, Cerebro-Spinal. 

Opium, no remedy so effective in small doses ; its utility ends when effusion, 
stupor, and coma ensue (B) ; large doses (Valleix), gr. j every hour in very 
severe cases (S) ; has been used in France and Germany with much success 



6 4 8 



MENINGITIS. 



(Tr) ; is the best remedy of all, gr. j every hour for 4 days ; even such doses 
will not narcotize (Da C). Aconite, useful combined with Opium (B) ; affects 
the cranio-spinal axis from 3d nerve to phrenics, the region where this disease 
is most manifest (Harley). Gelsemium, extremely valuable, rr\,v of fluid 
extract every 2 hours, to maintain constant physiological effect (B) ; is efficient 
for the delirium. Belladonna, in all hyperaemic conditions of brain and spinal 
cord, especially during stage of excitement (P). Iron, the Tincture of the 
Chloride, in 20-30 minim doses, every two hours, suggested by the similarity 
of the disease to erysipelas, has made many successful cures without leaving 
any sequelae (Klapp). Bromides to guard the Opium and enable the latter to 
be pushed, 20-grain doses every 4 hours (Da C). Hydrocyanic Acid, dilute, 
rr\j-ij, with gr. iij-v of Sodium Bicarbonate, every 3 or 4 hours, for severe 
vomiting (Delafield). Quinine in large doses at the commencement (B) ; has 
been exhaustively tried in this disease and failed (Da C). Potassium Iodide 
for the sequelae, a long course of Iodides during convalescence is the best 
treatment (Da C). Cold to the spine, the most satisfactory treatment (Rad- 
cliffe) ; to head and upper spine for 5 minutes only at a time, for the headache 
and tetanic symptoms (Da C). Venesection, or arteriotomy (temporal artery), 
probably of service, but cautiously (B) ; leeches at back of neck and on 
temples, to relieve the terrible headache, if patient is strong and vigorous 
(Da C). Digitalis, in early stage (Rummel). Ergot, one of the best remedies 
(B). Turpentine, enema, as derivative (B). Stimulants, in small quantities 
(A). Counter-irritation, by actual cautery freely applied to back, alleviates 
pain (A). Water, cold baths or wet pack for hyperpyrexia ; warm bath in 
uraemia (B) ; hot-water bottles or sand-bags to trunk and extremities to keep 
up warmth ; bath of 102-106 for short time only, then wrapped in blankets 
(A). Heat to the body, except the head and neck (Da C). Aliment, nutritious 
and suitable food a£ short intervals, day and night (A) ; tonics with fresh air 
and good diet during convalescence (A). Ventilation, of dwellings, the best 
sanitary precaution when the disease is epidemic (Simon). 



Prescriptions. 



R-. Morphinae Sulph., . . . . gr. ss. 

Ac. Sulphurici Aromat., . pjj. 

Tinct. Cinchonse Co., ad ^vj. 
M. Sig. — Tablesp. every 2 hours, for a 
boy of 12 years old. [Meigs &° Pepper.) 



R-. Potass. Iodidi, giv. 

Tinct. Gentian. Comp., 
Syr. Sarsse Co., . . . . aa ^ij. 
M. Sig. — Teasp. thrice daily, to pro- 
mote absorption during convalescence. 



Meningitis, Spinal. 

Aconite, is very useful (B) ; with Ergot and Opium impression to reduce the 
amount of blood in the vessels of the cord (Da C). Potassium Iodide, in the 
chronic form, with the Bichloride of Mercury when a specific history present 
(Hammond). Belladonna, strongly to be relied on, even when brought on by 
external violence (P). Bryonia, in serous inflammations when effusion, is 
extremely valuable (P). Purging, by Magnesium Sulphate, combined with 
Tinct. Hyoscyami (A). Quinine, when paralysis occurs, in 3-grain doses thrice 
daily, with ^ -grain doses of Extract. Belladonnae, or 20-30-grain doses of 
Potassium Iodide, and flying blisters along the spine (Da C). Opium, in some 
form, must be used for pain (Bastian). Mercury, gr. -^ of the Bichloride, with 
increasing doses of Potassium Iodide, to promote absorption of inflammatory 
products, if the inflammation subsides (Bastian) ; a mercurial impression often 
benefits the paralysis (Da C). Cold, by ice to spine is deemed necessary, and 
no doubt alleviates the pain, though heat would be a more rational application 
for the inflammation (Bastian). 



MENORRHAGIA MENSTRUAL DISORDERS. 649 

Menorrhagia. 

Opium, has specific action in reducing the uterine circulation, should be 
pushed, even to inducing habit, in severe cases (Lutaud). Ipecacuanha, in full 
emetic doses (Wa) ; is excellent (B) ; Ergot is better (P). Savine, enlarged, 
relaxed, and passively congested uterus (B) ; in 5-10 drop doses of tinct. in 
water every half-hour to three hours, has proved useful (P) ; when due to want 
of tone in uterus (R). Ergot, large spongy uterus ; Bromides better (B) ; 
Ergotin gr. j or ij in Glycerin and water, undoubtedly efficacious as hypoder- 
mic injection (P) ; in all forms (R) ; minim doses of the fluid extract are very 
beneficial (Smith). Hydrastinine, a powerful uterine vaso-constrictor ; very 
successfully used in grain doses of the Hydrochlorate in 10 per cent, solution 
hypodermically, for a few days before the expected term. Hamamelis, has 
decided influence on venous system ; of high repute (Pf ). Arsenic and Iron, 
when from anaemia (B). Cannabis Indica, often successful (R) ; gtt. v-x of 
tinct., thrice daily, productive of extraordinary success (Wa) ; has a stimulant 
action on the uterine muscular fibre, and may be given in combination with 
Ergot (B). Iron, when dependent on anaemia (B). Rue, low vascular tonus ; 
should never be used in the pregnant state (B). Erigeron, the Oil, in 10- 
drop doses, is efficient (Wa). Gossypium, a favorite uterine hemostatic in 
many hospitals, in 30-minim doses of the fluid extract every four hours 
(Parvin). Quinine, has been recommended (R) ; after Ergot it is the very 
best agent, in 6-grain doses every 3 hours (Parvin). Digitalis, very useful, 
especially when from heart disease, in plethoric subjects (R) ; ^j-jss of infu- 
sion as dose will arrest menorrhagia when unconnected with any disease (P, 
R). Aloes, debilitated and relaxed subjects, with Iron (B). Cimicifuga, pas- 
sive, coagulated and dark (P) ; for accompanying headache (R). Gallic Acid, 
is very efficient (R). Potassium Chlorate or Bromide, in doses of gr. xv thrice 
daily, combined with Ergot, has an almost infallible influence over uterine 
hemorrhage, unless caused by cancer, polypi, adherent placenta, or other sim- 
ilar affections (Tait). Bromides, usually arrest promptly (B) ; that of Potassium 
most useful in young women if loss occurs at natural period only ; commence 
the Bromide a week before and discontinue when discharge ceases till a week 
before the next term ; if loss occurs every two or three weeks give Bromides 
continuously in 10-grain doses, but more when organic changes in womb (R, 
Wa). Ammonium Chloride, for headaches (R). Calcium Phosphate, in 
anaemia from excessive menstruation (R). Magnesium Sulphate, very small 
doses with a little dilute Sulphuric Acid and syrup, is exceedingly useful (Wa). 
Cinnamon, the Oil, in drachm doses (R). Water, hot water bag to lower dor- 
sal and lumbar vertebrae (R) ; cold sitz-bag, feet in warm water, especially 
valuable. 6o°-6$° Fahr. for 5—1 5 minutes, patient then quickly dried and put 
to bed. [Compare Metrorrhagia.] 

Prescriptions. 



R. Ext. Ipecac. Fl., . . . . gij. 

Ext. Ergotse FL, . . . . giv. 

Ext. Digitalis FL, . . . . gij. 
M. Sig. — A half teasp. to a teasp. as 
required until emesis. (B.) 



R-. Ext. Ergotse (Squibb's), . gr. xij. 
Ext. Opii, gr. vj. 

M. et div. in pil. no. xij. 

Sig. — One pill every hour, in profuse 
menstruation of atonic type. 



Menstrual Disorders. 

Aconite, gtt. j of tinct. every half-hour to hour promptly restores discharge when 
sudden suppression from chill (P, B, R, Wa) ; as emmenagogue (Tr). Pul- 
satilla, often of the greatest value when menses scanty or delayed, or sup- 
pressed by fright or chill (P, B). Ignatia, in suppression of hysteria (P). Savine, 
a powerful uterine tonic ; as emmenagogue certain, powerful, safe (P). Ferrum, 
in anaemic subjects (B). Aloes, as emmenagogue [vide Amenorrhcea]. 
Cocculus Indicus, for irregular menstruation with colicky pains and scanty dis- 



65O MENTAGRA METRITIS METRORRHAGIA. 

charge ; should be given for a few days prior to and during period (P) ; rr\,ij-iij 
of a saturated tincture thrice daily. Opium, in suppression from violent mental 
emotions, a valuable remedy (Wa) : in many menstrual disorders Opium 
proves invaluable, but must be cautiously administered lest the habit be formed. 
Cimicifuga, relieves heat and pains in the head, flushings in the face, pains in 
back and limbs, etc., when occurring as the result of menstrual perversion 
(Wa). [Compare Amenorrhcea, Dysmenorrhcea, Menorrhagia, Climac- 
teric Disorders.] 

Mentagra. 

Mercury, the Oleate, or the Bichloride, gr. ij to ^j water, applied as lotion 
after each epilation (R) ; Citrine oint. extensively employed (Wa). Sulphu- 
rous Acid, with an equal part of Glycerin, is an efficient application (Jenner). 
Arsenic has a more or less powerful influence, used internally in doses of rt^v 
of Liquor Arsenicalis thrice daily (Wa) ; the Oleate of Arsenic is an efficient 
local application. Sulphur Iodide, as ointment (3j to ^jss), is efficient, with 
Donovan's solution internally (Sir E. Wilson). Copper Sulphate, as lotion, gj 
to ^xvj of water, with ^ss of Zinc Sulphate, and ^jss of Aqua Laurocerasi (B). 



Metritis, Acute. 

Opium, locally, in suppositories or enema is more effectual than if admin- 
istered internally (Wa). Aconite, is invaluable in early stage of simple in- 
flammatory fevers (P). [Compare Puerperal Fever.] Heat, to the feet, 
and by large poultice to the abdomen ; also hot water vaginal injection 
literally for hours, if possible ; repeated at short intervals, from a Davidson 
syringe ; the only means of aborting an attack of cellulitis (E), which is the 
condition generally present in cases which are usually supposed to be ones of 
acute metritis (Playfair). Turpentine, as hot epithems ; few measures are more 
generally serviceable (Wa). Linseed Poultices, produce great relief to pain 
and favorably affect the course of the disease (Duncan). Leeches, to the hypo- 
gastric region, may be required in patients of full habit. [Compare Puerperal 
Fever, Puerperal Metritis.] 



Metrorrhagia. 

Ipecacuanha, possesses considerable energy in arresting flooding (P) ; in 
full emetic doses, gr. xx in evening, followed by an acidulated draught in the 
morning (Wa). Hamamelis, when persistent oozing (R). Ergot, the most 
valuable remedy in full doses; repeated every hour or so (R, P). [See 
Menorrhagia for formula.] Savine, 5 to 10-drop doses of tincture in cold 
water every yi hour to 3 hours (P). Iron, styptic preparations as injections 
(B). [See Hemorrhage, Post-Partum.] Opium, has specific action on the 
uterine circulation (see ante, page 315), and should be given freely in intract- 
able cases of metrorrhagia from uterine fibroids or cancer, in which the estab- 
lishment of the opium-habit is often advisable (Lutaud). Hydrastinine, a 
powerful uterine vaso-constrictor; successfully employed in grain doses of the 
Hydrochlorate in 10 per cent, solution hypodermically. Atropine, gr. -j-^- to*^- 
hypodermically, in profuse metrorrhagia after abortion or of obscure origin ; 
may require as many as four injections to cause cessation of the flow (Squibb). 
Cannabis Indica, often arrests, especially when at climacteric ; tincture gtt. 
v-xx ter die (P) ; has had extraordinary success in number and rapidity of 
cures (Wa). Sulphuric Acid, sometimes very effective, especially when due to 
fibroid or polypus ; Ac. Sulphurici Dil., gtt. v-xx, well diluted (B) ; long exten- 
sively prescribed (Wa). Cinnamon, is used with good effect (P) ; has specific 
action on the uterus (T). Digitalis, in plethoric subjects ; the infusion best, 



MILIARY FEVER — MUSCLE MYALGIA. 



651 



a tablesp. bis die (P) ; the effect is prompt and decided (Wa). Magnesium 
Sulphate, often succeeds (B). Senegin,' in 2-grain doses, is successfully em- 
ployed (P). [Compare Amenorrhcea.] Ice, to abdomen, or within the 
uterus (B) ; Ice in every way the first thing to try (Wa). Rest, absolutely nec- 
essary. Dry cupping over sacrum is found useful (R). [Compare Menor- 
rhagia, Uterine Tumors.] 



Prescription. 



R. Ext. ErgotreFl., ^ss. 

Ext. Senec. Aur. Fl., . . . 
Ext. Viburn. Prunif. FL, aa Jj. 

Ol. Myristicse, Ti^xx. 

Syr. Simplicis, . q. s. . ad ^vj. 



M. Sig. — A dessertsp. every 



hour 



until relieved, then reduce dose. Keep 
the head low, and apply cold over hypo- 
gastrium. 



Miliary Fever. 

Aconite, for the hyperpyrexia (R, P). Cooling Drinks, purgatives and anti- 
phlogistics, in mild cases ; malignant ones sometimes occur, and are dangerous 
(A). Lime-water applied by sponging, is very useful ; or a lotion of Zinc Oxide 
suspended in Lime-water, gr. xl to §j, painted on the affected parts of the skin, 
and permitted to dry thereon (E. Wilson). 



Muscae Volitantes. 

Potassium Iodide, very effectual in curing muscae depending upon hepatic 
derangement (Wa). Valerian, often found curative (Wa). Muscae Volitantes 
are due to shadows cast on the retina by fibrillar floating in the vitreous body, 
and are most visible to myopic persons ; they do not merit attention unless very 
abundant, or steadily increasing (C). Rest of the eye necessary. Neutral-tint 
glasses may be worn to render the muscae less visible, if troublesome. 



Myalgia. 

Arnica, the best agent for contused muscular fibre ; also for shake, concus- 
sion, shock ; TiLv-x every 2 or 3 hours in water (P) ; a few drops of tincture in- 
ternally, removes stiffness, after packing with cold, wet sheet (R). Cimicifuga, 
often succeeds wonderfully, as often fails ; no indications for its use (B) ; general 
bruised sensation (R). Ammonium Chloride, in 10 to 20-grain doses, the most 
efficient remedy (Anstie) ; is effective (R). Veratrine, the ointment externally 
may control (B). Belladonna, as liniment, is often successful (R). Gelsemium, 
frequently cures, but large doses are necessary, rrvv-xx of the fluid extract every 
3 hours (B). Coca, to relieve the sense of fatigue (P). Opium, by frictions 
or poultices (R). Iodine, ointment for pain and tender muscles of the chest, 
when skin may be pinched without pain (R). Xanthoxylum, externally and 
internally, has a deserved reputation (B). Chloroform Liniment, with friction, 
often affords great relief (Wa). Firing, sometimes very beneficial (B). Pack- 
ing, with dripping wet sheet (R). Counter-irritation, by firing, aquapuncture, 
acupuncture (B). Electricity, the constant current (B). Baths, Turkish, in 
aching muscles, from over-exertion (R). Poultices, very hot, followed by ap- 
plications of lint and oilskin (R). Rest, is the remedy, of course (Wa). Rest 
and support to weak muscles important till they regain their tone ; especially 
in painful muscular affections following prolonged or excessive exertion, or in 
the soreness or stiffness which occur during convalescence from any long ill- 
ness, or accompanying general debility, and generally better after repose, but 
increase with fatigue. [Compare Pleurodynia, Lumbago.] 



652 MYELITIS NASAL AFFECTIONS. 

Myelitis. 

Belladonna, is decidedly effective, especially when disease is brought on by 
external violence (P). Ergot, most successful ; large doses are necessary (B). 
Electricity, in chronic, not in recent form (B). Silver Nitrate, in chronic inflam- 
mations of the cord, one of the few remedies which are ever of service ; gr. 
%-Yz (W). Phosphorus, of marked benefit in myelitic paraplegia from exces- 
sive venery (W). Water-cure, Ice-bag to spine, feet in hot water ; or better, 
hot douche to spine (B). Cold, externally, by Ice-bags, along the spine, with 
cupping or leeching if much localized pain or tenderness; spoon diet and a 
sparing amount of stimulants, also copious warm enemata to relieve the bowels 
and act as derivatives. Little, if anything, is to be done with mere drugs. 
Posture should be prone, or on side ; absolute rest (Bastian). [Compare 
Meningitis, Spinal.] 

Myopia. 

Atropine, by daily instillation, systemically, for the purpose of sacrificing 
either the convergence or the accommodation, in cases where failure of the 
internal recti occurs, the disability assuming the form of muscular asthenopia 
(C). Glasses, properly adjusted, should be worn from the commencement. 



Naevus. 

Ferrum Perchloride, injected, is effectual; but dangerous when applied thus 
to nsevi about the head (Wa). Creosote, pencilled over twice a day, may re- 
move naevi (Wa). Chromic Acid, as escharotic, or local application, gr. c ad ^j 
aquae destil. (B). Electrolysis, or galvano-cautery, to remove nsevi (B) ; 40 cases 
so treated ; the process is certain and safe, leaving a faint cicatrix and no after- 
pain (Knott) ; in my hands has answered well during ten years' use in these 
cases (Marshall). Nitric Acid, strong, as escharotic for small superficial naevi, 
followed by Oleum Olivae (B). Zinc Chloride, Iodide and Nitrate, locally, 
especially the first named (R). Setons, threads passed across the growth in 
various directions, to produce suppuration ; when pus appears the threads 
should be removed. Sodium Ethylate, prepared by adding the metal Sodium, 
piece by piece, to absolute alcohol in a wide-mouthed bottle ; the crystalline 
substance found deposited after effervescence ceases is an excellent caustic for 
naevi ; painted over them it causes a rapid eschar, and usually gives but little 
pain (Richardson). Mercury, the Acid Nitrate an excellent caustic for remov- 
ing moles from the face (Thomas). 



Nails, Ingrowing. 

Liquor Potassse, a solution (£ij to ^j) on cotton-wool in ingrowing toenail, 
to margin of nail at ulcerated surface, to soften the nail (B). Glycerin, or 
Silver Nitrate, on a fold of lint, to the ulcerated surface (C). Lead Carbonate, 
a piece softened between the fingers, and applied as plaster beneath the fung- 
ous cushion, cures in a few days (Tr). Paring the nail, after softening in warm 
water, and cutting a V-shaped incision in centre of nail ; the ingrowing portion 
should not be cut. 

Nasal Affections. 

Ammonia, by inhalation, in pain and inflammations of nose and frontal bones 
(R). Potassium Iodide, large doses (gr. xxx-lxxv daily), valuable in syphilitic 
affections of the nose (Wa). Glycerite of Tannin, to excoriations of inside of 
nose, after measles, scarlatina, etc. ; also for impetiginous eruptions of inside, 
most severe where hair grows ; epilation sometimes needful ; also in discharge 
of greenish, black, stinking mucus (R). Glycerite of Starch, or Zinc Ointment, 



NAUSEA NECROSIS NERVOUS AFFECTIONS. 653 

applied often, a good supplementary application (R). Hydrastis, in chronic 
catarrhal conditions and nasal ulcers, used internally and externally, with great 
benefit (P). Pulsatilla may be employed both internally and externally in nasal 
inflammations (P), and in acute inflammation of nose (B). Cod-liver Oil for 
chronic discharge (R). Injections, by nasal douche, are used with benefit in 
catarrhal states (Wa). Zinc Chloride, gr. ij to the ^, or the Sulpho-carbolate, 
gr. v to the %, as solutions locally by cotton-wrapped probe to diminish sensi- 
bility of the nasal mucous membrane (Sajous). Cocaine, has many applica- 
tions in treatment of nasal affections ; a 4 per cent, solution by mop or spray 
will empty the engorged venous sinuses, and is very useful in acute catarrh, hay 
fever, etc. also for posterior and anterior rhinoscopy (R). [Compare Acne, 
Catarrh, Epistaxis, Hay Fever, Influenza, Oz^ena, Polypus, Sneezing.] 

Nausea. 

Ipecacuanha, has no rival in sickness of pregnancy, scarcely less useful in 
that of chronic alcoholism ; very small doses, gr. -fa or tt\j of wine (P). 
Pulsatilla, in dyspeptic nausea, with coated tongue, flatulence, sick-headache 
(P). Cocculus Indicus, in cephalic nausea, violent but ineffectual efforts at 
vomiting (P). Calumba, in nausea of languid stomach with flatulence, has 
considerable reputation (P). Cinnamon or Cloves, will check nausea (P). 
Nutmeg, the simple powder in wine (P). Pimenta, Pepper, Peppermint, relieve 
(P). Tartaric Acid, as effervescing draught, with a few drops of Tinct. Opii, 
Tinct. Calumbae, or Dilute Hydrocyanic Acid added, when from morbid gastric 
irritation (Wa). Cold Compress or Ice-bag, over the stomach very useful. 
Bismuth Subnitrate, or the Liquor Bismuthi, when the salt in substance dis- 
agrees, is a remedy of established value in nausea and vomiting arising from 
gastric disorders ; may be combined with Hydrocyanic Acid (Wa). [Compare 
Vomiting, Vomiting of Pregnancy, Seasickness.] 

Necrosis. 

Sarsaparilla, a very useful medicine in diseases of the bones (P). Rest, in 
a " Salter's swing," with poultices, water-dressing, or stimulating lotions, to aid 
work of repair (CI, Hilton). Tonics, nutritious food, baths, good hygiene, all 
are necessary adjuncts to local treatment (Andrews). Acid Solutions, of no 
use as solvents, may be employed with benefit for detergent and alterative 
effects to expedite the sloughing and restorative processes (Gross). Operation 
to remove sequestrum is generally necessary ; or resection of the devitalized 
bone, the latter in young subjects greatly exhausted, where delay would 
endanger life (Gross). Potassa cum Calce introduced into fistulas, to convert 
them into large openings, permitting the removal of diseased bone (Kirk- 
patrick). [Compare Caries, Bone Diseases, Syphilis, Scrofulosis.] 

Nervous Affections. 

Nux Vomica, in one-drop doses of the tincture every 5 minutes, is promptly 
efficient in relieving many affections of reflex neurotic origin, as cough, 
dyspnoea, syncope, palpitation, flatulent dyspepsia, eructations, etc., especially 
when occurring in hysterical subjects (Macfarlan). Arsenic, of especial value 
in nervous affections resulting from malaria, in which large doses are required ; 
tt\,x of Liq. Arsenicalis, increased to rr^xxx thrice daily (Wa). Asafcetida, is a 
remedy of much value in nervous affections connected with uterine derange- 
ment, also in dyspeptic hypochondriasis and other nervous affections ; may be 
combined with bitter tonics and mild aperients (Wa). Potassium Bromide, 
takes precedence in epilepsy, epileptiform convulsions, hysterical convulsions 
and spasms, tetanus, etc. ; is of great value in chorea, insanity, acute mania, 
insomnia, delirium tremens, some forms of neuralgia, and the numerous 
symptoms of vaso-motor disturbance, such as — numbness, coldness, deadness, 



654 



NERVOUS EXHAUSTION. 



pricking sensations, indefinable but distressing sensations in abdomen, hypo- 
gastrium or epigastrium ; feelings similar to rigors, with anxiety, palpitation or 
fluttering of the heart, — all due to interference with the local circulation (Rey- 
nolds). Valerian and Valerianates, are thought to exercise some special 
influence over nervous affections, especially Zinc Valerianate, in half-grain to 
grain doses in pill, or the Ammoniated Tincture of Valerian, from which every 
good that can be expected from the valerianates will be more certainly 
obtained (W). Sumbul, acts as a nervous stimulant, and is especially effi- 
cacious in neurotic migraine, also in hysteria and the obscure paralytic affec- 
tions associated therewith (Wa). Caffeine, is of signal value in neuralgia, 
hemicrania and other nervous affections (Shafter) ; grain-doses in solution 
hypodermically, afford great relief in dorso-intercostal neuralgia attending 
shingles, insomnia, etc. (Anstie). Cocaine is a powerful nerve stimulant, 
destroying the sense of fatigue, and often evincing marked analgesic power in 
neuralgia? ; is effective in melancholia, hypochondriasis, etc., as well as locally 
in nerve pain over a limited area ; it acts as an excitant upon the central 
nervous system (R). Opium, is a remedy of marked value in insanity, melan- 
cholia, mania, and all nervous affections accompanied by pain (W) ; gives 
general repose to both body and mind, is of decided value in diabetes, and 
produces marked improvement in melancholia and despondency (R). Lupulin, 
is peculiarly useful in nervous affections when Opium cannot be tolerated, 
especially in chronic hysteria attended with morbid vigilance, io-grain doses 
every 6 hours afford great relief, without causing any unpleasant symptoms 
(Eberle). Santonin, in convulsions, epileptiform seizures, and affections 
regarded as choreic, etc., the result of reflex irritation from worms (Wa). 
Phosphorus, of occasional utility in affections of the nervous system induced 
by mental exertion or over-excitement ; the danger from its use is its liability 
to produce fatty degeneration of the internal organs (Wa). Silver Phosphate 
is regarded as of special value in myelitis with disturbance of bladder and 
rectum, and in sclerosis of the nervous substance (Wa). Silver Nitrate, the 
only remedy which has done good in progressive locomotor ataxia ; gr. x 1 ^-^ 
two or three times daily, with Sodium Hypophosphite, both to be discontinued 
when blue line appears on gums (Althaus). Cold Shower Baths, are often 
beneficial in nervous diseases unconnected with disease of the brain. [Com- 
pare Hysteria, Melancholia, Mania, Diabetes, Locomotor Ataxia, 
Hemicrania, Neuralgia, Neuritis, Neurasthenia, Nervousness, Insom- 
nia, Hemiplegia, Paralysis, P. Agitans, Spinal Paralysis, etc.] 



Nervous Exhaustion. 

Ammonia, the Aromatic Spirit proves very serviceable; '^ss-j in water 
thrice daily (Wa). Hypophosphites of Lime or Sodium, or Iron, are actively 
tonic in cases of nervous depression and torpor, with occasional shooting 
pains (Wa). Strychnine Acetate, a remedy of great promise, when combined 
with a rigid system of diet, mental discipline, etc. (Marshall Hall). Zinc 
Oxide, often excellent as a tonic and sedative, in nervous irritability and de- 
pression from anxiety, over-study, etc. (Wa). Phosphorus, of occasional 
utility in nervous breakdown from over-study, etc. (Wa). Caffeine, gr. j or 
more in a cup of coffee, to relieve brain weariness and nervous exhaustion 
(Wa). Cocaine, in ^ -grain doses proves serviceable in nervous exhaustion 
(R) : danger of cocaine-habit if identity known to the patient. 

Prescriptions, 



R . Strychninas Acetatis, . . . gr. j. 
Ac. Acetici Diluti, .... rrvxx. 

Alcoholis, ^ij. 

Aquae Destill., gvj. 

M. Sig. — Ten drops thrice daily. 

{Marshall Hall.) 



R. Ac. Phosphorici Dil., . . . ^j. 
Elixir Calisayae (U. S. Disp.), ^vj. 
Elix. Ammonii Valerian., . jfij. 

Glycerini, ^iij. 

. ViniXerici, .... q. s. adO). 
M. Sig. — ^j thrice daily. 



NERVOUSNESS NEURALGIA. 655 

Nervousness. 

Aconite, gtt. j of tinct. at bedtime, repeated if needful, for restlessness and 
"fidgets" of men as well as women (R). Ignatia, in small doses better than 
Morphine for mental excitement and nervous erethism (P) ; for the nervous 
exaltation of cinchonism (Pf ). Caffeine, for restlessness due to great lowering 
of nervous power (P). Chamomile, lowers reflex excitability (P) ; minim doses 
of the tincture every 15 minutes an excellent sedative for children (Smith). 
Resorcin, produces quiet sleep in general nervous excitability. Potassium 
Bromide, especially for women who are despondent, irritable, and sleepless, 
from overwork, grief, worry, etc. ; often connected with migraine (R) ; gr. ss-j 
of any Bromide every X hour, is very efficient for the nervous disturbances of 
children (Smith). Conium, where a great deal of motor agitation, especially 
in the typhoid-like condition often resulting from mental overwork, with 
insomnia, exaggerated nervousness and delirium, — it acts charmingly in secur- 
ing sleep, by removing the motor agitation ; ttVx of a fluid extract of the unripe 
fruit, every y z hour, carefully watched (Madigan). Strychnine, affords relief 
in functional irritability of the nervous system, manifested by restlessness and 
wandering neuralgic pains (B) ; especially useful as a tonic in nervousness from 
over-use of tobacco (H). Valerian, extremely useful as a sedative to reflex 
excitability, calms nervousness, does much good in fevers where restlessness, 
fidgets, anxiety, etc. (P). Musk, serviceable in nervous affections when from 
uterine derangement (Wa). Opium, calms the nervous system and gives 
general repose to both body and mind (R). Sumbul, often invaluable in rest- 
lessness of pregnancy ; w L xxx-xl of tinct. with a little Chloric Ether as draught 
(P). Camphor, a powerful subduer of reflex excitability (P). Chloral, where 
restlessness, debility (R). Chloroform, the Spirit internally (R). Hop, the 
hop-pillow is deserving of trial. Lupulin, peculiarly useful when Opium can- 
not be tolerated (Wa). Water, warm sponging to induce sleep and calm rest- 
lessness in convalescence ; also, cold sponging (R). [Compare Insomnia,. 
Irritability.] 

Prescriptions. 

5c. Potassii Bromidi, .... f ) ). 

Ext. Guaranae FL, .... ,^jss.. 

Syr. Tolutani, Jiij. 

Aquae, q. s. ad jjvj. 

M. Sig. — Teasp. to a dessertsp. three or 
four times daily. To relieve nervousness. 



R • Strychninae Sulphatis, . . gr. j. 
Quininae Sulphatis, . . . ^j. 
Tinct. Ferri Chloridi, . . 3 v. 
Ac. Phosphor. Dil., 
Syrupi Limonis, . . . . aa^jij. 
M. Sig. — A teasp. in water thrice daily. 



Neuralgia. 

Aconite, when arterial excitement (B) ; in congestive neuralgias, and acro- 
dynic, at extremities ; has important role (P) ; as ointment or liniment, espe- 
cially when fifth nerve affected ; also in neuralgic headache (R) ; a remedy of 
great value (Wa) ; a perfect physiological remedy against neuralgia, especially 
those forms which are based on congestive or sub-inflammatory affections ; 
but its action is often slow, so that Morphine must be given with it as a pallia- 
tive. Aconitine, with Veratrine as an ointment locally, a good application 
(Da C) ; internally the best agent of all in essential neuralgia ; should be com- 
bined with Quinine in intermitttent forms and those which resist quinine alone. 
[See formula below.] Belladonna, must be persisted in with full doses ; gr. -^ of 
Atropine, or gr. -^ to -^ hypodermically, in vicinity of nerve, has special utility 
in tic douloureux and sciatica ; also in peri-uterine and dysmenorrhceal neural- 
gias (B) ; rt\J of solution of gr. j in 3'ij of water hypodermically (P) ; for spinal 
irritation ; intercostal neuralgia ; the Liniment or Ointment of Atropine in facial 
(R); gramme 0.15 of the extract every hour till giddiness, then lessen doses „ 



656 NEURALGIA. 

and continue for several days (Tr). Veratrum Viride, tincture, said to be very- 
useful (R). Veratrine Ointment for facial and sciatica (R) ; the Oint. (gr. viij 
to ^j) frequently of much benefit (P). Quinine, large doses, (gr. v-xx, in 
sherry), just before attack in periodical neuralgia, whether malarial or not; 
useful also, in small, frequently repeated doses, in other types, especially of 
supra-orbital nerve (P) ; has selective action upon supra-orbital form (Spender). 
Arsenic, cures by its influence on bodily nutrition ; directly so in neuralgias of 
malarial origin, though inferior to Quinine (B) ; in various neuralgias, also in 
angina pectoris (R) ; the Bromide of Gold and Arsenic rendered good service 
in an obstinate case of trifacial neuralgia diagnosed as due to syphilis, after 
other treatment besides anti-syphilitic had failed (E. A. Wood). Opium, inter- 
nally, or Morphine, hypodermically, in the vicinity of the affected nerve, the 
best treatment ; — Caution ! morphine-habit (B) ; gr. -^ to % often relieves and 
frequently cures after a few repetitions (P) ; no remedy promises more speedy 
and permanent relief than Morphine by subcutaneous injection in sciatica, 
lumbago, tic douloureux and other neuralgic affections (Wa). Phenacetin, 
Antipyrin, and Acetanilid, are used with great satisfaction as analgesics in 
many forms of neuralgia ; of the three, the first named in doses of gr. x, is the 
safest and most efficient. Salipyrin has been employed with excellent results ; 
a dose of gr. viij being often sufficient. Phenocoll, is used successfully, espe- 
cially for the neuralgic pains of epidemic influenza (grippe). Salol, is very 
efficient in some forms. Salicylates, in large doses, cured a case of tic doul. 
of 12 years' standing (Dercum). 

Nux Vomica, is most useful in visceral neuralgise, as gastralgia, hepatalgia, 
etc., the tincture with carminatives in the former affection ; or Strychnine, gr. 
y^ to -g 1 ^ twice or thrice daily : in all forms of neuralgia this remedy should be 
used in small doses (P). Ignatia, in hysterical and intercostal neuralgia with 
nervous erethism, is valuable (P). Phosphorus, gr. -^ every few hours, has 
made very effective cures (B) ; gr.j^o to -^ every 3 hours ; very useful in all 
forms, especially when uncomplicated (R) ; always a good remedy, except for 
cases due to cold or inflammation, and those not depending on depraved nutri- 
tion (H). Ammoniated Copper, in neuralgia of the 5th, used by Fereol with 
remarkable success; ^-grain doses pushed. Eserine, very efficient in neu- 
ralgia of the eyeball, a solution of gr. ij to the ^ by instillation. Cannabis 
Indica, X~K g r - doses of extract 2 or 3 times a day ; especially for neuralgic 
headache (P) ; found useful (R). Cod-liver Oil, when low nutrition, faulty 
assimilation (W). Iron, when from anaemia ; the Tincture of Chloride (rr^xxx-xl 
ter die), also chalybeate waters (B) ; moderate doses only required (R) ; in 
chlorotic subjects, of whom nearly all will have neuralgia (Tr). Iodides, for 
neuralgia of fifth, dependent on syphiloma of the nervous system, pain noc- 
turnal chiefly (B). Bromides, benefit some kinds, especially ovarian (B) ; 
Potassium Bromide occasionally relieves (R). Ammonium Chloride, half- 
drachm doses in facial and other neuralgias, is much used (R) ; a very efficient 
and diffusible stimulant, gr. xx-gj at first, repeated every hour during the 
attack (H). Chloroform, as anaesthetic to relieve pain, is occasionally useful 
locally, also as spray for uterine neuralgia (R) ; by deep injection into vicinity 
of affected nerve rr^v-xv of pure Chloroform, a very efficient method of dealing 
with long-standing cases (B) ; used in one case it caused symptoms so severe as 
to imperil the life of the patient (W). Theine, hypodermically, is promptly anal- 
gesic, and has prolonged influence, but must be aided by remedies to improve 
the nutritive state of the affected nerves, or those which are capable of remov- 
ing the diathesis upon which the neuralgias depend (Mays). [See Formula 
below]. Caffeine, hypodermically has been found useful, especially in cervico- 
brachial neuralgia (P). Cocaine, as a hypodermic injection, a 4 or 5 per cent, 
solution is very effective if administered in the vicinity of the aching nerve 
(R); also by instillation in neuralgia of the eyeball, and whenever it can be 
applied to the mucous surface in the vicinity of the pain. Croton Chloral, very 
effective, especially in tic douloureux and sciatica, gr. ij-v every hour till gr. 
xv are taken (B) ; in facial, that from carious teeth, that of neck and back of 



NEURALGIA. 657 

head, tic douloureux, etc. (R) : gr. j, every J^-hour is a very efficient dose 
(Smith) ; rarely of any value, but when used is best given in 20-grain doses 
twice daily (H). Chloral and Camphor, equal parts, triturated together, and 
painted over surface (R) ; also with Morphine (B). Amyl Nitrite, inhaled in 
dysmenorrhceal neuralgia (B) ; and when of 5th nerve (R). Nitro-glycerin, 
has often afforded great relief (Wa). 

Sumbul, for certain types, of more value than any other remedy ; facial, 
sciatic, or ovarian, in women of nervous constitution, often yield to it at once 
(P). Cimicifuga, in neuralgia of the 5th from cold, and in ovarian neuralgia 
(B). Gelsemium, successful in neuralgia of 5th (B) ; especially dental branches 
(R) ; of value in trigeminal, ovarian, etc. (W) ; in suitable cases small doses 
answer as well if not better than large ones (Pf); ttliij of the tincture every ]/ z 
hour often succeed miraculously with no ill results in neuralgise about the head 
and face (Smith) ; no better remedy in tic douloureux, but must be given in 
large doses, tt\,x-xv of a strong tincture or fluid extract (H). Zinc Valerianate, 
extremely beneficial in neuralgia from reflex irritation of female pelvic organs 
(B). Spigelia Anthelmia, useful in facial form (P). Ammonium Valerianate, 
or Zinc Val. in neuralgia of face or head (R) ; the latter in nervous cases, and 
uterine (Wa). Chamomile, in neuralgia of 5th nerve (R). Staphisagria, in- 
ternally and externally often curative in obstinate facial and cervical neuralgia 
(P). Ergot, much employed in visceral forms, especially gastralgia (P) ; said 
to be useful (R). 

Digitalis, is strongly recommended in sciatica, also locally in earache (P). 
Valerian, serviceable in facial neuralgia of hysterical type (P). Bibiru Bark, 
in intermittent forms (P). Pyrethrum, root, is chewed with benefit in facial 
neuralgia (P). Capsicum, a strong infusion, on lint covered with gutta-percha 
(R). Coccus Cacti, has been very successful in 20-30 minim doses of a ^th 
tincture twice daily, the larger doses in the paroxysm (W). Peppermint, the 
Oil, painted over the part in facial neuralgia (R) ; especially the Chinese oil, 
which contains a large excess of Menthol, a very useful application in superfi- 
cial neuralgise (W). Turpentine, has cured tic douloureux and sciatica (B) ; 
often of wonderful service (P). Potassium Chlorate, for facial neuralgia (B). 
Alcohol, with much volatile Ether ; care must be taken in prescribing it (R). 
Piscidia, almost specific in many forms, useless in many cases (W). Tonga, 
is efficient in facial neuralgia, rtix-xx every two hours (H). Osmic Acid, a one 
per cent, aqueous solution with Glycerin to prevent change, of which 5 to 10 
drops hypodermically, has made striking cures of inveterate neuralgias, with 
no ill effects resulting (Shapiro). Carbonic Acid Gas, injected into vagina for 
neuralgia of uterus. Aquapuncture, strangely relieves pain in a superficial 
nerve, so much so, that some hold the curative effects of morphine injections 
to be due to the water (B). Counter-irritation, Mustard poultices in neuralgic 
pains (P) ; blisters to a posterior branch of the spinal nerve-trunk from which 
the painful nerve issues (Anstie). Wet Pack, is of great benefit, especially in 
sciatica. Intense Cold, produced by a spray of Methyl Chloride, or concen- 
trated Carbonic Acid gas, directed along the nerve from special apparatus, 
immediately relieves the pain, and usually cures (Jacoby). Compressed Air, 
by insufflation into the middle ear, in cases of persistent and paroxysmal tem- 
poro-occipital neuralgia, due to chronic follicular pharyngitis and inflammation 
of middle ear (Legal's Disease) ; if these insufflations result in diminution of 
the pain, treatment should be directed to the naso-pharynx and Eustachian 
tubes (Masucci). Galvanism of the affected nerve, one of the most important 
curative measures ; a continuous current of 4 to 8 cells down the nerve gen- 
erally answers best, though some cases are helped more by a rapidly inter- 
rupted faradic current : Electricity is of no value in cases dependent upon 
organic lesions, and in any individual case is purely experimental (W). Diet, 
Animal fats necessary, as Cod-liver Oil, butter, cream, etc., in as large quantity 
as can be digested. Rest often needed, with protection from cold and damp, 
flannel clothing, bathing and shampooing. [Compare Gastralgia, Hepa- 
talgia, Sciatica, Tic Douloureux, Hemicrania, etc.] 
42 



658 



NEURASTHENIA. 



Presa iptions. 



For Local Use. 



R . Chloroforrai, 

Tinct. Aconiti, ... aa % ss. 

Linim. Saponis, ^j. 

M. Sig. — Apply on flannel and cover 
with oiled silk for superficial neuralgia. 



R. Aconitinae (Duquesnel), . gr. iv. 

Veratrinse, gr. xv. 

Glycerini, gij. 

Cerati, £vj. 

M. Sig. — To be rubbed over the part, 
avoiding any abraded surface carefully. 

{Da Costa.) 

R . Mentholi, gr. xlv. 

Cocainse Hydrochlor., . . gr. xv. 
Chloralis Hydratis, . . . gr. x. 

Vaselini, 3 v. 

M. ft. ung. Sig. — For local use. 

{Potter.) 



R 



r 



. Veratrinse, gr. xl. 

Adipis, vel Unguenti, . . . ^j. 
M. Sig. — Local use. [Da Costa.) 



Theinae, 

Sodii Benzoatis, . . . aa gj. 

Sodii Chloridi, gr. x. 

Aquse Destil., 5jj. 

M. Sig. — 3 to 20 drops hypodermically 

at central seat of disturbance. {Mays.) 
Tr^vj = gr. ss of Theme. 



a. 



M. 



For Internal Use. 

Phosphori, gr. ss-jss. 

Alcoholis q. s. ad solv. 

Spt. Menthae Piperita?, . . q. s. 
Glycerini, . . . . q. s. ad "g'w. 
Sig. — A teasp. after each meal. 

(H.) 



R. 



Cupri Ammonio-sulphat., . gr. j-iv. 
Syr. Aurantii Flor., . . . gj. 

Aqua; Destil., giij. 

M. Sig. — One-third as a dose, thrice 
daily. (Prof. Fireol.) 



R . Quininae Sulphatis, 
Ferri Pyrophosphatis, 
Strychninae Sulphat., . 
Ac. Phosphor. Diluti, . 
Syr. Zingiberis, 
Aquae, q. s. 



ad 



3h 

gr. ss. 

3 IV. 



M. Sig. — A tablespoonfultwice daily. 



R 



3¥- 
XX. 



. Aconitinae Crystal., . . . gr. 
Quininae Hydrobrom., . . gr. 
M. ft. massa, et div. in pil. no. xij. 
Sig. — One every 4 or 5 hours. {Potter? 



R. Tinct. Aconiti, 

Tinct. Colchici Sem., 

Tinct. Cimicifugae, 

Tinct. Belladonnae, . . aa part. aeq. 
M. Sig. — 6 drops every hour until re- 
lieved. {Met calf) 



Neurasthenia. 

Coca, as a stimulant has been used with benefit, but only for a short time, 
and acts deleteriously unless given in small doses (W). Kola-nut is used in 
France, contains Caffeine, and is subject to the same remarks as above. 
Musk, is a valuable remedy in such cases, being stimulant and antispasmodic ; 
it stimulates the nervous centres when exhausted, without producing any very 
pronounced symptoms (W). Hypophosphites, the Syrup, with Strychnine, is 
of service as a general tonic, in connection with other remedies. Arsenic, is 
often very serviceable : Fowler's or Pearson's solution, in doses of tt\,iij-v, in 
water, after each meal. Aurum, the Bromide of Gold and Arsenic (Barclay), 
gave excellent results in 3 out of 4 cases of marked neurasthenia, in doses of 
tt\,v of the solution 4 times daily (Love). Artificial Serum in cases of lowered 
arterial tension (lessening of first sound, tachycardia embryocardia), an injec- 
tion hypodermically of rr^xv of the solution formulated below, 2 to 4 times a 
day {La France Medicale). Diet should be chosen from the most readily 
assimilable food, calling for a minimum amount of digestive work. As a rule, 
neurasthenics eat too much and drink too little ; plenty of water, at least a 
litre and a half per day, is the best drink ; it maintains the arterial tension, 
irrigates the tissues and assists the excretion of debris. Milk should be pro- 
hibited, also vegetable soups, peptones and extracts of meat. The albuminoid 
element of the food should not exceed one-sixth of the total (Vigoreaux). 
Counterirritation. The actual cautery along the spine has rendered excellent 
service in several cases of neurasthenia accompanied by neuralgia of the super- 
ficial branches of the spinal nerves. Its action is doubtless often a mental 






NEURITIS NIGHTMARE NIPPLES. 659 

one, and it renders the carrying out of the rest-cure more thorough than when 
attempted without something to enforce quiet. Rest-cure, with forced alimen- 
tation and systematic massage to keep up the muscles while holding the nervous 
system as inactive as possible, will do more than medicine in these cases. 
Many such will recover under the discipline and quiet of an hospital or sani- 
tarium alone ; while others are greatly benefited by removal from home influ- 
ences and cares, and from association with certain persons who irritate them. 
[Compare Gout, Hysteria, Spinal Irritation, Adynamia, Exhaustion.] 



Prescriptions. 



Artificial Scrum 
R . Sodii Phosphatis Pur., 
Sodii Sulphatis Pur., . 
Sodii Chloridi Pur., . 
Ac. Carbol. Cryst., . . 
Aq. Destil. Bullient, . 
Dose, rt\xv hypodermically 



• 3 "J- 
. gr. lxxx. 
. gr. xxx. 
. gr. v. 

ad ^iv. 



Tonic and Stimulant. 

R. Tinct. Kolas, gjss. 

Ac. Citrici, gr. xx. 

Sodii Arseniat., g r -j^ 

Tinct. Cocas, . . q. s. ad Jiv. 
Dose, gj at each meal. 



Neuritis. 



Strychnine, internally, is of value, and may be given in increasing doses (O). 
Antipyrin and Salicylates, are recommended in the acute cases with fever (O). 
Arsenic may be employed (O) : the Bromide of Gold and Arsenic cured a case 
of neuritis with partial hemiplegia lasting five years, with inability to walk and 
considerable pain along the spine and in right arm and leg (Barclay). Potas- 
sium Iodide and Mercury, if there is a history of syphilis (O). Massage is 
probably the most reliable means at our command in the later stages, when 
the atrophy is marked and the pains have lessened. Contractures may be 
gradually overcome by passive movements and extension. The interrupted 
current is useful when the acute stage is passed (O). [Compare Alcoholism, 
Spinal Irritation, Neuralgia.] 



Nightmare. 

Potassium Bromide, in nightmare of adults ; and children's attacks of night- 
screaming often associated with squinting : the digestive organs may also 
require attention (R). Camphor-water, a teaspoonful or two the most suitable 
medicine (H). Sleep, in abundance, may prevent (H). Diet, light ; avoid late 
meals. 

Nipples, Sore, Fissured. 

Benzoin, an admirable local application (P) ; the tincture locally for slight 
erosions (Parvin). Arnica, the Cerate or Glycerite of Starch, or Glycerin, 1 to 

2 of Eau-de-Cologne (R). Silver Nitrate, touched lightly, is effectual (Wa). 
Sulphurous Acid, solution neat or diluted, constantly applied, or with equal 
quantity of Glycerin as lotion (R). Collodion, sometimes used (R) ; useful for 
protection (P) ; as coating (B). Alcohol, Brandy and water as lotion before 
delivery and after each suckling to prevent cracking (R). Borax, saturated 
solution, beneficial (Wa). Iron, the Solution of the Subsulphate diluted with 

3 parts of Glycerin, and applied with a camel's-hair brush, an effective applica- 
tion for fissured nipples (B). Tannin, the Glycerite, one of the best applica- 
tions to fissured nipples (B). Lead Nitrate, in Glycerin, or ointment 3j to ^j, 
in fissured nipples (B). Zinc Shield, constantly worn (R). Balsam of Peru 
or Tolu, valuable as application, with Oil of Almond, gum arabic, and rose- 
water (P). Rhatany, as wash or cerate, has had great success in fissure 
(Tr) ; 1 part of extract to 15 of Cacao-butter (Wa). Nipple-shield, to give the 



660 NODES NYMPHOMANIA — OBESITY. 

nipple rest while the child sucks, gives great comfort. [Compare Lactation, 
Mastitis.] 

Prescriptions. 



R . Balsam. Peruvian., . . . 5fij. 

Olei Amygdalae, 3J SS - 

Mucil. Acaciae, spj. 

Aquae Rosae, q. s. „ 

M. Sig. — Apply to the nipples after 

each nursing. {Phillips.) 



]£ . Liq. Plumbi. Subacet. Dil., g ss. 

Ext. Opii, £j. 

Aquae Rosae, ^ iijss. 

M. Sig. — Lotion, to be used after a 
bread-and-milk poultice, for inflamed nip- 
ples. [P. Barker.) 



Nodes. 

Mercury, the Oleate of Mercury and Morphine externally, is very valuable 
(R). Potassium Iodide, as ointment in conjunction with internal use, in syph- 
ilitic nodes of children; also in non-syphilitic periosteal thickenings (R) : in 
syphilitic nodes it holds the first place, especially when pains are worse at 
night, and by heat of bed (Wa). Stramonium leaves, locally, relieve (Wa). 
[Compare Exostosis, Periostitis.] 



Nymphomania. 

Potassium Bromide, when from plethora ; not useful when relaxation, or 
from cerebral lesion (B) ; large doses required, at least gr. xx ter die (R) ; an 
abundance of evidence testifies to its value (W). Tobacco, to nausea, effect- 
ually cures, but is horribly depressing (B). Camphor, in considerable doses 
said to control inordinate sexual desire (R) ; at present not much relied on 
(Wa). Lupulin, seems worthy of fair trial (Wa). Sulphur, or dilute Sulphuric 
Acid internally, when arising from hemorrhoidal congestion, not an infrequent 
cause (Wa). 

Obesity. 

Banting Dietary is alone sufficient to improve the condition ; its chief feature 
is the exclusion of the two elements, starch and sugar, from the food; there- 
fore bread (except toast, or the crust of a common loaf), potatoes, sweet roots, 
butter, sugar, cream, beer, porter, and champagne, should be avoided. In 
one year, on this diet, Mr. Banting reduced his weight 46 pounds, and his 
girth about 12 inches; at the same time, his numerous corporeal infirmities 
were greatly mitigated or altogether removed ; but it cannot be recommended 
indiscriminately. This was the method of Hippocrates, avoiding all fats, 
starches, and sugars ; in fact, all roots or vegetables grown underground (B). 
Meat Diet, very successful in 42 cases, the diet being confined to rump-steak, 
hot water and codfish, for 14 days, absolutely excluding everything else 
(Smith, Yd- Brit Med. Jour., Nov. 20th, 1888). The Schweninger or GErtel 
method is similar, using chiefly albuminous food, excluding fat and carbo- 
hydrates, limiting the fluids drank, especially at meals, and enforcing exercise. 
Peanuts, are an excellent article of food for the corpulent (Furbringer). [See 
under Diabetes Mellitus.] Iodoform is highly efficient, but causes wasting 
and anaemia, the latter by injuring red blood corpuscles (B). Iodol, in 2-grain 
doses thrice daily, is equally effective (B). Alkalies, as solutions of Oxides or 
Bicarbonates (R) ; alkaline mineral waters, with exercise and dietary (B) ; 
serviceable (Wa) ; Liquor Potassae gss in milk, thrice daily, of established 
value (Wa) ; generally fails (R). Ammonium Bromide, sets up gastric catarrh 
(B) ; but lessens corpulency (Wa). Sulphurous Waters, especially Blue Lick, 
3iv before each meal (B). Potassium Permanganate, for attendant dyspepsia 
and flatulence ; also useful for the obesity ; gr. %.-] ter die, in aq. dest. (B). 
Vinegar, only successful at expense of serious injury to the body (R). Fucus 
Vesiculosus, has power to reduce adipose tissue ; an extract is sold under the 



ODONTALGIA CESOPHAGUS. 



66 1 



title " Antifat " as a proprietary medicine (W). Phytolacca, has been long known 
as a reducer of adipose tissue ; a resinoid preparation, named Phytoline, is on 
the market as an "anti-fat," the dose of which is n\,x, six times daily, before 
and after each meal. Exercise, daily, in the open air, is necessary, and if 
carried on systematically is the most efficient and least injurious method of 
reducing an excess of adipose tissue. 



Odontalgia. 
Aconite, as ointment or liniment for facial neuralgia due to diseased teeth, 
will succeed quickly if at all (R, Wa). Arsenic, gr. ■£$, as escharotic to destroy 
pulp ; when used for pain may be mixed with Opium ; it sometimes at first 
aggravates pain (R, W). Staphisagria, the alcoholic solution dropped into 
the cavity (P). Alum, a solution in Nitric Ether (^ij to gvij) is said to be an 
effectual application (B) ; Alum and salt powdered and placed in the cavity, 
excellent when nerve exposed. Chloral, rubbed up with equal weight of 
Camphor, put into cavity (R). Chloroform or Croton-Chloral, equal parts of 
the former and Creosote, a good application (R). Tannin, a solution in Ether 
is a good application to a carious tooth (B). Creosote, with Tannin or Opium 
or Chloroform, placed in the cavity of a decayed tooth, often gives relief (R). 
Cocaine, a 5 per cent, solution of the Hydrochlorate on cotton applied to a 
cavity will often bring instant relief. Coniine, a solution in alcohol placed 
into a hollow painful tooth (R). Collodion and Carbolic Acid, equal parts, as 
jelly for stopping carious teeth (R). Opium, mixed with Tannin or Creosote 
inserted in cavity of painful tooth (R). Morphine, hypodermically for severe 
toothache (R). Oil of Cloves, inserted into cavity (B, P). Camphor, with 
Morphine and Flaxseed, as a cataplasm to the cheek (B). Xanthoxylum, a 
domestic remedy (B). Capsicum, a strong infusion on lint (R). Gelsemium, 
useful in some forms (R). Zinc Chloride, to destroy exposed painful pulp (R). 
Ginger, Mezereon, Pyrethrum, are useful masticatories in toothache (P). 



Prescriptions. 



R. 



Linim. Aconiti (B. P.), 

Chloroformi, aa giij. 

Tinct. Capsici, 5jj. 

Tinct. Pyrethri, 
Olei Caryophylli, 
Pulv. Camphorae, . . aa gss. 
M. Sig. — A few drops to be placed on 
a pellet of cotton and applied to the cavity. 

{Mason .) 

R . Ac. Tannici, gr. xx. 

Mastiches, gr. x. 

Athens, ^ss. 

M. Sig. — On cotton to cavity. (D.) 



rj* . Creosoti, 5 ij. 

01. Caryophylli, £iv. 

01. Menth. Piperit., . . . ]f j. 

Camphorae, ^ ijss. 

Alcoholis, . . . q. s. ad Oj. 
M. Sig. — "Toothache Drops." 



R. Morphinae Sulph., . . . . gr. iv. 

Atropinae Sulph., . . . . gr. j. 

Aquae Destill., Jjj. 

M. Sig. — A few drops on cotton, placed 
in the cavity. (B.) 



CEsophagus, Affections of. 
Belladonna, the liniment with frictions to the sternum, often very useful as a 
palliative in stricture of the oesophagus (Wa). Conium, in spasmodic contrac- 
tions, with crampy pains of stomach, flatulence, and globus hystericus, has 
proved very serviceable (Wa). Hyoscyamus, or Conium, in stricture of oesoph- 
agus, if much irritability ; with occasional leeching to relieve exacerbations 
of pain or spasm (D). Silver Nitrate, in stricture of the oesophagus, a weak 
solution on sponge probang (D). Anaesthetics, should be used only to meet 
temporary indications (W). Nutrient Enemata, in stricture of the oesophagus, 
when swallowing impossible (R) ; may, in some cases, even preserve life (Wa). 
[See Enemata.] Dilatation, by bougies, in non-spasmodic (structural) strict- 
ure, the only appropriate treatment (H). [Compare Dysphagia, Choking.] 



662 ONYCHIA OPHTHALMIA. 

Onychia and Paronychia. 

Silver Nitrate, a strong solution in Nitrous Ether, painted over the adjacent 
tissue, will abort if applied early (B) ; frequently causes resolution of the 
inflammation (Wa). Lead Nitrate, dusted over night and morning (R) ; 
relieves pain and hastens healing process (B). Turpentine, applied on a piece 
of lint or other absorbent material, stops the pain at once, and seems to kill the 
felon. Mercury, as ointment, for 10 minutes in every hour ; poultices in interim 
(R). Arsenic, gr. ij ad Sjj Adipis, as ointment, almost specific in onychia 
maligna (Wa). Tartar Emetic, will shorten course and render it milder (R). 
Iodoform, oint. or powder dusted on (B) ; or i part to 9 of Ether applied by a 
dropper, in syphilitic onychia (Fox). Iodine, a strong alcoholic solution locally 
will often subdue the disorder (Wa). Chloral, a solution locally, as antiseptic, 
and to promote healing (B). Sodium Chloride, common salt roasted until 
chlorine is driven off, equal parts of this, Castile Soap and Venice Turpentine, 
as a poultice, is a very efficient application. Carbolic Acid, to benumb surface 
during incision (R) ; which should be carried down to the bone, 1 especially in 
tendinous whitlow (D). Cocaine, hypodermically, will accomplish the local 
anaesthesia more thoroughly, if delivered deeply into the tissue. Morphine, 
powdered, as local application to relieve pain. Heat, by poultices, is very use- 
ful. In Opening a felon avoid the lines of the arteries on the sides of the 
fingers, and that of the flexor tendons, which is the median line on the palmar 
surface. The incision should be made midway between these lines. If the 
sheath of the tendon be opened the tendon may slough, and the finger be ren- 
dered useless (Ashhurst). 

Ophthalmia. 

Silver Nitrate, a strong solution (gr. xx to ^j) in granular lids ; cautiously 
when corneal ulcers exist (B) ; solid stick diluted with 2 to 4 parts of Potassium 
Nitrate, applied lightly and quickly, or a solution (gr. ij-x to %}) painted over 
everted lids, which should be washed with a solution of common salt, and then 
with water before being replaced (C) ; in solution, gr. v to ^j aquae destillatae, 
locally once a day in purulent ophthalmia of the new-born, washed off with a 
weak solution of common salt (Noyes) ; in solution, gr. iij to the J, to abort 
the discharge in catarrhal ophthalmia (Fox). Boroglyceride, in many catarrhal 
affections, especially ophthalmia neonatorum, is a most efficacious application, 
the solutions used being of 10, 25 and 50 per cent, strength (Fox). Alum, gr. 
viij to ^j aquae, applied every J£ or ]/ z hour in purulent ophthalmia of children ; 
success depends on the frequency of the application (R) ; a crayon formed of 
a crystal of alum, a mild and occasionally useful application (C). Mercury, 
Calomel dusted over membrane in phlyctenular ophthalmia ; or after detach- 
ing scales rub in Brown Citrine Ointment every night, for eczema of margin of 
lids (B). Pulsatilla, as a lotion to conjunctiva 8 or 10 times in 24 hours, also 
internally (P) ; much used by homoeopaths (B). Spigelia, useful in rheumatic 
ophthalmia (P). Antimony, as Tartar Emetic, gr. ¥ X F to -^, three or four times 
a day in strumous ophthalmia, with sharp purgation at commencement (R). 
Belladonna, or Atropine, locally, of great service in strumous ophthalmia to 
relieve pain ; constitutional treatment also required (Wa) ; Atropine, gr. ij of 
neutral sulphate to the ^ of aqua destillata, twice or thrice daily, as soothing 
application (C). Arsenic, invaluable in inveterate cases of strumous ophthal- 
mia, especially when complicated with cutaneous eruptions (Wa). Copper 
Sulphate, gr. j to ^j aquae camphorae as collyrium in purulent ophthalmia of 
infants ; in substance to inner part of lids in granular conjunctivitis (Wa). 
Tannin, powdered (or in solution gr. j-x to J;j) produces remarkable results (B). 
Lead Acetate, gr. j. ad %j aquae destillatae, applied by camel's-hair pencil to sur- 
faces of everted lids, washed away before the lid is replaced ; or the Tannate 
of Lead i}4 to 3 parts fine Oil, and 1 of fresh Lard, a very small piece as oint- 
ment to lid (C). Carbonic Acid Gas, said to relieve the pain and photophobia 
of strumous ophthalmia, when locally used (R). Physostigma, to reduce pupil 



OPIUM HABIT. 663 

and shut out the light (P). Iodine, is employed in scrofulous ophthalmia, locally 
for its alterative stimulation (W). Iodoform, in gonorrhceal ophthalmia, and 
purulent conjunctivitis, of very great value locally, but should be pulverized 
very finely (Grossmann) ; does not bear out the claims made for it (Keyser). 
Zinc Chloride, gr. j ad %] aquas as collyrtum, in gonorrhceal ophthalmia, used 
with marked benefit; also a stronger solution (gr. ij-iv ad gj), effectually arrests 
the muco-purulent discharge remaining after subsidence of purulent ophthal- 
mia, and has succeeded admirably in diphtheritic conjunctivitis and pustular 
ophthalmia (Wa). Zinc Sulphate, as collyrium, gr. j-iv ad §j, is very service- 
able in ophthalmia of infants or adults ; Liquor Plumbi added improves it (Wa). 
Staphisagria, especially in tarsal ophthalmia (P). Colchicum, when gouty dia- 
thesis (P). Cod-liver Oil, in strumous subjects, tends to remove the manifesta- 
tions of the disease (R). Cold Wet Compresses, or iced, are held to be essen- 
tial in early stage of acute purulent and gonorrhceal ophthalmia (C). [Com- 
pare Blepharitis, Conjunctivitis, Keratitis.] 



Opium Habit. 

Sodium Bromide, in large and increasing doses, Z] twice daily, increased 
by 20 grains each day, to a maximum of 100 to 120 grains twice in twenty- 
four hours, with simultaneous gradual reduction of the opiate dose, so 
that from the 8th to the 10th day it is entirely abandoned ; each dose 
of the salt should be given in 6 or 8 fluid ounces of cold water : this drug, 
with Codeine and Trional, form a combination of unrivalled efficacy, if 
properly used in proper cases, and combined with minor aids make a method 
far in advance of any yet presented, to secure the minimum duration of 
treatment and maximum freedom from pain .(Mattison) : a 'combination of 
Bromides [See formula below], commencing with 40 grains twice daily, in- 
creasing to 100 grains twice daily, at 10 a. m. and 4 P. m., freely diluted with 
water, does not depress vitality, or produce the injurious results of the bromides 
as commonly administered ; this, with 3j of Warburg's Tincture before break- 
fast each morning, with the use of Spt. Etheris Nitrosi to eliminate the bromides 
rapidly, electricity, a mixture of Iron and Strychnine, and an occasional hypo- 
dermic of 5 or 10 minims of a 4 per cent, solution of Cocaine for nervous rest- 
lessness, is the general line of my treatment (Mann) : Bromides may do great 
harm, if recklessly administered, paralyzing the muscular system and causing 
prolonged delirium. Cocaine, or the fluid extract of Coca, has been used to 
relieve the depression caused by the withdrawal of the drug (B) ; has been, by 
many careful observers, pronounced of great benefit, restoring appetite, induc- 
ing sleep, promoting digestion, while soothing the brain and inducing a feeling 
of contentment and calm (R) : should never be entrusted to the patient, lest he 
jump out of the frying-pan into the fire. In the treatment of the combined 
morphine and cocaine habit, the latter drug may be withdrawn entirely at 
once without any suffering, and the former may be reduced one-half at the 
same time. Codeine, in doses of a grain or more, is very useful in combating 
the nervous agitation which succeeds to the final withdrawal of the opium. 
[See under Sodium Bromide above.] Trional. in dose of 30 to 40 grains as 
a hypnotic, is of special value in these cases. Paraldehyde, in dose of gjss-ij, 
as a hypnotic, is efficient, but its sleep is of briefer duration than that produced 
by Trional or Sulphonal. Gelsemium, subdues the restlessness and motor 
excitement; proved of great value in one case where 30 grains of morphine 
were used daily ; tt\j of tincture every }4 hour (Pennoyer). Conium, in 10-drop 
doses of a good fluid extract, to check motor activity and relieve the wander- 
ing pains. Sparteine, in doses of gr. x / z to ^ hypodermically, at moment of 
systolic cardiac depression which answers to the period of craving, and corre- 
sponds to the truncated curve of the sphygmographic trace, which is charac- 
teristic of the period when the stimulant effect of morphine has passed (Jen- 
nings). Nitroglycerin acts in the same manner, but its effect is more rapid 



664 



OPIUM HABIT. 



and more ephemeral (Idem). Cannabis Indica, may be required in full doses, 
for restlessness after withdrawal of the opiate, 3-doses of Squibb's fluid extract, 
repeated every hour or two, as required (M). Galvanism, is very efficient for 
the neuralgic pains in various parts ; a strong faradic current sometimes acting 
better (M). Baths, if hot, 105 to 112 F., are of great value to relieve dis- 
quiet ; warm baths are worthless (M). Chloral, as a hypnotic, fails in the first 
few days of abstinence ; later in full doses, 45 grains at once, rather than three 
1 5-grain doses, alone or with a Bromide, it can be relied on (M). Hyoscya- 
mine, Merck's amorphous, gr. T ^- to |- hypodermically, or more, is useful as a 
hypnotic, and perfectly safe, in patients of good general condition, in whom 
the disuse of opium produces unusual insomnia and motor activity (M). Hy- 
oscine, the Hydrobromate, in doses of gr. j^q to -^, hypodermically, is highly 
efficient for the same purpose, but must be used sparingly, as it excites high 
delirium in most subjects for a time. 

Capsicum, very serviceable from its power as a stimulant to the stomach, 
and its sedative action on the cerebrum (B) ; removes the sinking sensation at 
the pit of the stomach experienced by alcoholics, when trying to break off that 
habit (R). Lupulin, with Phosphoric Acid [see formula below], helps to sus- 
tain the patient, lessens the force of his suffering, and shortens its duration 
(Fleming). Zinc and Iron as blood tonics, given for a month at least, are 
valuable, and are best given on alternate days (Fleming) [see formula below]. 
Piscidia Erythrina, has been proposed as a substitute, and highly commended, 
but is worthless, as are also Avena Sativa and many other falsely termed sub- 
stitutes (M) ; there is no remedy for the opium habit (Da C). Zinc Oxide, for 
the vomiting and diarrhoea, beginning with gr. j once daily and increasing 
to tolerance (Da C). Withdrawal of the drug suddenly and completely, is 
the method of Levinstein and other Germans, and is preferred when we can 
have absolute control and surveillance of the patient (Da C) ; entails horrible 
suffering, and,, is utterly inexcusable (M) : a more gradual reduction is the 
method usually employed, taking off one-third the first day, one-fourth the 
second day, and then gradually reducing the amount until the sixth or seventh 
day, when it is entirely withdrawn. No agent is of any value unless strength- 
ened by moral courage and perseverance on the part of the patient (Squibb). 
Useless to try to cure a patient while he is pursuing his ordinary avocations ; 
failure will result unless there is complete seclusion and entire giving up to 
the treatment (Mann). It is very important to keep the patient in total ignor- 
ance of the rate of reduction. 

Prescriptions. 
Combination of Bromides. 
R . Ammonii Bromidi, 

Sodii Bromidi, . . . . aa Jf ss. 

Potassii Bromidi, . . . . ^j. 

Liq. Potass. Arsenit, . . £j. 

Syr. Tolutan., t ^j. 

Aquae Menthae Piper., . . ,^jss. 

Syr. Hypophos. Comp., . Jiij. 
M. Sig. — ^j to 3 ij in water thrice 



Has of total Bromides, gr. 2\y 
% . (Mann. 



daily, 
in each 

R • Tinct. Capsici, 

Potassi Bromidi, . . . aa ^iv. 

Spt. Ammoniae Aromat, . ^ iij. 

Aquae Camphorae, . q. s. ad ^vj. 
M. Sig. — A dessertsp. several times 
daily, in the depression of alcoholism and 
opium - habit. Instead of the bromide, 
Fowler's Solution (Liq. Potass. Arsenitis), 
rr\,l, may be added; or Tinct. Nucis 
Vomicae 3 ij, or Tinct. Aurantii Amari 3 v. 

(Ringer.} 



R . Codeinae, gr. xvj. 

Alcoholis, ... q. s. ad solv. 

Cocainae Hydrochlor., . . gr. xvj. 

Elixir Simplicis, . q. s. ad ^ij. 
M. Sig. — gj in water, occasionally, 
when great restlessness. Formula never 
to be given to patient. (Potter.*) 



R 



M 



Tinct. Cannabis Ind., . . tt\xl-lx. 

Spt. yEtheris, % j 

Aquae, .... q. s. ad £]. 

Sig. — One dose, if insomnia is very 



protracted. 



R 



(Fleming.) 



Tinct. Nucis Vomicae, . . 5 iij. 
Ac. Phosphor. Diluti, . , 3 v. 
Syr. Pruni Virg., . . . . ?ij. 
Aquae, . . . . q. s. ad J iv. 
M. Sig. — 3 i j twice daily as a nerve 
tonic. (Potter.) 



ORCHITIS — OTALGIA OTITIS. 665 

Orchitis. 

Pulsatilla, rr\J or less, every hour, relieves pain rapidly, though not the 
oedema (St). Belladonna, int., and as oint. (Extract j ad iij Adipis) when in- 
flammation has subsided (Wa). Sodium Salicylate, in gonorrhceal orchitis, 
subdues pain in a few hours. Iodine, tinct. locally to remove swelling after the 
acute stage has passed (B). Mercury, the Oleate locally (B) ; Calomel gr. iij 
with Ipecac, gr. x at once, followed by a saline next morning, and smaller 
doses of Calomel and Ipecac every 6 hours, with Morphine hypodermically, 
gr. X into cellular tissue of scrotum (McElroy). Ammonium Chloride, makes 
a good evaporating lotion, in solution with alcohol and water (R). Silver 
Nitrate, a strong solution to the scrotum, with gentle pressure (Wa). Tartar 
Emetic, in acute orchitis (R). Digitalis, locally, is found most useful (P). 
Alcohol, with equal quantity of water, as evaporating lotion (B). Ice, benefits 
and relieves pain (B). [Compare Epididymitis.] 



Prescriptions. 



R- . Ammonii Chloridi, . . . . gr. xl. 

Alcoholis, Aquse, . . aa ^ ij. 

M. Sig. — Lotion, to be applied 
cloths to the part. 



R. Hydrarg. Ammoniat., . . gj. 

Cerati Simplicis, Jj. 

M. ft. unguent. Sig. — Apply locally, 
with gentle friction. 



Otalgia. 

Aconite and Opium, equal parts of the tinctures, a few drops well down the 
external meatus, will usually subdue the pain. Blistering Fluid, or Croton Oil 
Liniment, behind the ear often relieves earache (R). Glycerin, for dryness 
of meatus (R) ; or Olive Oil for accumulation of wax in external meatus dropped 
in every night, gentle syringing in the morning with warm water (CI). Opium, 
Morphine in solution, gr. iv to the ^, with gr. j — ij of Atropine, is an excellent 
application (B). Atropine, gr. -^ in gxx of water, a teasp. every three hours 
for a child in the acute otitis media of children from coryza, very successfully 
used to abort the otitis, and relieve the earache (Miot) ; a solution locally is 
especially applicable in the earache of children from whatever cause, gr. j to 
the §, of which gtt. iv dropped into ear to remain for 10 or 15 minutes. Pul- 
satilla, internally and externally, is often used with advantage (P). Cocaine, 
a 4 per cent, solution sprayed over the tympanic membrane through the exter- 
nal meatus, and forced into the Eustachian tubes by inhaling the vapor and 
then expanding the tubes by Valsalva's method ; this repeated every three 
minutes is a very sure method of curing otalgia (R). Olive Oil, often used 
warm, as local application, but is of no service, and may do harm by under- 
going decomposition and becoming favorable soil for the growth of aspergillus 
or other vegetable fungi. [Compare Otitis.] 



Otitis. 

Pulsatilla, in inflammation of external auditory canal ; in otitis, as lotion 
warmed and applied by syringe, three or four times a day (P). Aconite, 
quickly relieves the pain (R) ; should be used internally and locally. Carbolic 
Acid, a 20 per cent, solution instilled into ear in moderate otitis, relieves 
pain at once and checks progress ; a solution in Glycerin is best (Rohrer). 
Atropine, in the acute otitis media of children, is very efficient. [See Otalgia, 
above.] Blisters, behind ears, either kept discharging or repeated, often 
very useful (Wa). Leeches, behind the ear, afterwards a small blister upon 
the same place, when leech-bites have healed (H). Warm Douche frequently, 
to the ear, to secure cleanliness, then drying the parts (Roosa). [Compare 
Otalgia.] 



666 OTORRHCEA OVARIAN NEURALGIAr— OVARITIS. 

Otorrhcea. 

Salol and Camphor, equal parts, heated together, have given good results in 
suppuration of the middle ear ; the application causes neither pain nor inflam- 
mation (Pegon). Bismuth Subgallate (Dermatol), on cotton tampon, intro- 
duced after thorough syringing with a 3 per cent, solution of Boric Acid, and 
careful drying with absorbent cotton,— the best means of combating an acute 
or chronic otorrhcea, outside surgical measures (Chaniavsky). Boric Acid, 
finely pulverized, as astringent and disinfectant application ; may be mixed 
with pulv. Alum, and just enough powdered Lycopodium to keep it dry ; — this 
packed carefully through speculum, after washing with a weak and tepid alka- 
line solution. Absorbent Cotton, on holder, may be used every few hours by 
patient to keep pus removed from the canal. Syringing with warm salt water, 
once daily ; as absolute cleanliness is essential in the treatment. Politzer Bag 
is a useful adjunct in keeping secretions out of tympanum and breaking up ad- 
hesions (Roosa). Mercury, in chronic cases, the Brown Citrine Ointment (B). 
Lead lotions much employed (B). [See Gonorrhoea, for formula.] Potas- 
sium Permanganate, as injection ok spray, gr. j to ^j aq. destil. (B). Silver 
Nitrate, locally, a solution of gr. iv to the % (B) ; gr. x to the % (Roosa). Cop- 
per Sulphate, gr. j-v to the ^ (Roosa). Tannin, the Glycerite, locally, is suc- 
cessful (B) ; especially in children (Wa). Zinc Sulphate, locally, in solutions 
of gr. ij-viij to the % (B) ; gr. j-v to the S§ (Roosa). Cadmium, gr. ij to gj 
rose-water (B). Liquor Sodae Chloratse, TT^xv-xxx ad ^j aquae when discharge 
fetid ; is highly useful as injection (Wa). Quinine, with Sulphuric Acid, advis- 
able in otorrhcea after scarlatina (Wa). [Compare Otitis.] 



Ovarian Neuralgia. 

Atropine, subcutaneously, the best remedy for pain in the pelvic viscera 
(Wa). Ammonium Chloride, gr. xxx with gtt. ij-v Tinct. Aconiti, repeated in 
)4-hour if necessary, to remove pain (W). Camphor, with Cannabis Indica, of 
great service in relieving ovarian pain, especially when spasmodic in character 
(Wa). Opium, often the cause ; if use stopped entirely improvement may 
ensue (E) ; one of the best remedies in ovarian pain of non-inflammatory 
character (Graily Hewitt). Codeine, has especial value against ovarian pain 
(Freund), whether of inflammatory or neuralgic origin, in dose of gr. % at least. 
Conium, or, better still, its alkaloid, used as a vaginal pessary, in all cases of 
ovarian pain, whether neuralgic or inflammatory, is quite a specific (Meadows). 
Hot Water, vaginal injections, night and morning; sunlight baths, fresh air 
(E). Ether, the compound spirit, in doses of rr\,xxx-xl as a palliative (Anstie). 
Gelsemium, deserves a trial ; its power is great but not certain (Wa). Leeches 
over the groin, or inside the thigh, where ovarian pain persistent, or tenderness 
and aching (Wa). Surgical, Battey's operation as a last resort (E). [Com- 
pare Dysmenorrhea.] 

Ovaritis. 

Turpentine Epithems, may be applied hot over the seat of the disease (Wa). 
Tartar Emetic, as ointment for counter-irritation over seat of disease, in sub- 
acute ovaritis; at same time a pill of Opium, Hemp and Camphor (Hewitt). 
[See formula below.] Opium, in suppository or enema, more effectual than 
internally (Tilt). Mercurial Ointment, combined with Camphor and Bella- 
donna, over the seat of the disease by friction (West). Blisters, in subacute 
ovaritis are often of great service, placed over the region or to the cervix uteri 
(Wa). Enemas, of warm water, simple or medicated, in subacute ovaritis, 
are warmly recommended ; they should be retained as long as possible (Wa). 
Salix Nigra, the " pussy willow," in doses of tt\,xxx of the fluid extract thrice 
daily, of decided benefit in ovarian hyperesthesia, etc., of highly nervous 
women. Ergot, is valuable in chronic ovaritis, with rest and Potassium Bro- 



OXALURIA OZ^ENA. 



667 



mide (Tait). Ice, in bag, over seat of pain, when intolerable, and patient too 
much reduced to bear leeches ; is often of benefit (Wa). Poultices of Linseed 
meal, as light as possible, often produce great benefit in ovarian inflammation. 



Prescriptions. 



R. 



gr. iij. 



Ext. Opii, .... 
Ext. Cannabis Ind., 

Camphorse, aa gr. vj. 

M. ft. pil. no. vj. Sig. — One pill twice 
dai ly . ( Gra ily Hewitt. ) 



R. Ung. Hydrargyri, . . . . ^vj. 

Camphorse, gr. xl. 

Ext. Belladonnse, . . . . gij. 
M. ft, unguent. Sig. — To be rubbed in 
twice daily. ( West.) 



Oxaluria. 

Mineral Acids, when eructations of sulphuretted hydrogen (R). Nitro- 
muriatic Acid, renders important service (B) ; especially in the condition show- 
ing general malaise, weakness, and depression of spirits, with oxalate crystals 
in the urine (W) ; also in sciatica and other forms of neuralgic rheumatism 
accompanied with oxaluria, full doses (tt\,vj-x) °f this acid, with an occasional 
brisk purgative, and cold douche, followed by friction (Wa). Zinc Sulphate, 
often very serviceable in irritability of the nervous system, associated with dys- 
pepsia and oxaluria (Bird). Lactic Acid, aids imperfect digestion (B). [Com- 
pare Dyspepsia.] 

Ozaena. 

Gold, the auric salts are very serviceable in syphilitic ozaena (B). Mercury, 
the Ointment of the Nitrate in syphilitic form ; the White or Red Precipitate 
with 58 times its weight of sugar, snuffed after clearing the nose, in non-syphi- 
litic forms (R). Potassium Permanganate, Z] to Oj solution as an injection or 
spray (B). Hydrastis, the fluid extract locally (B) ; Z) to 3 viij solution as 
lotion with tt^v of the tincture internally thrice daily (P). Bromine, as inha- 
lation, [See formula below] ; or Iodine with Carbolic Acid, or the latter in one 
per cent, solution, as inhalations (B). Carbolic Acid, inhaled, 1 per cent, solu- 
tion (B). Silver Nitrate, applied behind veil of palate ; — gr. v-xx ad ^j (B). 
Alum, solution (3j to Oj) for irrigation (R.). Glycerite of Tannin, by irrigation 
(R). Salicylic Acid, in very weak solution (1 to 500), as cleansing, astringent, 
and disinfectant wash, used by retro-pharyngeal syringe, and followed by ap- 
plications of Calomel, in powder, to the ulcerated portions of the mucous 
membrane (Massei). Hydrogen Dioxide, the solution as spray, is a most excel- 
lent application. Salol, has done good service, as insufflation. Strontium 
Iodide, has been used in scrofulous ozaena, with varied results. Cubeb, the 
Oleo-resin, gtt. xv-xx on sugar after each meal, to restrain the secretion and 
perhaps modify its character (Cohen). Calcium Chloride, gr. xxx-lx with ^j 
Decocti Kramerise ; of which ^ij-iij, diluted with an equal quantity of water, 
should be injected twice daily after cleansing with salt and water (Cohen). 
[Compare Catarrh, Chronic Nasal.] 

Prescriptions. 



R. Tinct. Iodi, giv. 

Ac. Carbolici 3J-ij 

M. Sig. — Use on sponge in a wide- 
mouthed bottle as inhalation. To be va- 
porized by heat of hand. {Potter.) 



R. Bromi, p^ss. 

Alcoholis, ^ ss. 

M. Sig. — Inhalation when vaporized 
by heat of the hand. 



3>J- 



R . Sodii Carbonatis, 

Sodii Boratis, .... aa sjij. 

Liq. Sodse Chloratae, . . . ^ss- 

Glycerini, ^j. 

Aquae, q. s. ad ^ vj. 

M. Sig. — Apply by means of a hand- 
spray apparatus. {Thornton.') 



R. Acidi Carbolici, rrvxx. 

Aquas Calcis, Oj. 

M. Sig. — Use as wash or spray. 



66S pain. 



Pain. 



Opium, is universally used to quiet pain. Morphine, hypodermically, in 
vicinity of nerve, is curative when not so by stomach ; Morphinae Acetas vel 
Sulphas gr. l /e to yi t with Atropine gr. T | 7 to T \-^ ; Caution ! morphine habit (B) : 
sometimes a single injection curative of sciatica and neuralgia. Poultices con- 
taining Laudanum useful in inflammation. Linimentum Opii by friction, relieves 
pleurodynia, neuralgia, etc. The conjoint administration of Morphine and 
Antipyrin is much more efficient than the use of either agent alone to relieve 
pain. Opiates soon lose their influence in any certain dose, requiring increased 
quantities to keep up analgesic influence, so in chronic cases it is best to exhaust 
all other means before resorting thereto (R). Codeine, has special influence 
over abdominal pain, and that of the ovaries, besides being safe as to habit. 
Chloral, has no direct pain-relieving power, except in dangerous doses. To 
relieve pain and promote sleep, the best agent is a combination of Chloral and 
Morphine ; cautiously, if heart trouble, or to old drunkards ; gr. xv-xxx -J- gr. 
% (B) : sometimes relieves neuralgia and pain of chronic rheumatism, gall- 
stones, colic, gastralgia, and even of cancer (R). Aconitine, locally over seat 
of pain ; one of the most certain and powerful palliatives in neuralgic, rheu- 
matic, and gouty affections (Wa) ; especially serviceable in neuralgia of 5th 
nerve (B). Belladonna, the best remedy for every kind of pain in pelvic 
viscera (Anstie). Atropine, hypodermically in local pain, neuralgia, sciatica, 
glaucoma, etc. ; when it succeeds, has more lasting effect than morphine (R) ; 
for sciatica, tic douloureux, etc. (B). Iodides, are magical in syphilitic nocturnal 
pains of head (B) ; the Ammonium Iodide, gr. iij ad ^j 01. Olivae, with friction ; 
causes the disappearance of nocturnal syphilitic pains (W). Cimicifuga, relieves 
many kinds of pain, as neuralgia of 5th, rheumatic headache, ovarian neuralgia, 
dysmenorrhcea ; inferior to Ergot in labor-pains or after-pains ; Z) doses (B). 
Conium, in cancer, rheumatism, neuralgia, ovarian pain, etc. (R) ; also for the 
fulgurant pains of locomotor ataxia, chronic alcoholism, sciatica, phthisis, etc., 
doses of rr^x of a fluid extr. of the unripe fruit every % hour, well watched 
(Madigan). Iron, with Belladonna, for the wandering pains of anaemia, in 
which Morphine is dangerous and Bromides useless (Waugh). Antipyrin, a 
most efficient analgesic ; may be administered hypodermically : is especially 
adapted to neuralgiae, migraine, and gouty pains. [See ante, page 120, also 
Opium, above.] Theine, of very great value for neuralgic pain ; affects the 
nerve outwardly along its course from the site of the injection (Mays). Chloro- 
form, locally, inferior to other local anaesthetics, two or three drops on cotton 
into the ear for faceache or toothache ; vapor on raw surface of cancers, for 
neuralgia of uterus, photophobic eye, etc. ; by inhalation in renal and biliary 
colic, and to produce general anaesthesia, which see (R). Ether, spray for local 
anaesthesia ; inhaled for general anaesthesia (R). Carbolic Acid, as local anaes- 
thetic (R). Cocaine, as a local anaesthetic to mucous surfaces, or hypodermic- 
ally for minor operations involving a small area, as circumcision, eye oper- 
ations, etc., has no equal ; a 4 per cent, solution of the Hydrochlorate is 
generally employed (R) ; has many applications, as odontalgia, otalgia, neu- 
ralgia of superficial nerves, etc. Iodoform, as suppository in painful diseases 
of the rectum or bladder (R). Stramonium, is used as ointment (R). Dubois- 
ine, used instead of Atropine (B). Rhatany, relieves the pain of ulcerative 
disease of mucous membranes, pain of burns, ulcers, and especially of blisters 
(Tr). Cannabis Indica, formerly used (B). Aquapuncture (B). [See Neural- 
gia.] Galvanism, of an affected nerve gives certain relief ; the positive pole 
on point of emergence, — negative over superior ganglion of cervical sympa- 
thetic (B). Heat, if pain is without fever or inflammation (B) ; warm injections 
soothe the pain of cystitis, prostatitis and abdominal pains generally (B). Hot 
Water, as bath, relieves pain most wonderfully. Napoleon, on St. Helena, 
suffering from cancer of the stomach, appreciated highly the pain-relieving 
power of the hot bath ; often staying half and even whole days therein. Cold, 
when pain is inflammatory (B). [See After-pains, Anaesthesia, Boils, 
Chest-pains, Colic, Gastralgia, Headache, Hepatalgia, Inflammation, 



PARALYSIS. 669 

Lumbago, Myalgia, Neuralgia, Odontalgia, Otalgia, Ovarian Neural- 
gia, Rheumatism, etc.] 

Prescriptions. 



R . Antipyrini, gr. xv. 

Cocainae Hydrochlor., . . gr. ss. 
Aquae Destil., Tlpcy. 



M. Sig. — One-half as hypodermic in- 
jection, or the whole when rapid action de- 
sired. (Sie.) 



Paralysis. 

Strychnine, internally, gr. -^ to f^ [gr. gV to tV ( r ) ] '■> also hypodermically 
into the affected muscles, — for hemiplegia, paraplegia, local, mercurial, paludal, 
rheumatismal, facial, infantile, and diphtheritic paralyses; in that of spinal 
muscles, of bladder and all local forms (B) ; often of use in hysterical (P) ; all 
forms, except, according to Barwell, in cerebral and spinal paralyses (R). Nu-x 
Vomica, in hysterical, and in that from lead-poisoning; only in chronic cases 
(P) ; in paraplegia from softening and wasting of cord (Brown-Sequard). 
Ignatia, in paralysis of lower extremities (P). Cannabis Indica, for retention 
of urine in spinal paralysis (R). Rhus Toxicodendron, is certainly efficacious 
in paralysis depending on rheumatism (P). Ammonium Iodide and Carbonate, 
to aid in absorption of thrombi, thus promoting cerebral nutrition in cases of 
incipient hemiplegia, due to endarteritis deformans reducing the lumen of the 
vessels in the brain (B). [See formula below.] Arnica, in paralysis of the 
bladder, and many forms (P). Phosphorus, with Cod-liver Oil in the paralysis 
of white softening of the brain (B) ; in hysterical paralysis (R) ; in myelitic 
paraplegia from excessive venery ; the only drug which really affects the nerve- 
centres (W). Belladonna, when depending on chronic inflammation of the 
cord (R) ; externally as ointment along spine, with Ergot internally (Brown- 
Sequard). Physostigma, into the eye in ocular paralyses (B) ; in general 
paralysis of the insane, also in progressive muscular atrophy without much 
mental disorder, long-standing hemiplegia, paraplegia, locomotor ataxia (R). 
Ergot, in paralysis of bladder from over-distention (B) ; paralytic dysuria, 
sensation of but partial emptying of bladder (P) ; said to be useful in para- 
plegia (R) ; in paraplegia complicated with menstrual irregularity and forms of 
paralysis arising from spinal congestion (Wa) ; has cured cases of constipation 
of the paralytic when all the most powerful cathartics failed (Curran). Cocculus 
Indicus, valuable in hemiplegia, paraplegia, and paralytic stiffness (P). Picro- 
toxin has greatly benefited several forms, especially paralysis of the sphincters, 
hemiplegia from cold, and glosso-labio-laryngeal paralysis. Capsicum, in y 2 
to 2-grain doses every 4 hours as general stimulant (P). Colocynth, in cerebral 
paralyses, sometimes seems to act favorably upon principles of revulsion or 
counter-irritation (P). Mustard, as an emetic to stimulate failing heart in 
certain forms of paralysis (P). Senega, in rheumatic paralysis, is a powerful 
help (P). Nutmeg, the Oil as external stimulant (P). Oil of Bay, has been 
given ; is obsolete (P). Cajuput Oil, efficacious in palsy (P). Counter-irrita- 
tion, by blistering fluid in peripheral paralysis of the 7th nerve (R). Cod-liver 
Oil, Anstie insists on it when low nutrition and faulty assimilation (B). Gal- 
vanism, in hemiplegia and many forms (B). Electricity, faradization of the 
muscles affected. Localized electricity probably of more importance in con- 
firmed spinal paralysis than medicinal treatment. Massage, in infantile 
paralysis, given with Calcium Lactophosphate and Cod-liver Oil. Strychnine 
injected into the muscles (B). [Compare Hemiplegia, Locomotor Ataxia, 
Tongue, Paralysis Agitans.] 

Prescriptions. 

R . Ammonii Iodidi, £ j. 



R. Strychninae Sulph., .... gr. iij. 
Aquae Destillatae (fervid), . 3 x. 
M. Sig. — For hypodermic administra- 
tion : TT^x = gr. 2V °f Strychnine Sulphate. 



Ammonii Carbonatis, . . . ^ij. 
Liq. Ammonii Acetatis, . . §yj. 
M. Sig. — A tablesp. thrice daily. See 
Ammonium, above. (B.) 



67O PARALYSIS AGITANS PAROTITIS PEDICULI. 

Paralysis Agitans and Tremor. 

Hyoscyamus, full doses of the tincture, to palliate the trembling of paralysis 
agitans and mercurial tremor. Hyoscyamine, gr. ^ gradually increased to'gr. 
yL, in paralysis agitans and locomotor ataxia (B). Hyoscine, the Hydrobro- 
mate, gr. y^ or less, efficiently but temporarily controls the tremor of paralysis 
agitans ; is a useful drug in diseases in which tremor is a marked symptom, as 
disseminated sclerosis, delirium tremens, etc., and has the great advantage of 
being in most circumstances quite safe (Weatherly). Sodium Borate, gr. xv- 
xlv daily, in 3 or 4 doses, produced most striking improvement in a case of 
paralysis agitans which developed after a fall upon the shoulder (Sacaze). 
Phosphorus in small doses, with Cod-liver Oil, is very useful (R). Hypophos- 
phites, the Syrup ought to be of service, if taken steadily for a long time. Cod- 
liver Oil, long continued, is more constantly useful than any other medicine 
(Anstie). Conium, has benefited some cases (Harley) : Conii'ne will control 
excessive tremor in many instances. Veratrine, has been used successfully in 
tremor due to alcoholism, disseminated sclerosis, and weakness after typhoid 
fever (Ferris). Calcium salts were given by me in one case of tremor occur- 
ring at the commencement of general paralysis, resulting in the tremor ceasing 
for several months (Br). Cannabis Indica in large doses, will lower reflex 
activity. Picrotoxin has greatly benefited some cases. Gelsemium in full 
doses, may palliate excessive tremor. Opium, Arsenic and Hyoscyamine 
may be tried, but the disease is incurable, and nothing can be done except to 
attend to the physical comfort of the patient ; there is no treatment which can 
be recommended as satisfactory in any respect (O). [Compare Chorea, De- 
lirium Tremens ; also Brnntori s Pharmacology, etc., 3d edition, page 133, for 
the Pathology of Tremor.] 

Parotitis. 

Aconite, in febrile conditions (R). Mercury, y£ grain of Gray Powder, 3 or 
4 times a day, is very useful, relieving pain and swelling (R). Poultice of 
Flaxseed meal, a good local application for gland. Leeching-, often gives 
speedy relief, when pain is great and resists hot fomentations (Wa). Care to 
avoid chilling, important. Incision, when suppuration occurs. Stimulants 
and Tonics internally are very necessary in symptomatic parotitis, occurring 
as a complication or sequel of other diseases, with adynamic symptoms. 



Pediculi. 

Mercury, as Citrine Ointment or a wash of Corrosive Sublimate solution, for 
lice on all parts of body ; the Oleate destroys lice immediately, and also kills 
the ova (R) : for crab-lice the ordinary Blue Oint. is very disagreeable, and 
often toxic in its effect on the patient ; a better preparation is Calomel in 5 per 
cent, oint., or the Bichloride, a 1 per cent, solution in alcohol, of which a teasp. 
to a pint of w water, as a bath to parts twice daily. Cocculus Indicus, destroys 
pediculi (P) ; the tincture undiluted as a wash. Staphisagria, as Oil or oint- 
ment of the powdered drug (R) ; " lice-bane " (P) ; the tincture a very efficient 
application, and much more cleanly than an oil or an ointment. Acetum, — 
Vinegar will kill the nits, as it softens the adhesive chitin by which the ova are 
glued to the hairs. Benzol, is a very efficient, convenient and cleanly applica- 
tion for destroying pediculi capitis or pubis, if fire or light be carefully avoided : 
a single application is usually sufficient. Ether, washed over the parts, effectu- 
ally destroys crab-lice. Tobacco, a decoction of the leaf is an efficient appli- 
cation, but requires care, especially if the surface is abraded (Wa). Essential 
Oils, will kill pediculi, as Rosemary, Anise (P) ; or powdered Pyrethrum (R). 
Cleanliness, cannot be dispensed with, and in many cases may alone be suffi- 
cient. Boil the underclothing. Isolation of person, and of brushes, towels, 
etc., to prevent infection. In Vienna the following prescriptions are used : — 



PEMPHIGUS PERICARDITIS PERIOSTITIS. 



67I 



Prescriptions. 



R. Bals. Peruvian., 

Petrolei, aa part. xv. 

Olei Pichuri (Oil of Laur- 
el), part. j. 

To be applied and washed off after 3 
hours. 



R . Ac. wSalicylici, part, ij-iij. 

Aceti, part. xxv. 

Alcoholis (80 per cent.), part. Ixxv. 
To be rubbed on with a bit of flannel. 
One application is often enough. 



Pemphigus. 

Antipyrin, internally, for the itching, is efficient. Arsenic, is curative, espe- 
cially when chronic (B) ; largest dose, n^v Liquor Arsen. 3 times a day, on full 
stomach (R) ; exercises a powerful influence (Wa). Mercury, as Citrine Oint- 
ment is largely used (Wa). Potassium Iodide, improves the condition in 
pemphigus (Wa) ; with good, simple diet ; Quinine, Cod-liver Oil, etc. Silver 
Nitrate, in pemphigus, after the bullae have burst, and excoriations remain (gr. 
ij ad ^j aquae) (Wa). Water Dressings, on lint, covered with oiled silk, con- 
stantly, in pemphigus and rupia (Wa). Cod-liver Oil, with nutritious diet, is 
a powerful auxiliary to treatment (Wa). Puncturing the blebs and evacuation 
of their contents is necessary as soon as formed ; then dusting-powders of Zinc 
Oxide, Starch, or Buckwheat flour, or lotions of Liquor Plumbi Subacetatis 
Dilutus. 

Pericarditis. 

Aconite, when violent throbbing and extreme pain (R) ; of great value, if 
given early (P) ; proves in the highest degree serviceable, when object is to 
diminish vascular excitement or irritability (Wa). Spigelia Anthelmia, useful 
in rheumatic pericarditis (P). Digitalis, when rapid and feeble heart, cyan- 
osis and dropsy (P, N) ; in second stage when heart flags, a tablespoonful of 
the infusion every 4 hours is beneficial. Bryonia, exceedingly valuable in 
second stage, that of exudation ; fully equals any remedy in pericarditis (P). 
Opium, regularly in grain doses, every 3, 4, 6, or 8 hours, is very beneficial 
(Wa). Veratrum Viride, extract made by inspissating the juice of the root, of 
which gr. ij, with gr. j of Calomel, every 2 hours, valuable (Waring-Curran). 
Quinine, gr. xv-xx may suppress an acute attack, if given at critical moment 
(B) ; may be used as an antipyretic. Counter-irritation, has been much 
abused ; useful at commencement, but not in acute inflammatory stage (B) ; by 
Iodine painted over the cardiac region, or flying blisters in the second stage. 
Iron, the tincture in full doses may be required in the second stage. Poultices, 
large, hot, often renewed (R). Ice may be used instead of poultices in the 
early stage. Paracentesis, by aspiration may be required in the second stage. 
[Compare Endocarditis.] 

Periostitis. 

Mezereon, in the rheumatic and scrofulous form (P). Mercury and Mor- 
phine, the Oleate externally (R). Potassium Iodide, in syphilitic children, 
also in non-syphilitic periosteal thickening (R) ; holds the first place for syphi- 
litic affections of the bones (Wa). Ammonium Iodide, cures periostitis most 
readily when syphilitic (Wa). Staphisagria, when long bones affected (P). 
Iodine, the tincture, or blisters locally of great service in chronic form (R) ; 
under the external use of Iodine it often rapidly improves (Wa). Poultices, 
after an early and free incision, when suppuration takes place (C). Incisions, 
carried deeply, should be made without waiting for fluctuation, when great ten- 
sion exists and there is a tendency to suppuration; the sides of the abscess 
should then be brought together with compresses and a bandage (Gross). 
Tonics and Stimulants, as milk-punch, Quinine, Iron, and Opium, in full and 
sustained doses, are imperatively demanded in many cases (Gross). [Compare 
Nodes, Onychia.] 



672 PERITONITIS PERSPIRATION. 

Peritonitis. 

Phenacetin, as an antipyretic ; is efficient and safe. Aconite, of great utility 
when sthenic reaction ; [See Opium below] ; should be given early in all 
inflammations of serous membranes (P). Bryonia, exceedingly valuable 
in second stage, when exudation (P). Mercury, when tendency to fibrinous 
exudations, is employed with good effect (W). Opium, to quiet intestinal 
movements (R) ; by far the best agent (P). Morphine, gr. % hypoder- 
mically, will often abort, if given early. Aconite and Opium, the tinctures, 
gtt. ij of the former with gtt. vj of the latter, in water every hour or two ; a 
larger dose of opium if pain is severe (B) ; large doses of opium easily borne 
in this affection (Wa). Cocculus Indicus, for tympanites ; a few doses will often 
remove the pain and relieve distention (P). Quinine, strongly urged by Trous- 
seau; is naturally indicated in most inflammations (P). Turpentine, for tym- 
panites (P) ; turpentine stupes, v-xv drops of turpentine on flannel wrung out 
of hot water during acute stage, then blisters for a short time (B). Leeches, to 
abdomen, if patient plethoric, and sthenic reaction, relieve pain (B). Purga- 
tives, are inadmissible when from perityphlitis or inflammation of appendix 
vermiformis (B). Poultices, large, hot, and frequently renewed; should be 
thin, and covered with cotton-wool (R). Ice, to abdomen (B) ; cold relieves 
(W). Hot Water, as fomentations to relieve pain, sometimes cold, compress 
better. Ice, sucked or swallowed, to assuage the vomiting ; sips of cold water. 
Diet, after acuteness of attack passed, should be mild and unstimulating. 
[Compare Puerperal Peritonitis.] 



Perspiration. 

Belladonna, as liniment locally, also the tincture internally, especially in 
weakly children who sweat profusely (R). Atropine, gr. ^^ to y^ hypoder. 
(or in exceptional cases even gr. -£$ in pill), in sweating of phthisis and exhaust- 
ing diseases (R) ; gr. -^ at bedtime for sweats of phthisis (B). Jaborandi, gr. 
-£q of Pilocarpine, thrice daily, checks profuse perspiration (R, Pf ). Naphtol, 
in a 5 per cent, ointment or alcoholic solution, is a very efficient application for 
local sweating (Kaposi). Potentilla Sarmentosa, the Cinquefoil, an infusion of 
the vine, leaves, and root, may be drunk ad libitum, and is a very efficient 
remedy for night-sweats, having stopped them when Atropine failed to relieve 
(Pope). Salvia, the ordinary Sage-tea is very efficient, used internally and 
locally by sponging the body ; the infusion for night-sweats of phthisis (Da C). 
Quinine, in exhausting diseases ; in many, a night-draught of Quinine, Zinc 
Sulphate and Sulphuric- Acid, useful (R). Opium, as Dover's powder, may 
succeed in profuse colliquative sweating (R) ; a fact, though hard to account 
for it (Wa). Agaricine, is used successfully, (See formula below). Agaricic 
Acid, in dose of gr. T ^ to \ f not hypodermically, one of the most efficient agents 
against sweating from various causes* especially that after influenza ; in over 
two years use, it only failed me in one case (Richards). Camphoric Acid, gr. 
x-xxx, dry on the tongue, not over 2 hours before the expected sweating, is 
remarkably efficient against sweating from various causes, especially that of 
phthisis even when very profuse (Jas. Wood). Aromatic Sulphuric Acid, 
to check sweats of phthisis ; bad for digestion (B). Muscarine, has been used 
with great success in the sweats of phthisis and of other morbid states (R). 
Zinc Oleate, rapidly controls excessive and offensive sweating on slight 
exertion in the axillae and groins, also the night-sweats of phthisis (Murrell), 
Zinc Oxide, gr. iij, with gr. ss of Ext. Belladonnas, in a pill at bedtime for the 
sweats of phthisis (R). Gallic Acid, is very useful for the same condition, and 
may be combined with Extract of Belladonna (B). Tannic Acid, may also be 
used with benefit. Aluminum, the Oleate, checks hyperidrosis and antiseptizes 
the sweat, thus forming a useful application to the axillae and groins of children 
(Wa). Potassium Permang., gr. j in ^j of water, for fetid perspirations of 
axillae, feet, etc. (B). Salicin, profuse sweats of hectic fever (Wa). Salicylic 



PERTUSSIS. 



673 



Acid, in solution with Borax, the most agreeable and efficient deodorant for 
fetid perspirations (B). Carbolic Acid, 2 parts to 3 of Glycerin and water, twice 
daily for fetid sweat (Wa), Oils, rubbed into the whole skin to prevent sweat- 
ing accompanying exhausting diseases, as phthisis ; but sponging with a weak 
acid wash better (R). Ergot, said to arrest sweating (R). Sponging, with 
acidulated water, or very hot sponging in phthisis (R). [Compare Feet.] 



Prescriptions. 



& . Acidi Gallici, gr. xxx 

Ext. Belladonnae, . . . . gr. ij. 
M. ft. pil. x. Sig. — Two at bedtime. 



R- 



Acidi Tannici, gr. xxx. 

Pulv. Digitalis, gr. xv. 

Ext. Cinchonse, q. s. 

M. ft. pil. xx. Sig. — One at bedtime. 



R. Agaricinse (Merck), . . . gr. x. 

Atropinae Sulph., . . . . gr. j. 

Ac. Sulph. Aromat., . . . 11^1200. 
Solve et filtra. Dose, rr^ x in syrup or 
simple elixir, 5 or 6 hours before retiring, 
as action is slow. 



Pertussis. 

Antipyrin, is successfully employed. Phenacetin, is highly praised. Aconite, 
in all acute congestions (P) ; as a preventive or abortive remedy very efficient, 
when associated with Ipecac and Cherry-laurel water (Dervieux). Amyl 
Nitrite, with Carbolic Acid, in steam atomizer, has proved a very efficient in- 
halation (Bayliss). Ipecacuanha, useful in many cases (R) ; try for 5 years of 
age, every hour or two, with the greatest relief (P) ; when bronchitic or pneu- 
monic complications, combined with Ammonium Bromide (Wa). Bromides, 
relieve spasmodic element (B) ; that of Ammonium will readily cure many 
cases ; gr. ij or iij ter die for infants (Wa). Lobelia, in spasmodic stages ; well 
tolerated by children ; rr\,x of tinct. every hour for child 2 years old ; also ad- 
ditional dose when cough is imminent (R, P). Alum, when acute stage over 
and no complication, gr. ij-vj every three hours, or less every hour in Glycerin 
or Honey (R). Bromoform, in daily dosage of 5 to 20 minims, in Glycerin and 
Alcohol, very efficient in relief of paroxysms, and to reduce their number, but 
has little other influence on the course of the disease ; must be pure, hence 
colorless ; and increasing doses should not be pushed very far, for fear of toxic 
symptoms (Bedford) ; may be used by inhalation instead of chloroform or ether, 
to lessen severity of the paroxysms. [See formula below.] Hydrogen Dioxide, 
the solution, in drachm doses diluted with 2 or 3 of water, internally, cuts short 
the paroxysms and lessens the duration of the disease. Benzol, is a reliable 
pulmonary antiseptic, and has been used for many years in this disease, with 
unvarying success (Robertson); the vapor may be diffused throughout the room, 
carefully avoiding a light or fire. Ouabain, in doses of gr. yoVo every 3 hours, 
is highly efficient in all stages of the disease (Gemmell). Resorcin in solution, 
applied to the perilaryngeal mucous membrane, has aborted an attack at the 
outset in 24 hours, has cured well-marked cases in from 9 to 14 days, and is a 
perfect method of prophylaxis for children living with those suffering from the 
affection (Moncorvo). Naphtalin, burned in the patient's room, is of high 
value, both as a palliative and a curative agent (Chavernac). Belladonna, 
obviously of value in febrile stage, is of special use when dentition is in pro- 
gress ; relieves the congestion of air-passages and also the determination of 
blood to the head (P) ; good when profuse bronchial secretion ; best in spas- 
modic stage ; children bear this drug well ; rT\, x of tinct. may be given hourly 
to a child 2 or 3 years old (R). Sodium Benzoate is highly efficient. Conium, 
or the Hydrobromate of Coniine, in doses of gr. -^ to gr. \ according to age, a 
very efficient remedy (W). Drosera, small doses are very effective (Murrell). 
Chamomile Oil, a very useful remedy (P). Coccus Cacti (Cochineal), in doses 
of gr. J/3 thrice daily for infants, has been highly recommended (W) ; proves 
very effective in most cases. Hydrocyanic Acid, very serviceable in cough by 
habit, after cessation of whooping-cough proper, or in nervous sympathetic 

43 



-674 



PHARYNGITIS. 



-cough of mothers (B, P). Opium, in convulsive stage, to produce and main- 
tain slight heaviness (R). Cocaine, a 5 per cent, solution, painted on tonsils, 
fauces, back of tongue, and if possible on larynx, is very efficient (Labrie). 
Chloral, gr. v-x in spasmodic stage, relieves quickly (B) ; gr. iij-viij every 4 
hours (Porter). Carbolic Acid, as vapor, with steam atomizer; found to be 
very beneficial (J. L. Smith). Castanea, a decoction of chestnut leaves has 
been used with much success ; dose ad libitum (B) ; the fluid extract, in 5- 
doses, exercises a remarkable influence over the cough (W). Valerian, said 
to control the paroxysms (R). Nitric Acid, well diluted in sweetened water, 
after the subsidence of the catarrhal stage (B). Gelsemium, in spasmodic 
stage (B). Camphor Monobromide, gr. v in mucilage and Syrup. Tolu. 3 or 4 
times a day, has been very serviceable (B). Zinc Sulphate, gr. %-] with Ext. 
Belladon., gr. l /e-%, has varying degree of success (B). Lactucarium, the 
syrup as vehicle for cough mixtures (B). Quinine, in solution, locally to fauces 
(Dawson) ; the Tannate with Sodii Bicarb, of each 5, and Pulv. Acaciae 100 
parts, used with an insufflator (Pollack). Petroleum, on rags around head of 
the bed, is recommended highly by Hildebrandt. Silver Nitrate, when acute 
stage passed (Tr) ; probably inferior to Alum (Wa). [Compare Cough.] 



Prescriptions. 



Zh 
3>J- 



H. Chloralis, 

Potassii Bromidi, . . 

Syr. Pruni Virgin., 

Aquae, aa §j. 

M. Sig. — A teasp. thrice daily for in- 
fants in the convulsive stage. [Dessau.) 



B 



. Olei Morrhuae, 

Mellis Despumat., 

Succi Limonis, , . . aa partes aeq. 
M. Sig. — A teasp. or two as required. 
{Sir Wm. Gull.) 



R. Bromoformi, rr\,xyj. 

Glycerini, Si ss - 

Tinct. Cardamom. Co., 
Aleoholis, . . . . . . aa^ij. 

M. Sig.^ — A teaspoonful at commence- 
ment of the paroxysm. [Bedford.) 



R . Amyli Nkritis, 3 ss. 

Acidi Carbolici, rr\,x. 

Glycerini, 

Aleoholis, aa|;ss. 

M. Sig. — Use by inhalation with steam 
atomizer. [Bayliss.) 



Pharyngitis. 

Aconite and Belladonna, for acute attacks (B) ; when high temperature (R). 
Belladonna, is very useful, relaxes the pharyngeal muscles (W). Capsicum, as 
gargle, Z] a d 0% aquae, in very early stage only (R). Alum, gargles, in chronic 
inflammations (R). Silver Nitrate, gr. v-xx ad %j, on sponge probang, suc- 
cessful if systematically applied (B) ; in early stage of inflammation ; also in 
chronic on brush, or as spray (R) : the solid stick to each diseased follicle, 
after scraping (A). Ammonium Chloride, gr. ij with t^xv of Tinctura Cubebae, 
every half hour, often controls acute pharyngitis; when a gouty diathesis exists 
add rr\,x of the Ammoniated Tincture of Guaiac, and give every hour (Smith). 
Xanthoxylum, a decoction of the bark locally to throat, and ttlx-xxx of the 
fluid extract thrice daily, a very successful remedy for chronic pharyngitis (B). 
Tannin, insufflation to affected surface (B). Cubeb, powdered, locally, useful 
(B). Glycerin, pure, locally, with Tannic Acid, very serviceable (B) ; in chronic 
inflammation of the throat (R). Glycozone, frequently applied, is of benefit in 
follicular pharyngitis (Edson). Hydrastis, the fluid extract locally, also n\v-x 
internally (B). Alcohol, diluted, as gargle in relaxed throat (R). Cimicifuga, 
when pharynx dry and spotted over with inspissated mucus (R). Ipecacuanha, 
the wine as spray in non-inflammatory sore throat, with hoarseness from con- 
gestion of vocal cords (R). Pomegranate Bark, as gargle (P). Resorcin, in 
strong solution, a very efficient application (Tymowski). Potassium Chlorate, 
as lozenge to stimulate the follicular secretions to a healthy condition (A). 
Iron, Quinine, and Strychnine, as tonics, are mainly indicated (A). Zinc Sul- 
phate, as gargle, occasionally employed in relaxed throat (R). Inhalation of 



PHIMOSIS PHLEBITIS PHLEGMASIA. 



6/5 



vapors, or of pulverized fluids, by the atomizer, found very beneficial (Wa). 
Food, of piquant kind, spices, pepper, mustard, etc., should be strictly pro- 
hibited ; all fluids should be used at a moderate temperature (A). Water, by 
throat compress, relieves ; also in daytime, in obstinate cases. Rest to voice 
and cultivation of beard, are useful aids. 



Prescriptions. 



R. 



Tinct. Aconiti, 

Tinct. Belladonnge, . . aa 3 ss. 

Tinct. Guaiaci Ammon., . 3 v. 

Syr. Limonis, i; ss. 

Aquae Cinnamomi, q. s. ad Jiv. 
M. Sig. — A teasp. every 3 hours for 
acute pharyngitis. 

R . Tinct. Aconiti, 3 ss. 

Ac. Hydrocyan. Dil., . . . rrixl. 

Liquor Ammonii Acetat.,^ ^iv. 
M. Sig. — Teasp. every 2 or 3 hours 
according to the severity of the case. In 
acute and subacute pharyngitis. 



R. Aluminis, o ss ~'J- 

Sodii Boratis, .... gjss. 

Glycerini, 3 ij. 

Tinct. Myrrhae . . . . ,^ij. 

Aquae, . . . q. s. ad ^ iv. 
M. Sig. — Use as an astringent g; 
4 or 5 times a day. 



gr. lx. 
TTLxxx. 



R. Acidi Tannici, . . . 

Alcoholis, 

Aquae Camphorae, . q. s. ad g iv. 

M. Sig. — An astringent gargle, to be 
used several times a day. 



Phimosis. 

Belladonna, as ointment, the Extract 7 to 20 parts of Lard, has proved effect- 
ual (Wa). Lupulin, 5 to 15 grain doses, of advantage after operation, to keep 
penis at rest (Wa). Surgical. Division of the prepuce by a bistoury and 
director ; circumcision (D). Cocaine, a 4 per cent, solution injected at several 
points around edge of prepuce, as local anaesthetic during the operation of cir- 
cumcision. Chloroform, or Ether, as an anaesthetic in paraphimosis, before 
attempting reduction (Wa). 

Phlebitis. 

Hamamelis, has as decided an influence on the venous system as Aconite on 
the arterial (Pf ). Mercury, in frequent and liberal doses, to early and decisive 
constitutional impression ; the best form being Calomel, or Calomel and Blue 
Mass (Gross). Rest, fomentations, poultices, early incision of abscesses, aperi- 
ents, Opium to relieve pain and insure quiet of mind and body (D). Blister, 
over course of an inflamed superficial vein (R). Diet, nutritious, and wine, 
especially if great loss of blood (D). Stimulants, as Quinine and Iron, espe- 
cially the Tincture of the Chloride, also milk-punch, are needed to combat the 
depression which is sure to arise : the disease is always dangerous and often 
fatal (Gross). Incisions, must be freely made if abscesses form, and the inter- 
nal organs watched for multiple abscess. Ulceration, if it occur, must be 
watched for hemorrhage, which should be arrested by compression and styptics 
(Gross). [Compare Phlegmasia, Varicosis.] 



Phlegmasia Alba Dolens. 

Belladonna, and Mercury, equal parts, as ointment, often of much benefit 
(Wa). Hamamelis, has specific action on venous system (P) ; extolled by Dr. 
Preston (R). Blisters, in early stage ; are extremely useful if judiciously em- 
ployed (L). Ammonium Carbonate, often valuable where great prostration ; 
full doses (Wa). Creosote, injections daily (Wa). Hydrochloric Acid, £j of 
dilute acid in Oij of Barley-water, with Jss of Potassium Chlorate, to be taken 
daily (Mackenzie). Opium, large doses internally, with leeches and anodyne 
ointments (Wa) ; Laudanum, if pain severe, sprinkled on hot fomentations (L.). 
Leeches, of great service during the acute inflammatory stage (Wa.). Bandag- 



676 PHLEGMON PHOTOPHOBIA PHTHISIS. 

ing, when the more acute symptoms subside ; at first with flannel, afterwards 
with ordinary roller bandage (L.). Regimen, should be tonic (L.). Water, 
compresses in active stage ; douches, hot and cold in chronic form. 



Phlegmon. 

Aconite, or Belladonna, are certainly efficacious ; Aconite best (R.). Sulph- 
ides, to abort, or when inevitable, to promote ; gr. ss-j every hour or two of 
Potassa Sulphurata (B.). Silver Nitrate, strong solution may check if applied 
early in the vicinity (B). Carbolic Acid, injections; a 2 per cent, solution (B) ; 
used with great success (W). Iodine Injections, after evacuation (B). [Com- 
pare Erysipelas.] 

Photophobia. 

Atropine, a neutral solution of the Sulphate (gr. j ad ^j), for adult, dropped 
into the eye every 4 hours (C) ; if much lachrymation, so as to dilute the solu- 
tion, it may be applied more frequently ; in some cases Belladonna irritates 
and has to be abandoned (Wa). Conium, in scrofulous photophobia, gr. ss of 
Coniine in Z] of 01. Amygdalae, locally twice or thrice daily ; or the vapor of 
Coniine (Wa). Mercury, Calomel by insufflation (C). Canthoplasty, for the 
spasm of the orbicularis in severe photophobia (C). Glasses, of cobalt blue, 
the best (R). Arsenic, in the condition described by old writers as strumous 
ophthalmia, with its attendant photophobia, is very valuable as an internal 
remedy (C). Chloroform, the eye exposed to the vapor of a few drops, in severe 
photophobia will be speedily relieved (Jones). Croton- Chloral, gr. v-x, in young 
people and those suffering from syphilitic corneo-iritis (Bader). Potassium 
Chlorate, internally, is most useful in some cases (Vernon). Cocaine, in 2 to 4 
per cent, solution, a few drops upon the conjunctiva, will be found promptly 
efficient in most cases. 

Phthisis. 

Creosotum, gives excellent results (Bouchard) ; is directly curative, at least in 
the initial stage of the disease (Frantzel) ; promotes the sclerotic change by 
means of which recovery is found to occur (Jaccoud) ; Morson's beechwood 
Creosote should be used, in doses of try in whiskey and glycerin, every 3 or 4 
hours : should be largely diluted to prevent irritation, and continued for many 
months, — relieves cough, diminishes expectoration, stops night-sweats, increases 
weight, decreases fever, promotes appetite, and in many cases improves the 
local condition, as shown by the physical signs (Robinson). Creosote, Tar, or 
Carbolic Acid, to check expectoration (R, P) ; Creosote is often curative in many 
forms, gr. iij in a pill with Bals. Tolu., three or four times daily, the dose being 
increased until urine is darkened ; or it may be inhaled with Iodine from hot 
water (B). Guaiacol, the principal ingredient of Creosote, and equally efficient : 
may be given in the same doses ; the Carbonate, in doses of 6 to 8 grains, up 
to 3jss daily, is better borne, and a useful substitute. Benzosol, contains 54 
per cent, of Guaiacol, which it yields up in the intestines : in doses of 4 grains, 
gradually increased to 12 grains, thrice daily, it has given results in phthisis, 
equal if not superior to those from Creosote (Walzer). 

Iodine, or Iodoform, with Creosote, Carbolic Acid, Eucalyptus, Chloroform, 
Alcohol or Ether, as a combination for an antiseptic inhalation (Br) : extremely 
useful; also as intra-pulmonary injection, a solution of the Compound Tinc- 
ture of Iodine, 1 to 4 of distilled water, of which rt\,x-xx injected once every 4 
or 5 days, through the 1st, 2d, or 3d intercostal spaces, anteriorly, or in the 
axillary region, avoiding the pericardium and great vessels (Robinson). Iodo- 
form, internally, has proved extremely effective in all forms, as witnessed by 
numerous observers in various countries (S. Smith) ; though not one of the 
most active germicides, it is very destructive to the bacillus tuberculosis (B). 



PHTHISIS. 6J7 

Iodol may be advantageously substituted for Iodoform (B). Hydrogen Dioxide, 
the solution internally, in doses of 3j to iij diluted with 3 to 4 of water, renders 
good service by promoting digestion, palliating cough, and increasing the 
activity of chalybeate remedies. Cod-liver Oil, holds first rank as a remedy 
and food in the chronic forms ; a teasp. after meals ter die is enough ; when 
not well borne may be combined with Aqua Calcis, Comp. Tinct. of Gentian ; 
or, when not digested, with Ether (B, R) ; is of great utility by improving nu- 
trition, and by affecting the tubercle; give ^ss thrice daily one hour after 
meals, with rr\,v-xv of Ether, or an equal quantity of malt or whiskey ; do not give 
it in hot weather (Da C). Terebene, with Thymol and Carbolic Acid, equal 
parts of each, and gss to a pint of hot water as an inhalation : is extremely use- 
ful for the dyspnoea (Camman). Aconite, in small doses for the irritative fever, 
is a remedy of much value (Da C). Antipyrin in a 2^ -grain dose hourly for 
3 doses daily, for the hectic fever. Phenacetin is better borne and is efficiently 
antipyretic ; extensively employed in the hectic of phthisis. Cinchona, for the 
hectic and sweats, Quinine, gr. xv-xx (B) ; if small doses fail, a dose of 6 or 8 
grains at once, or in portions repeated hourly (R). Ipecacuanha, spray to 
throat when bronchial asthma and emphysema combined with fibroid phthisis 
(R). Opium, or Morphine, in a viscid vehicle for cough, or as lozenges when 
cough due to inflamed throat (R) ; must in time be given for the cough, which 
is an irritative one. Codeine, gr. yi to %. in simple elixir, is useful and does 
not constipate (Da C). Alcohol, an important remedy ; may be given with 
Cod-liver Oil; or Spt. Frumenti, ^j-^ij with some Bitter, immediately after 
meals, or the stronger wines ; if it disagrees, it harms : — curiously, it induces 
an intractable form of phthisis (B). Verbascum, the Mullein-plant, has long 
been a popular remedy in phthisis ; it facilitates expectoration, improves the 
general condition, and palliates the cough. Calcium Phosphate, in diarrhoea, 
and in chronic forms of phthisis, with little or no fever (R). Iodine, should be 
more used than it is; the compound solution, gtt. j — iij thrice daily, or when 
anaemia and not much fever use Ferrous Iodide, gr. xv of the Syrup pushed to 
3j ter die (Da C) ; as inhalation in chronic phthisis ; to lessen expectoration 
and cough ; also as liniment painted under clavicles, to allay harassing cough, 
and to check secretion (R). Cimicifuga, useless in tuberculosis, but in phthisis 
it relieves cough, improves appetite, lessens intercurrent bronchitis, and so 
improves the patient's general condition (Wa). Aurum, the Bromide of Gold 
and Arsenic internally, with inhalations of Papoid as glycerole by the atomizer, 
gave astonishing improvement in two cases of fibroid phthisis with cavities, 
due to neglected pneumonitis ; also in a case of grinders' consumption (E. A. 
Wood) ; the Chloride has rendered excellent service in the hands of Gibbes 
and Shurley. [See infra, under Chlorine.] Arsenic, valuable in chronic 
forms as no other remedy ; but not in caseous nor where much hectic ; may 
be given by stomach or fumigation (B). [See under Asthma] : as cigarettes, 
useful in the diarrhoea, probably diminishes temperature, — caution required 
(R) ; of great value in early stage, in later stages it is of no avail ; Arsenous 
Acid, gr. ■£$, or TT\,iij of Fowler's solution, thrice daily (Da C). Cocaine, locally 
for the throat symptoms, to be applied just before meals are eaten (Da C). 
Sulphurous Acid, by inhalation, spray, or fumigation, in chronic phthisis (R). 
Sanguinaria, helps expectoration, and revives the enfeebled stomach (P). 
Camphorated Naphtol, undiluted, or rr^ij in Olive Oil, hypodermically, used 
with very good results in 15 out of 32 cases so treated (Reboul). 

Chloroform, with Glycerin or Honey, for the cough in fibroid phthisis (R) ; 
by inhalation continuously as germicide, in connection with other agents of 
same action (Potter, see Pacific Medical Journal, October, 1890). Chlorine gas, 
by inhalation, also the hypodermic use of Iodine and Chloride of Gold and 
Sodium, extensively employed in pulmonary consumption with good results. 
(Gibbes and Shurly in Therapeutic Gazette, April, 1891, and April, 1892.) Fer- 
rum, often prescribed; has no especial influence on deposit (B) ; is prescribed in 
tuberculosis (Tr) ; the Liquor Ferri Perchloridi, £j ad ^j aquae, the most ser- 
viceable local application in laryngeal phthisis, diminishing irritability of the 
mucous membrane, and quieting cough (Mackenzie). Mercury, gr. -^^ of 



I 



6; 8 



PHTHISIS. 



Corrosive Sublimate every two or three hours, for the diarrhoea (R). Benzoin, 
as inhalation, to lessen cough and expectoration (R). Mineral Acids, for trie 
indigestion ; the Acidum Muriaticum Dilutum (B). Prunus Virginiana, has a 
domestic reputation, probably due to its influence over cough; the Syrup is 
much used as vehicle for cough-mixtures (B). Hypophosphites, are very use- 
ful in chronic cases (B) ; have no special effect (Da C). Digitalis, as antipy- 
retic ; deranges intestinal canal, therefore injurious in phthisis (B). Copper 
Phosphate, in nascent form soluble in an alkaline body, is held to be specific 
by Prof. Luton of Rheims ; his formula contains Neutral Acetate of Copper 
0.15, Cryst. Phosphate of Sodium 0.75, Glycerin and Pulv. Licorice, aa q. s. 
for one pill. Copper Sulphate, gr. ■£% or Silver Nitrate, gr. }( , or Bismuth, gr. 
xx, for the diarrhoea (Da C). Gaseous Enemata, Bergeon's treatment, made a 
noise for a few months, but soon fell into contempt. Baths, sea-bathing, if 
chronic, little or no fever, without active deposition of tubercle, or scrofulous 
pneumonia ; Turkish baths for the cough (R). Grape-cure, is serviceable (B). 
Aliment, should be nutritious and digestible, malt liquors better than wine or 
spirits : — Extract of Malt, Cod-liver Oil, plenty of meat, and alcohol in modera- 
tion (Da C) ; warm clothing, bathing and friction of skin, moderate exercise, 
and a suitable climate. Forced Alimentation, when anorexia appears, and 
superalimentation at all times, necessary to successful treatment ; washing out 
the stomach daily by syphon-tube, with warm water alkalinized with Borax, and 
then feeding through tube (Robinson). Climate, the best by far is that of Egypt, 
or Algeria ; next coming New Mexico, Southern California, especially in the 
desert along the Colorado River, South Carolina and portions of Georgia and 
Florida ; the latter being especially suitable for cases having a co-existing bron- 
chitis ; for some cases Colorado is very good, and the Adirondack region for 
early cases in which there is no tendency to hemorrhage (Da C). Tuberculin or 
Koch's Lymph has been a deceptive bubble which for a short time commanded 
the attention and admiration of the whole world, but which has been ruthlessly 
pricked by the critical scalpel in the hands of the father of modern pathology 
(Senn). Amick Chemical Cure consists in the use of Calomel, Iodoform, 
Guaiacol, etc., as described by Dr. N. B. Shade in various journals (Waugh). 
[Compare Cough, Hemoptysis, Hectic Fever, Perspiration.] 



Prescriptions. 



R • Quininae Sulphatis, . . . gr. xviij. 

Pulv. Digitalis, gr. vj. 

Pulv. Opii, gr. iij. 

M. ft. pil. no. xij. Sig. — One pill thrice 
daily, for the irritative fever. (Niemeyer.) 



R. Pepsini (Jensen), .... gr. xl. 

Ac. Hydrochlor. Dil., . . gijss. 

Glycerini, 5 v. 

Succi Limonis, 3 1V - 

Aq. Aurantii Flor., q. s. ad ^ iv. 
M. Sig. — Dessertspoonful with meals 
for the dyspeptic symptoms. 



R- . Iodoformi, gr. xxiv. 

Creosoti, V\sv. 

Ol. Eucalypti, rr\^viij. ' 

Chloroformi, TT^xlviij. 

Alcoholis, 

Etheris, . . . aa q. s. ai/ J ss. 
M. Sig. — 10 to 20 drops on the sponge 
of perforated zinc inhaler, to be worn 20 
minutes thrice daily. [Brunton.) 



R. Tinct. Belladonnae, . . . 55 ij. 

Syr. Scillae, J; ij. 

Morphinae Sulph., .... gr. j. 

Syr. Tolutani, .... ad 5 iv. 
M. Sig. — Tablespoonful at bedtime, for 
cough and restlessness, to be repeated if 
necessary. 



R . Arseni Iodidi, 

Strychninse Sulph., 

Hydrarg. Chlor. Corr., . aagr. j. 

Quininae Sulph., 

Iodoformi, aa g ij. 

M. ft. pil. no. xl. Sig. — One thrice daily 
as a tonic in tubercular cases. [Mann.) 



R . Olei Morrhuae, ^ ss. 

Mucil. Acaciae, '^ij. 

Sacchari, ^ij. 

Tinct. Lavandulae Co., . . rr^xx. 

Aquae, % ss. 

M. Sig. — Teaspoonful for children. An 
agreeable mixture. (Farquharson.) 



PITYRIASIS PLETHORA — PLEURITIS. 



679 



R. Petrolei Massae, !§j. 

Pulv. Cubebae, 

Pulv. Doveri, . . . . . aa ^ ss. 
Cinchonidinae Sulph., . . gij. 
M. ft. massa., et div. in pil. no. cclxx. 
Sig. — One pill every 3 or 4 hours. 

' (Griffith^, 

R. Iodoformi, 
Creosoti, 
Pulv. Benzoini, 

Bals. Tolu., aa gr. j. 

In pill, of such 2 to 4 daily. (Huchard.) 



R . Codeinae Sulphat gr.v-viij. 

Ac. Hydrocyan. Dil., . . n\,xx. 

Syr. Tolutani, ^ij. 

M. Sig. — A teaspoonful several times 
daily, for the cough. (Potter.) 



R . Creosoti (beech-wood), . . TT^vj. 

Glycerini, t ^j. 

Spt. Frumenti, % ij. 

M. Sig. — For one day's use, as directed, 
in 3 ss doses. (Robinson.) 



[For a Cod-liver Oil Emulsion see formula on page 471.] 



Pityriasis. 

Alkaline and Tonic Remedies generally control mild cases, together with 
baths and emollients ; the more severe ones requiring constant envelopment in 
oil, as Linseed or Cod-liver Oil (Bulkley). Mercury, in obstinate cases, Dono- 
van's solution of Arsenic and Mercury, is highly successful (Wa) ; the yellow 
Iodide, gr. x to Jj of lard, or a 5 per cent, solution of the Oleate of Mercury in 
Oleic Acid with one-eighth part of Ether, applied by a camel's-hair brush (B) ; 
Citrine Ointment, especially when the hairy parts of the face are affected (R) ; 
an ointment of Ammoniated Mercury and Calomel is very useful in ordinary 
cases of dandruff or pityriasis simplex (Bronson). Sulphur, 3j of Sulphur 
Lotum to ^j of Vaselin applied every morning to the scalp, with sweet Almond 
Oil anointing at night (Jackson). Soap, the Liniment of Soft Soap as shampoo 
every morning for cleanliness, or Borax and water, or the yolks of three eggs 
beaten up in a pint of Limewater with ^ss of Alcohol, all of which make good 
shampooing mixtures (Jackson). Borax, to cleanse the scalp, a saturated solu- 
tion ; or the Glycerite of Borax (R). Lead, the Liquor Plumbi, with Glycerin, 
equal parts of each, and two of water, as lotion for cases where there is high in- 
flammation and abundant weeping (R). Carbolic Acid, 2 parts to 3 of Glycerin 
and water, twice daily, with the daily use of a carbolized soap, is often effectual 
(Wa). Sulphides, ^ss of Potassa Sulphurata to Oj of Lime-water, as a lotion, 
or the Bareges Pomade. [See formula below.] Baths, frequently, and hard 
rubbing after shampooing the scalp ; avoid stimulating food in bad cases, as 
well as the use of a fine-toothed comb on children's heads. [Compare Sebor- 
rhea, and for Pityriasis Versicolor, see Tinea Versicolor.] 



Jj* . Sodae Sulphurate, 

Sodii Carbonatis, . . . aazij. 

Axungiae, ^ij ss 

M. Sig. — Pomade de Bareges. 



Prescriptions. 

R- . Hydrarg. Ammoniat., . . gr. xx. 
Hydrarg. Chlor, Mitis, . . gr. x. 

Petrolati, f j. 

M. ft. unguent. Sig. — Local use. 



Plethora. 

Aconite, is useful for affections of plethoric subjects ; and is decidedly the 
best remedy for apoplexy in the plethoric (P). Arsenic, used with advantage 
when determination of blood to the head (Wa). Sulphur, as mild purgative 
for plethora from cessation of the menses (Wa). [Compare Abdominal Ple- 
thora.] 

Pleuritis. 

Aconite, no remedy more effective prior to stage of effusion (R) [See 
Inflammation] ; the tincture in doses of % drop every 3 hours to a child 3 
years old, for 2 or 3 days (J. Lewis Smith). Veratrum Viride, gtt. viij of tine- 



680 PLEURODYNIA. 

ture every 3 hours, with a drop added to each dose until pulse reduced or 
nausea (Wa) ; opinions differ as to whether it should be used in sthenic or 
asthenic forms (R). Bryonia, exceedingly valuable in second stage; should 
follow Aconite (P). Tartar Emetic, in early stages and young plethoric sub- 
jects, when much febrile action, small doses (gr. ^ to %) may be useful (Wa). 
[See under Inflammation.] Digitalis, as antipyretic (R) ; deranges intestinal 
canal (B) ; Aconite preferred (P) ; the tincture in doses of one drop every 3 
hours to a child of 2 years old (J. Lewis Smith). Potassium Iodide, to promote 
absorption of effusions, steadily for a long time (R) ; also chest painted with 
Tincture of Iodine, one day on each wall alternately ; may be washed off with 
Potassium Iodide, Alcohol or Ether (B) ; as a diuretic to remove effusion 
(Clark). Iodine, also as injections, with great benefit and without risk, in 
empyema and hydrothorax (R). Quinine, has abortive power, increased by 
combination with Morphine (gr. xv -f- gr. ss) ; also as restorative tonic in low- 
type cases (B). Opium, cannot be too highly extolled (P) ; is especially bene- 
ficial ; gr. ss of Morphine hypodermically at beginning will often cut short an 
attack ; during the disease its effects are very beneficial ; a slight physiological 
effect should be maintained (B) ; Morphine for severe pain (R). Burgundy 
Pitch, plaster externally as a mechanical support (P). Asclepias, the popular 
"pleurisy-root," is a favorite remedy in the south (W). Pilocarpus, in sub- 
acute cases to remove fluids (Caro) ; or the Pilocarpine Nitrate, gr, \ bis die, 
for children (Vigier) ; is too depressing and therefore unsafe (Smith). Sodium 
Chloride, gss in gj of water, flavored with Liquorice, in tablesp. doses every 3 
hours, often very useful in causing absorption of pleuritic serous exudations ; 
but is contraindicated when exudation is purulent (Br). Bloodletting, by cups 
or leeches, useful by reason of counter-irritation produced, and to relieve pain, 
only in robust sthenic cases (B). Blisters, often greatly abused ; are harmful 
during inflammatory stage (B). Poultices, large, hot, and frequently renewed 
(R). Water, cold wet-pack to chest probably better than a hot one, pinned 
tightly to limit movement of chest-walls (B). Thoracentesis, by aspiration, if 
the quantity of fluid seriously embarrasses respiration. [For Chronic 
Pleurisy see Empyema, also compare Hydrothorax, Pleuro-pneumonia.] 

Prescriptions. 

R- . Potassii Acetat., 5 j. | R . Morph. Sulphat., . . . . gr. j. 

Infusi Digitalis, . q. s. ad t ^iv. Tinct. Aconiti ttVxxiv. 

M. Sig. — Teasp. every 3 hours to a ' Liq. Potassii Citratis, . . . ^ij. 

child of 4 or 6 years, in the second stage. I M. Sig. — A teasp. every 3 hours. 



Pleurodynia. 

Cimicifuga, curative when rheumatic, valuable in sympathetic cases from 
irritability of uterus (P) ; or uterine derangements (R, Wa). Croton Oil, in 
obstinate pleurodynia especially when blackened feces (R). Belladonna, 
plaster or liniment; the latter generally best (R). Chloral, made liquid with 
equal weight of Camphor, rubbed in gently, often affords instant relief in severe 
pleurisy (R). Sodium Salicylate, gr. xv-xx, every 2 or 3 hours, useful in most 
cases (Hughes). Ether, as spray, sometimes immediately and permanently 
removes the pain (R). Opium, liniment rubbed in after warm fomentations 
(Wa) ; or a hypodermic injection of Morphine (R). Iodine, as liniment painted 
on the chest, often relieves where mustard fails (R). Blistering, often success- 
ful when other means fail ; sometimes strong vesication necessary (R). Rest, 
is important and may be obtained by strapping the affected side with strips of 
adhesive plaster. Poultices, very hot, followed by application of lint and oil- 
skin ; Belladonna Liniment generally better (R). Mustard, as a poultice, is 
generally efficient, and can be renewed when pain returns (R). [Compare 
Neuralgia, Myalgia.] 



PLEUROPNEUMONIA PNEUMONIA. 68 I 

Pleuro-Pneumonia. 

Bryonia, often of great service ; limits effusion and assists absorption (P). 
Carbolic Acid, a 2 per cent, solution injected parenchymatously, once or twice 
a day, has had remarkable success (B). Sanguinaria, as a contra-stimulant 
(P). Turpentine, as a fomentation (P). Arnica, the tincture in doses of tt\,x 
every 3 or 4 hours, very useful in controlling the heart's action (Wa). Pilocar- 
pine, gr. ss, or gij of the Tincture of Jaborandi, benefits cases of pleuro-pneu- 
monia (Wa). [Compare Pneumonia.] 



Pneumonia. 

Aconite, gives good results in catarrhal and fibrinous forms (B) ; has marked 
effect (R) ; very valuable in first stages (P) ; in several cases it apparently cut 
short the attack (Wa) ; to reduce circulation either Aconite or Veratrum Viride, 
until pulse is impressed (Da C). Veratrum Viride, valuable (P) ; in the very 
incipiency (B) ; opinions differ as to whether it should be used in sthenic or 
asthenic cases (R). Bryonia, when pleural complications (P). Phosphorus, 
especially when typhoid symptoms ; approved by Fleischmann (R). Bella- 
donna is useful in the first stage (P) ; Harley esteemed it highly in pneumonia 
(Wa); as an adjuvant to Digitalis in infantile pneumonia, to soothe the irri- 
table nervous system and curtail superabundant secretion (Brown). Tartar 
Emetic, formerly given in large doses ; now abandoned ; small doses may 
be useful, but should be used with care, lest depression ensue (B) ; at com- 
mencement with alcoholic stimulants, if patient weak (R) ; may benefit 
young, robust subjects (Wa). [See Pleuritis.] Sanguinaria, as a contra-stimu- 
lant, when fever has abated, and graver symptoms have amended (P). Iodides, 
no remedy more efficient ; Ammonium Iodide with Arsenic, to prevent casea- 
tion of inflammatory products (R) ; Ethyl Iodide, gtt. v-xx ter die by inhala- 
tion, very valuable in catarrhal form (B) ; Sodium Iodide is useful in catarrhal 
pneumonia (Da C). Ipecacuanha, the wine in infantile pneumonia, should 
never be dispensed with, as it promotes expectoration, controls hemor- 
rhage and regulates secretion (Brown). Senega, in advanced stages as expec- 
torant, when cough is dry, irritating and painful, tightness and oppression of 
chest (P). Opium, or Morphine by injection, sometimes needed for severe pain 
(R) ; Opium is very desirable in many cases, relieves the symptoms and arrests 
delirium (Wa). Copper Acetate, Kissel regards it curative ; under it the mor- 
tality was only 4^ per cent. Ammonium Carbonate, at crisis for depression ; 
give in Infusion of Senega (B) [See formula below] ; is useful as expectorant 
late in disease when lung tissue breaks down (Da C). Digitalis, of doubtful 
value ; may be useful for high temperature, ischasmia, and low tension of ves- 
sels (B) ; as case goes on and circulation is to be further controlled, Digitalis is 
indicated (Da C) ; the best agent to slow the heart in infantile pneumonia, with 
Belladonna as an adjuvant (Brown). Antipyrin, to reduce pyrexia ; is deci- 
dedly more serviceable in pneumonia than Quinine (Wa) ; gr. xv several times 
a day, or 3 hourly doses each of gr. xxx, then stopping until temperature rises 
again (R). Stimulants, in asthenic cases, those of malignant type, and those 
occurring in aged people (Wa). Ammonia, the Aromatic Spirit as substitute for 
Ammonium Carbonate, in doses of gss i n simple elixir (Da C). Turpentine, as 
stimulant at crisis (B). Serpentaria, with Ammonium Carbonate in low types, 
as a stimulant about the crisis. Quinine or Salicylic Acid, to reduce tem- 
perature (R) ; Quinine as a tonic in cases which are asthenic from the first 
(P) ; in conjunction with Aconite and Veratrum, gr. viij-xij daily at start, is 
beneficial (Da C). Blisters, useful at very beginning only, or at crisis of dis- 
ease, harmful in inflammatory stage (B) ; to lessen the pain, but should be used 
in moderation (R). Wet-pack, hot, tightly pinned to limit motion of chest- 
walls (B). Poultices, encircling whole chest in children (R). Diet, farina- 
ceous, mucilaginous drinks, and rest in warm room (R). 



682 



POLYPUS — POULTICES. 



Prescriptions. 



R . Tinct. Veratri Viridis, . . TT\xl. 

Spt. ^Etheris Nitrosi, . . ^vj. 

Liq. Potassii Citratis, . . ^ivss. 

Syr. Zingiberis, . . q. s. ad |j vj. 
M. Sig. — A tablesp. every 3 hours, in 
the early stage. {Da Costa.) 



R. Sodii Iodidi, %} ss - 

Morphinae Sulph., . . . . gr. ss. 
Elixir Simplicis, . . . . j| ij. 
M. Sig. — Teasp. thrice daily with blis- 
ters over the apex, in catarrhal pneumonia. 
{Da Costal) 

R. Ammonii Carbonat., . . . gr. xl. 
Infusi Serpentariae, . . . j| iv. 
M. Sig. — A teasp. ever} 7 3 hours, as a 
stimulant about the crisis. {B.) 



R. Potassii Iodidi, gj. 

Ammonii Chloridi, . . . ^jss. 

Mist. Glycyrr. Comp., . . Jvj. 
M. Sig. — Tablesp. 4 times daily, to pro- 
mote absorption, together with blisters to 
the chest. {[/niv. Penna.) 



R . Tinct. Aconiti, Tttjcxiv. 

Tinct. Opii Camphorat., . gij. 

Liq. Ammonii Acetatis, 

Syr. Zingiberis, ... aa % ss. 

Aquae, q. s. ad ^yj. 

M. Sig. — A tablesp. every two hours, 
after free catharsis by Hydrarg. Chlorid. 
Mite. {Ripley.) 



Polypus. 

Sanguinaria, has been employed as snuff for nasal polypi (P) ; with doubtful 
benefit (W). Tannin, finely powdered, as snuff blown daily into nostrils 
through a quill, is especially adapted to the soft and gelatinous varieties ; while 
it has apparently no effect on the healthy mucous membrane, it causes the 
complete withering of the polypus (Wa). Zinc Chloride, has been injected 
interstitially with success in a case of naso-pharyngeal polypus (Barthelemy). 
Iron, a solution of the Chloride is advised as an interstitial application (Auger). 
Acetic Acid, glacial, injected into the body of the tumor, will cause it to shrink 
up and to drop off in a few days. Alum, in powder, applied to point of origin 
to prevent recurrence (D). Surgical, — a nasal polypus should be seized with 
polypus forceps and twisted off at the neck ; it may be removed through the 
mouth or the nostril ; in a few cases the nostril must be dilated with a specu- 
lum, or the ala slit to give access to root of tumor (D). 



Poultices. 

. Poultices and Fomentations are simply local baths utilizing warmth and 
moisture, relaxing the tissues and relieving pain. If applied early they will 
check inflammation, or assist the evacuation of pus when suppuration has set 
in. Poultices should be applied thick (thin in peritonitis), as hot as possible, 
covered with cotton wool, and frequently changed ; large at onset, very small 
after maturation. Belladonna and Glycerin, partes sequales, smeared over tis- 
sues under a poultice, aid the latter greatly, also Tinctura Opii, especially where 
skin is broken. Linseed-meal or Oatmeal, Starch, Bread, Bran, are best in the 
order mentioned ; add meal to boiling water, stir and spread quickly on warm 
linen. Charcoal under the poultice, when foul sores are being treated. 

An excellent method of preparing poultices is to make a lot of bags of various 
sizes, and of the fabric known as "Swiss," filling each one half-full of the Lin- 
seed meal or other agent employed, before sewing up its open end. When 
wanted for use, one of these bags is submerged in boiling water for a few 
minutes, and on taking it out the meal is found to have swelled so as to fill the 
bag, which should then be squeezed enough to rid it of the superfluous water, 
laid on the part and covered with oiled silk and a bandage. If too hot, will 
scald the part. 

Fomentations. Flannel should be wrung very dry out of boiling water, ap- 
plied and covered with oiled silk. Spongio-piline, a fabric composed of sponge 



PREGNANCY PROLAPSUS ANI ET UTERI. 683 

and wool, coated with india-rubber, is an excellent vehicle for the application 
of warmth and moisture. The inner surface is moistened with hot water ; and 
its utility may be increased by sprinkling the moistened surface with charcoal 
or yeast ; or by saturating it with any desired lotion or liniment. 



Pregnancy, Disorders of. 

Mercury, a few grains of blue pill to correct clay-colored stools (L). Iodine, 
the tincture internally for cardialgia (Wa). Aloes, have cured piles in preg- 
nancy, by removing constipation ; cautiously (P). Alum, Tannin or Catechu, 
in medicated pessaries for vaginal leucorrhcea (L). Castor Oil, an excellent 
laxative (P) ; to clear out the bowels in diarrhoea (L). Cocculus Indicus, 
when intestines much distended with flatus, and frequent desire to urinate from 
flatulent pressure on bladder (P). Bismuth, Calumba and Antispasmodics, 
with minute doses of Opium, for gastrodynia and pyrosis (L). Potassium Bro- 
mide, with Chloroform, as an antispasmodic in dyspnoea (L). Sumbul, is invalu- 
able in restlessness ; n\, xxx-xl of tincture with a little Chloric Ether, giving 
quiet nights for a long time (P). Galla, Unguentum Gallae cum Opio, the best 
local application to hemorrhoids, also fomentations with sponges wrung out in 
very hot water, to relieve pain (L). Digitalis, in infusion, very beneficial in 
albuminuria (L). Potassium Acetate, with Basham's mixture (Liq. Ferri et Am- 
monii Acetatis), when albuminuria with anaemia. Calcium Phosphate, believed 
to exert an influence on the foetus if administered during pregnancy, so that 
mothers who have borne only rachitic or. scrofulous children will bear healthy 
ones (W). Berberine, found very useful in the periodical neuralgiae of preg- 
nancy, even in cases in which Quinine had previously failed (Maclagan). 
Camphor Liniment, for lumbar pains (Wa). Senna, the Confection proves a 
mild and efficient purgative in the constipation of pregnancy (Wa). Milk-diet, 
for albuminuria of pregnancy the best remedy, if strictly carried out (Parvin). 
Injections, must be used carefully, even tepid water often induces uterine con- 
tractions (L). [Compare Vomiting of Pregnancy, Ptyalism, Albuminuria, 
Nephritis, Nervousness.] 

Prolapsus Ani. 

Nux Vomica, or Strychnine, especially when in children, with constipation ; 
in the latter event add Nux Vomica to a purgative, as Tincture of Rhubarb 
(R, P) ; Strychnine hypodermically, gr. ■£% for an adult every 48 hours, ^ inch 
from anus and parallel to rectum, into the cellular tissue ; generally requires 
4 to 8 injections (Weber). Piper, the Confectio Piperis in doses of gr. lx to 
cxx, persevered in for 3 or 4 months, in chronic, weak subjects (Wa). Sulphur, 
has a beneficial effect in addition to its laxative value (R). Alum, in solution, 
gr. vj to the j§ (R). Ice, locally, when parts inflamed (R). Ergot, the fluid 
extract injected into the perineum, is followed by immediate relief (Vidal). 
Ferrous Sulphate, j>j to ^viij aquas, of which one-third by enema twice daily. 
Podophyllin, in small doses for rectal prolapse in children (P). Tannin, by 
injection to restrain the prolapsus (R). Hydrastis, by enema, or as a lotion (P). 



Prolapsus Uteri. 

Cimicifuga, to prevent miscarriage in prolapsus uteri (R) ; has a remarkable 
effect upon the uterus (P). Astringents, as Decoctum Quercus, Decoctum 
Gallae (Wa) ; or Pomegranate bark (P). Tannin, as Catechu, Kino, Rhatany. 
Alum, a solution, gr. vj ad ^j (R) ; lb. j ad Cj aquae, as hip-bath, should also 
be passed well up vagina (Wa). Ice, locally when parts inflamed (R) ; ap- 
plied to the spine (Wa). Pessaries, in any form, are of but temporary benefit, 
and in the end positively detrimental (E) ; but many cases cannot be treated 
without mechanical support of some kind. 



i 



684 PROSTATE PROSTATITIS PRURIGO. 

Prostate, Hypertrophied. 

Alkalies, for the cystic irritation with acid urine ; great benefit from Liquor 
Potassse, or Citrate and Acetate of Potassium (B). Triticum Repens, benefit 
follows its use in the prostatic enlargement of old men (Sir H. Thompson). 
Ammonium Benzoate, for the cystitis, urine alkaline (B). Ammonium Chloride, 
is occasionally useful, gr. xv-xxx, 3 or 4 times daily (Wa). Iodine Injections, 
through rectal walls (B) ; a weak ointment applied by rectum (Wa). Iodine, 
has been tried in all forms, but is of no value (Thompson). Iodoform, as sup- 
pository in rectum, has proven of great value (B). Colchicum, in persons of a 
gouty diathesis (Wa). Medicine is not likely to have any control over this 
condition, which is a simple hypertrophy. [Compare Cystitis.] 



Prostatitis. 

Cantharides, gtt. j of tincture (5 may be required) 3 or 4 times a day (R). 
Triticum Repens, is found to be of benefit (Sir H. Thompson). Urino-Genitals, 
especially Turpentine, Cubeb, Juniper, Cantharis (B) ; Cubeb, in doses of gr. 
xx daily, is found of much benefit (Wa) ; Buchu relieves (P). Silver Nitrate, 
a solution (gr. v-x ad § j), applied to the prostatic urethra in chronic prostatitis, 
may be useful (Wa). Blisters, in chronic prostatitis, a small blister on each 
side of the raphe of the perineum, kept open 4 to 6 weeks, has given the best 
results (Wa). Tonic medicines and regimen should be prescribed (Wa). Hot 
Injections, to relieve pain (R). [Compare Prostatorrhcea.] 



Prostatorrhcea. 

Iron, the Tincture of the Chloride, when there is much debility (B) ; chaly- 
beate tonics with Quinine and Strychnine (Gross). Atropine, indicated in all 
cases, with Potassium Bromide (Gross). Potassium Bromide, when irritability 
and excitement (B) ; indicated in all cases (Gross). Lead, injections of Gou- 
lard's Extract, Z] to ^x of water, night and morning, for 10 minutes at a time 
(Gross). Ergot, when relaxation exists (B). Bougie, methodically intro- 
duced, is one of the best local measures (Gross). Hydrastis, locally applied, 
a useful medicine (B). [Compare Prostatitis.] 



Prurigo. 

Antipyrin, as a symptomatic remedy, is efficient in true prurigo. Alkaline 
Baths, followed by a carbolized ointment, and Carbolic Acid internally, are of 
value in the papular eruption known as prurigo (Bulkley). Sulphides, Potassa 
Sulphurata, with Tar and Benzoated Lard, as ointment in genuine prurigo (R). 
Arsenic, in doses of tt\,v of Liquor Arsenicalis thrice daily and gradually in- 
creased, has exercised a more or less powerful influence (Wa) ; has only a 
moderate effect (Bulkley). Belladonna, controls cases which have resisted 
ordinary treatment (B). Carbolic Acid, locally and internally, is especially 
serviceable in prurigo senilis (B). Mercury, the Bichloride gr. xx, with Ammo- 
nium Chloride, gr. xxx, in Oj of pure water, as lotion in prurigo contagiosa, 
"army-itch;" nothing equal to it (White). Borax, a saturated solution in 
Rose-water locally (R) ; gr. v-x to ^j of hot water for pruriginous eruptions on 
mucous membrane of vulva and vagina (R). Galvanism, when prurigo is 
referable to alterations in the cutaneous nerves (B). Tonics, are required, 
nerve-tonics as well as general ones, Cod-liver Oil, Quinine, Strychnine and 
Phosphorus (E. Wilson). Quinine, in large doses, gr. v-x, will control violent 
exacerbations (Wilson). Baths, the Turkish, frequently repeated, with inunc- 
tion of the skin, may be regarded as curative in most cases (Wilson). [Com- 
pare Pruritus.] 



PRURITUS. 685 

Pruritus.' 

Cocaine, in 5 per cent, solution or oleate, is by far the most efficient of all 
antipruritics ; relieves the itching of scrotal eczema, pruritus ani et pudendi, 
and especially in lesions of the epidermis where the oleate or solution can 
penetrate at once to the true skin. Resorcin, in solution locally, gives marked 
relief, lasting for several hours, in the majority of cases. Tumenol, as tinc- 
ture, is used locally with almost universal success (Neisser). Menthol, seems 
to be of marked value in almost all cases of pruritus, from whatever cause 
(Squibb). Antipyrin, internally as a symptomatic remedy against itching, is 
promptly efficient in nervous pruritus, true prurigo, urticaria, erythema, pem- 
phigus vulgaris and lichen ruber. Alkaline Baths, locally, followed by the 
application of Carbolic Acid Ointment, give great comfort in all forms of pru- 
ritus (Bulkley) ; Sodium or Potassium Carbonate preferred (Tr) ; in solution 
locally, 3iij ad ^iv (B). Carbolic Acid, with Glycerin, as lotion to the itching 
surface, gives great relief (Bulkley) ; internally and locally in pruritus senilis 
(B) ; a one per cent, solution as lotion in pruritus ani (R). Mercury, strong 
solutions of the Bichloride, Black or Yellow Wash or Mercurial Ointment, in 
the itching of skin affections (R) : Yellow Wash is one of the most efficient 
applications for pruritus ani. Solutions of the Bichloride are very useful 
applications in pruritus vulvae et ani (Tr) ; for pruritus vulvae a lotion of the 
Bichloride 1 to 2500 parts of water, with Alum and Starch, is recommended 
(B) : Calomel 3j to ^j of Lard, as ointment, is the best application, except in 
the pruritus of urticaria ; very useful in pruritus ani, less so in pruritus pudendi 
(R) : the Oleate, a 5 per cent, solution in Oleic Acid with one-eighth part of 
Ether, applied by a camel's-hair brush, in pruritus ani et pudendi (Marshall). 
Alum, a strong solution is very useful for pruritus vulvae (Tr). Hydrocyanic 
Acid, diluted as lotion, often very serviceable ; may be prescribed in solution 
with Borax (B) ; or Laurel-water as lotion, especially in pruritus senilis (P). 
Potassium Cyanide, 5j to Oj of water, as lotion for pruritus of various kinds 
when the skin is unbroken (R) ; as ointment or solution, if strong enough, 
relieves greatly, but must be used with caution (B) ; or rr^xxx of the dilute Hey 
Acid of the Br. Ph. in %] of water or Glycerin, may be used instead (R). Silver 
Nitrate, a solution (gr. xx ad Jjj), painted over the affected parts in pruritus 
vulvae, is very effective (B). Tobacco, is an effective but dangerous applica- 
tion (B). Iodoform, as ointment, Z] ad ^j Adipis (R). Iodine, for itching of 
the nose or inner canthus, sneezing, etc., Iodine inhalations have a marked 
effect (R). Arsenic, for itching of the nose accompanying asthmatic symptoms 
(R). Benzoin, the compound tincture painted on the skin, for the itching of 
eczema, urticaria, etc. (R). Boracic Acid makes an excellent lotion in pruritus 
pudendi, a teasp. to the pint of hot water (R). Borax, gr. v-x ad ^j hot water 
(R). [See Prurigo.] Balsam of Peru, is a very good application in pruritus 
ani, scabies, and many other forms of itching (Auerbach). Camphor, with 
Chloral, rubbed together, makes a liquid which, added to Vaselin, makes an 
ointment which is powerfully antipruritic (Bulkley) ; added to dusting powders, 
allays heat and itching of eczema and intertrigo (R). Chloroform, as ointment 
to allay itching of skin diseases. Gelsemium, rr\,xv of the tincture every half 
hour, up to 3j in all, for itching which is out of proportion to the cutaneous 
lesion (Pelcher). Lead Lotions, to ease the itching of urticaria, pruritus pu- 
dendi, etc., especially when the mucous membrane is red and excoriated (R). 
Piperazin, gives immediate relief in the pruritus of the uric acid diathesis. 
Salicylic Acid, as ointment, in pruritus ani et vulvae (R). Sodium Salicylate, 
in 15-grain doses by mouth every four hours, will greatly relieve pruritus vulvae, 
when due to diabetes (G). Tar, as ointment, is strongly recommended (Tr) ; 
for general pruritus, if no cause can be found, the two best remedies are Tar 
and Sulphur, as lotion or bath (Sparks) ; ointments containing Tar give relief 
in many instances (Bulkley). Sulphur, may be employed as a bath, Potassa 
Sulphurata, ^ij ad C xv of hot water (Sparks) ; or the alkaline sulphites locally 
(Wa) ; the Iodide of Sulphur externally and internally, in pruritus senilis (Wa). 
Chlorine, the Liquor Sodae Chloratae, diluted, a useful application in pruritus 



686 



PSORIASIS. 



ani (Wa). [Compare Eczema, Erythema, Lice, Pediculi, Prurigo, Sca- 
bies, Urticaria.] 



Prescriptions. 



R. Hydrarg. Chlor. Corr., 
Pulv. Aluminis, . . . 

Amyli, 

Aquas, 

M. Sig. — Apply locally. 



g r - J 
gr. xx. 

3Jss. 
3 V J- 

{Goodell.) 



. Acidi Hydrocyanici Dil., . 7, ss-j. 

Infusi Altheas, ^v-viij. 

M. Sig. — Lotion. {Fox.) 



R 



R 



. Potassii Cyanidi, . 

Aquas Laurocerasi, 
M. Sig. — Lotion. 



. gr. xv. 

(Anderson.) 



Acidi Benzoici, gr. ex. 

Ol. Caryophylli, . . . . ; gtt. xl. 

Alcoholis, 5ij ss - 

Solve et adde — 

Cerati Simplicis, . . . . Jjviij. 

Balsami Peruvian]', . . . Jj. 
M. ft. unguentum. Especially good for 
scabies, but may be used for any pruritus. 



R. Acidi Hydrocyan. Dil., . . gij. 

Sodii Boratis, sjj. 

Aquae Rosse, i| vn j- 

M. Sig.— Lotion. {Fox.) 



R. 



Potassii Cyanidi 
Pulv. Cocci, . . 
Ung. Aquas Rosas, 
M. Sig. — Ointment. 



V J- 



• gr. j. 
{Anderson?) 



R 



Gum mi Camphoras, 
Chloralis Hydratis, . . aagj-ij. 
Rub together until liquefied, 
then add slowly, with friction, — 

Unguenti Aquas Rosas, . . %]. 
Sig. — Ointment for itching. 

[Bulkley. 

R. Acidi Carbolici, :jij. 

Glycerini, . Jj. 

Aquas Rosas, . . q. s. ad ^ viij. 
M. Sig. — Lotion for pruritus. 



Psoriasis. 

Ichthyol, is a very efficient application. Thiol, is probably a better remedy 
than Ichthyol ; the dry form, used as a dusting powder, is remarkably efficient 
(Squibb). Aristol, is an excellent application. Arsenic, at first apparently 
aggravates, but soon heals the disease (R) ; must be persistently used for a 
long time (B) ; exercises a powerful influence (Wa) ; maximum dose tt\,v Liquor 
Arsenicalis ter die, never on empty stomach (R). Mercury, in patches of 
obstinate psoriasis, especially of hands, even when not syphilitic ; Calomel and 
Mercuric Nitrate ointment may be mixed and Tar ointment added (R). Lappa 
Major, a tincture of the seeds in whiskey, used by tablespoonful doses, cured 
several cases of long standing (Reiter). Carbolic Acid, I to 4 of lard, as 
ointment (Wa). Mezereon, a useful adjunct (Wa). Sulphur, internally (R) ; 
a solution of Potassa Sulphurata in water, is excellent in chronic psoriasis (B) ; 
not in acute (R). Sulphur Iodide, externally and internally, in doses of gr. j-vj 
used with great advantage (Wa). Silver Nitrate, occasionally in psoriasis of 
tongue and buccal mucous membrane ; if syphilitic, mercurials best (R). 
Chrysarobin, has the most decided effect on psoriasis, £>ss-ij ad %} of ung. 
aquae rosae ; often irritates, and should be employed at first with caution 
(Bulkley). Nitric and Nitro-Hydrochloric Acids, when symptomatic of imper- 
fect digestion and assimilation (B). Phosphorus, as substitute for Arsenic (B). 
Coptis, has reputation in New England (B). Copper Sulphate, applied solid 
to spots (R). Lead, the ointment of the Iodide (B). Tar, painted on, in 
obstinate cases (R). Oils, Cod-liver Oil internally and locally, is the 
sheet-anchor, especially when of strumous origin (B) ; oils and fats to lubri- 
cate skin, with warm baths (R). Diet and Hygiene, nourishing diet, frequent 
small quantities of raw vegetables, Cod-liver Oil for growing persons, espe- 
cially when stale fish the cause. Rest and change for overworked subjects. 
Daily baths and cold sponging. Free, open-air exercise is also most useful. 
Warm or tepid soft-water baths at night, with use of pure soap. 



PTERYGIUM — PUERPERAL CONVULSIONS. 68j 

Pterygium. 

Silver Nitrate, locally, especially when pterygium with catarrhal conjunc- 
tivitis (Wa). Treatment unavailing, benefit seldom derived from any opera- 
tion (C). Arlt's Operation, the most satisfactory ; cut away as little tissue as 
possible, dissect cleanly, close with future (Green). 



Ptosis. 

Veratrine, gr. x in gij of Sulphuric Ether and ^j of Alcohol, brushed over 
the eyelids, brows and temples every morning, till a slight burning sensation 
is produced ; conjoined with the use of electricity (W). Ergot, aqueous 
infusion as collyrium (Wa). Electricity, the constant current may often relieve 
recent cases (C). Operation for shortening the lid, by removing an elliptical 
piece of skin and subjacent muscle (C) ; is not advisable unless the ptosis is 
nearly or quite complete, and of great inconvenience. 



Ptyalism. 

Iodine, as gargle, ^ij of tinct. ad ^viij aquas (R) ; is worthy of trial (Wa). 
Acids, as astringents, small medicinal doses (R). Sulphuric Acid, internally 
and as a gargle with Decoctum Cinchonas, of great benefit in mercurial ptyalism 
(Wa). Potassium Chlorate, in simple or mercurial ptyalism (R) ; in the latter 
form 3j ad ^vj aquas as mouth-wash, and internally in teasp. doses, 4 or 5 
times daily (St). Belladonna, very effective in mercurial ptyalism, and that of 
pregnancy; gtt. v-x, or Atropine gr. T ^ to -^ every 4 to 6 hours (B) : 
Atropine hypodermically (R) ; should be useful (W). Tannic Acid, in mer- 
curial ptyalism is an excellent gargle, Z) of Tannin to ^ij of Mel Rosas, and 
^vj of water (B). Alcohol, diluted, as a gargle (R). Potassium Iodide, some- 
times beneficial in mercurial ptyalism, but often aggravates it (R). 



. Tinct. Myrrhse, . . . . %}. 

Aquae, ^ vj 

M. Sig. — Mouth-wash. 



Prescriptions. 

R- . Sodii Boratis, g ij. 

Pulv. Myrrhae, £j. 

Aquae, Jvj. 

M. Sig. — Mouth-wash or gargle. 



Puerperal Convulsions. 

Aconite, one of the best agents (P) ; gtt. j-ij of tinct. every 10 or 15 minutes 
for the first hour, then at longer intervals (B). Belladonna, the tincture inter- 
nally with Atropine hypoder., of verified utility (P). Veratrum Viride, in 3ss 
doses of fluid extract every 15 minutes, to nausea, invaluable (R) ; the fl. ext., 
in doses of TtLviij-x hypodermically, may be repeated in half- hour with Mor- 
phine, or riLx by enema, promptly efficient in the worst cases (Elmer) ; a very 
bad case cured by 20-minim doses every hour for 5 days (Dunn) ; the worst 
case seen in my 30 years' experience, after 14 seizures was promptly cured by 
a hypodermic injection of TTLiv of Norwood's tincture in a little water (Ether- 
idge). Pilocarpine Nitrate, gr. \ hypodermically every 2 hours, very success- 
fully used in several cases (Finniss). Potassium Bitartrate, administered for 
a month prior to confinement, in quantity sufficient to bring about free action 
of kidneys and bowels, will certainly prevent puerperal convulsions (Anderson). 
Opium is apt to induce eclampsia, unless its use be preceded by free purgation 
or venesection (Idem) ; as Morphine hypodermically, the most important agent 
for cure of urasmic convulsions (B) ; with the lancet, sometimes required (P). 
Anaesthetics, especially Chloroform (R) ; utility unquestionable, when not due 
to cerebral hemorrhage (B). Chloral, full doses (gr. xx-xxx) every 2 hours, 



PUERPERAL DISORDERS FEVER MANIA. 

may arrest (B) ; a remedy of the greatest value, a full dose, gr. xx-xxx, before 
proceeding to one of the Bromides (Playfair, Barnes). Amyl Nitrite, by inha- 
lation (B) ; may cause alarming hemorrhage (W). Ice, to the head (R) ; and 
mustard poultices at same time to the feet (Wa). Venesection, by far the most 
efficient measure (Wallace) ; when great cerebral congestion and vascular 
tension, shown by a livid face, a full and bounding pulse, and strong pulsation 
in the carotids (Playfair). 

Puerperal Disorders. 

Cimicifuga, in puerperal hypochondriasis, and depression (Wa, P). Opium, 
either alone or with alteratives, highly serviceable in puerperal intestinal irri- 
tation ; a few drops of tincture effectually arrests the diarrhoea (Wa) ; when 
shock and marked exhaustion, a moderate dose is of benefit (L). Castor Oil, 
undoubtedly the best laxative (L) ; purgatives generally are not required, 
Castor Oil the very worst (Fordyce Barker) ; action uncertain (Parry). Rhu- 
barb, or enemas, best means of stimulating bowels after fourth day (L) ; gr. 
xx-xxx in some aromatic water a good aperient (Wa). Aliment, in puerperal 
state should be easy of digestion and sustaining (L). Catheter, necessary often 
for several days when bladder paralyzed, if warm water lavements fail to excite 
(L). Water, tepid sponging of external parts, vaginal washings daily with 
warm water, with -^ part Carbolic Acid (L). [See After-pains, Hemorrhage, 
Labor, Lactation, Mastitis, Nipples, Phlegmasia Alba-Dolens, etc.] 

Puerperal Fever. 

Aconite, drop doses everyone or two hours steadily, with an occasional dose 
of Castor Oil, and repeated hot poultices or Laudanum fomentations, the most 
successful treatment, even in the worst cases, but useless if not promptly effi- 
cient (P). Veratrum Viride, is used with great benefit in most cases (Barker). 
Opium, for wakefulness and delirium (B) ; a very valuable remedy, tending to 
allay pain, and reduce excitement of the nervous and vascular systems (Wa). 
Alkaline Sulphites, especially valuable in early stages, internally and locally ; 
gr. xv-xxx of Magnesium or Calcium Sulphite every 2 or 3 hours, with injec- 
tions every day (Wa). Stramonium, when cerebral excitement (P). Potass. 
Permang., gr. %-) ter die, has been given with benefit (B). Alcohol, freely 
used, until all evidence of sepsis subsided, caused recovery in one of the most 
desperate cases of puerperal septicaemia, of three weeks' standing, with temp, 
falling to 95 and rising to 107 (Hills). Calumba, preferable to Cinchona (P). 
Quinine, only large doses are useful : gr. v-xx every 4 hours (B) ; reduces 
temperature (P). Turpentine, when depression of vaso-motor nervous sys- 
tem, cardiac weakness and tympanitic distention of abdomen (P, R). 
Resorcin, is much used in Vienna by Braun ; gr. xl repeated p. r. n. Anti- 
septic Injections into uterus, opposed very strenuously by many of our best 
men. [See N. Y. Med. Rec, 1884, p. 14. For antiseptic treatment by Hydrarg. 
Bichlor., see Dr. Garrigues in N. Y. Med. Rec, of December 9, 1883, and N. Y. 
Med. Jour, of March 1, 1884, and the discussion in the N. Y. Academy of Medi- 
cine, reported in the N. Y. Med. Record of January 5 and February 16, 1884, 
et seq.] Water, hot fomentations frequently to parts, a valuable preventive. 
Rest, and quiet but attentive nursing ; frequent liquid nourishment. Warburg's 
Tincture, is more efficient than the largest doses of Quinine in cases of puerperal 
malarial fever, ^ss every four hours until fever abates, then in diminishing 
doses to 3j-ij, until convalescence is established (Fordyce Barker). Compare 
Puerperal Peritonitis.] 

Puerperal Mania and Melancholia. 

Stramonium, will allay cerebral excitement, and soothe nervous system ; 
when delirium wild and furious, but intermittent ; tendency to suicide or to 
destroy the child ; rr\,x-xx of tinct. every 3-4 hours (P). Hyoscyamus, in 



PUERPERAL PERITONITIS PURPURA. 689 

milder cases ; nervous system greatly excited (P). Aconite, in puerperal 
mania with high fever, restlessness ; speedy and marked success if given soon 
after chill (P). Cimicifuga, has cured (B) ; its effects are truly remarkable in the 
mania and hypochondriasis of puerperal state (P). Chloral, often alleviates 
symptoms (B) ; to produce sleep (Wa). Potassium Bromide, in sthenic cases 
(R) ; its effects are very variable (Wa). Anaesthetics, Ether inhaled in violent 
paroxysms of mania (B). Tartar Emetic, in frequently repeated doses (Wa). 
Quinine, when much weakness ; skin cold and sweating (B). Chalybeates, 
Tinct. Ferri Chlor. (n^v-xx) in anaemic form (B). Opium, cautiously (B) ; gives 
the best results in such doses as may be necessary to allay irritation and pro- 
cure sleep (Wa). Poultices, hot fomentations, enemas, or gentle laxatives ; 
nutritious and stimulating diet. Lochia should be watched (P). Weaning, 
imperative in melancholia ; not so in acute mania. 



Puerperal Peritonitis. 

Aconite, has cured cases of the usual type (P). [See under Puerperal 
Fever.] Cimicifuga, especially in rheumatic form, has remarkable effects (P). 
Opium, its curative power in this, one of the best established facts in therapeu- 
tics (B) ; is good, but Aconite often better (P) ; especially valuable in adynamic 
cases (Wa) : the drug of all others to be relied on (Godson). Turpentine, as 
stimulant tt\,x frequently repeated ; better than Alcohol (B) ; by enema, also 
hot turpentine epithems may be used with advantage (Wa). Quinine, in con- 
siderable doses, with or without Opium (B) ; gr. x-xx twice daily as an antipy- 
retic (Wa). Antimony, as Tartar Emetic, gr. T ^ to |- every hour to shorten 
attack and render it more mild (R). Cathartics, advised by many, prohibited 
by as many ; evidence is in favor of mild aperients combined with Dover's 
powder or Hyoscyamus (Wa). Poultices, hot, of very great value (B). Water, 
Ice in mouth or swallowed, hot fomentations to abdomen ; in some cases cold 
compresses best. [Compare Puerperal Fever.] 



Pulse. 

Aconite, for a quick, resisting pulse (P) ; a moderate dose, while it makes the 
pulse less frequent, renders it fuller, stronger and less compressible (R). 
Veratrum Viride, reduces febrile heat with abnormal rapidity of pulse (P). 
Veratrine, pulse at first quick and strong, then slowed ; afterward quick, weak 
and irregular (R). Digitalis, for weak, quick pulse. [Compare Heart Dis- 
eases, etc., in this Part, also Vascular Stimulants, page 34.] 



Purpura. 

Sulphuric Acid, often acts happily (B). Ergot, has been strongly urged 
(R) ; is most useful in removing purpura (P) ; many cases are recorded as 
cured by hypodermic injections of Ergotin (Wa). Turpentine, has been used 
(R) ; with invariable benefit (Wa). [See Hematemesis.] Nux Vomica, no 
prescription more generally useful than the Syrup of Iron, Quinine, and Strych- 
nine (B). Iron, when due to anaemia; the Tincture of the Chloride (B) ; is 
preeminently the curative remedy for purpura hemorrhagica, arresting the 
hemorrhagic tendency in 24 to 48 hours (Pize). Vinegar, and water, is an 
excellent application by sponging over the body (E. Wilson). Quinine, or Hux- 
ham's Tincture of Bark, are much used (H). Potassium Nitrate, gr. x thrice 
daily in purpura simplex, used successfully (Wa). Styptics, as the Ammonio- 
ferric Alum, Tinct. of Ferric Chloride (Tr) ; Tannic and Gallic Acids, used in 
some cases (H). Alum, and brandy, or whiskey and water at such temperature 
as is not chilling, applied by sponging the body, is the best local measure (H). 
Wines are generally indicated (B). [Compare Hemorrhage, Scurvy.] 

44 



i 



( 



69O PUSTULE PYEMIA — PYROSIS — RECTUM. 

Pustule, Malignant. 

Nitric Acid, strong, applied steadily (after thorough cleansing and drying) to 
destroy the diseased mass (D). Bromine, to saturate the surface (D). Carbolic 
Acid, undiluted, as caustic, or with oil, the favorite application (D). Nitric 
Acid, fuming, is the preferable caustic (Greenfield). Quinine and Carbolic 
Acid, internally, are indicated in all forms, also stimulants, as Ammonia, 
Ether, and Alcohol (Greenfield). Eschar should be promptly destroyed, to 
avoid contagion (R). Excision and cauterization demanded, when from direct 
inoculation ; the two most successful measures (Greenfield). 



Pyaemia and Septicaemia. 

Quinine, large doses only (gr. xv-xx) are useful (B) ; supposed to diminish 
the temperature (R) ; to cinchonism, in childhood the best remedy (Wa) ; is 
probably the most useful medicine, given in full and frequently repeated doses 
(Haward). Salicin, to reduce the temperature in septicaemia and to relieve the 
cerebral symptoms (R). Salicylic Acid, has decided value (B). Potassium Per- 
manganate, is given with advantage, gr. %-gr. j thrice daily in distilled water 
(B). Boracic Acid, a saturated solution to wounds, ulcers, etc. ; also Chlorine, 
as disinfectant (B). Oleum Caryophylli, locally, also Oleum Gaultherise, Thymi, 
etc. (B) as antiseptics. Water, cold, as dressing. Hot better, 95°-ioo° F., 
Hamilton's immersion plan for wounds (B) ; stumps to be immersed in a 
warm bath, to avert pyaemia (R). Sulphites, may do some good in chronic 
cases, but the use of Sulphurous Acid has not given the results in man which 
Polli obtained from its use on animals (Haward). Turpentine, is a better stim- 
ulant than Alcohol (B). Ice, dissolved in the mouth (Wa). Aliment, plentiful 
nourishment, with wine and good ventilation, are not to be neglected (Wa) ; 
malt liquors are justly esteemed (B). Stimulants necessary, brandy the best 
(Wa). Abscesses, must be opened early, especially when in joints. 

Pyrosis and Cardialgia. 

Capsicum, in atonic dyspepsia, with heartburn and diarrhoea (P). Nux 
Vomica, of the highest possible value in atonic dyspepsia with heartburn, hic- 
cough, regurgitation, etc. ; an excellent combination is ttlv-x of the tincture 
with n\,xv of dilute Nitric Acid for one dose (P). Pulsatilla, a good medicine 
in heartburn of dyspepsia in phlegmatic subjects (P). Podophyllin, gr. ^ night 
and morning in obstinate heartburn, with liver derangement (P). Almonds, 
six or eight blanched, said to relieve heartburn (P). Diet, lemon-juice, aerated 
bread, plain biscuit, etc. ; but avoid new bread, much vegetable food, and 
pastry. [Compare Acidity, Dyspepsia.] 

Rachitis. 
Lime, as Lime-water, or the Carbonate, or the Syrupus Calcii Lacto-phos- 
phatis (B) ; in small doses (R) ; the Phosphate may be advantageously com- 
bined with Cod-liver Oil (Wa). Iron, the Syrup of the Iodide preferred; 
Calcium and Ferric Phosphates excellent in combination (B) ; must be con- 
tinued a long time (R). Nitro-hydrochloric Acid, as baths, gives excellent 
results (Wa). Quinine, often very valuable (P). Aliment, food rich in Calcium 
Phosphate and other phosphatic salts ; oatmeal, Graham bread, etc. (B) : Cod- 
liver Oil, the best constructive agent (B) ; a full animal diet (Wa) : cold 
sponging (R). 

Rectum, Diseases of. 

Podophyllum, in doses of gr. -fa to ^ night and morning, for a child, may 
relieve prolapsus of the rectum (P). Belladonna, the extract locally in fissure 
(R) ; and irritable ulcers (P) ; internally and locally to remove ulcers, also 



RECTUM REMITTENT FEVER. 69 1 

excellent in burning pain following defecation, or with mercurial ointment in 
equal parts, for fissures and ulcers (P). Phosphorus, in chronic inflammation 
of the rectum, has been highly recommended (R). Cocaine, gr. xl to ^j of 
Glycerite of Starch, applied by Seeley's Pile-pipe, very efficient in controlling 
spasm of the rectum. Potassium Bromide, in 5 parts of Glycerin, locally, for 
fissures and painful growths (R). Iodoform, as suppository in painful diseases, 
relieves greatly (R). Pepper, the confection, as gentle stimulant in fistula, 
ulcers, hemorrhoids (P). Castor Oil, in fissure and hemorrhoids, is commonly 
used as purgative (R, P). Sulphur, with Confectio Sennse, in irritable rectum, 
is very soothing (Wa). Stramonium, an ointment from fresh leaves to alleviate 
pain (P). Conium, the extract in doses of gr. x to allay pain and irritability in 
cancer (Wa). Purgatives, best for proctalgia (D). Surgical, an incision through 
mucous membrane, and in severe cases to divide part of the sphincter, in ulcer 
or fissure ; a flake of cotton should be laid in the wound, so that it may heal by 
granulation (D). [Compare Anus, Diarrhcea, Dysentery, Rectum Ulcera- 
tion of, Hemorrhage Intestinal, Hemorrhoids, Prolapsus.] 

Rectum, Ulceration of. 

Mercury, the Red Oxide, Z) to the ^j of Unguentum, as ointment in flat 
ulcers of rectum existing just within the anus (Coulson). Belladonna, the 
extract locally for rectal ulcers, is very efficient (P). Carbonic Acid, gas, per 
anum, is strongly advised (Wa). Chloroform, as ointment, in irritable ulcer of 
rectum (Curling). Iodoform, in suppository, extremely useful in painful ulcera- 
tion (R) ; used in many cases with very satisfactory results, but in some 
instances poisoning occurs ; hence it should be used with caution (Wa). Phos- 
phorus, as an internal remedy, is highly recommended in chronic inflammation 
of the rectum (R). Copper Sulphate, with Opium, may often be used internally 
with advantage, and a weak solution of the same, or of Silver Nitrate, locally 
(Curling) ; the writer had a case resisting treatment for three years, in which a 
cure was effected by a persevering use of a pill of Cuprum Sulphate, Extract of 
Opium, and Quinine Sulphate. Silver Nitrate, gr. %~) combined in pill with 
Opium, gr. ss ; and a solution, gr. x-xx to the pint, by enema (B). Glycozone, 
%} in ^xij of lukewarm water, mixed immediately before using, and given by 
enema once daily, in ulceration and chronic inflammation of the rectum and 
lower gut (Edson). 

Prescriptions. 



R- . Cupri Sulphat., 

Morphinae Sulphat., . . aa gr. ij. 

Quininae Sulphat., . . . . gr. xxiv. 

M. ft. pil. no. xxiv. Sig. — One pill 
thrice daily. {Potter?) 



R- . Chloroformi, 3J - iJ- 

Zinci Oxidi, 3 ss. 

Olei Olivse, gj. 

Cerati Cetacei, giv. 

M. ft. unguentum. {Curling?) 



Relapsing Fever. 

Cathartic, a mild one at beginning (H) ; if jaundice or other hepatic derange- 
ment, a Calomel purgative, cautiously, lest irritation (Wa). Potassium Citrate, 
as cooling diaphoretic. Quinine, in moderate doses after the crisis, at least 
until the relapse, which will not be prevented by any amount of Quinine (Wa). 
Leeches or Cupping, best for headache (A). Alcohol, required by some pa- 
tients. Diet, supporting, especially in third week, beef-tea, etc. Urine, should 
be watched carefully (A). [Compare Typhus Fever.] 

Remittent Fever. 

Antipyrin or Phenacetin, in full dose during pyrexia, to lower the temp., is 
very efficient treatment, especially if conjoined with Quinine during the remis- 
sion ; the latter drug being too slow of action to be of immediate service in the 



692 RETINA RHEUMATISM. 

pyrexia. Aconite, in hot stage, if any febrifuge is required, frequently re- 
peated doses (B) ; is next in value to Quinine for high fever and headache, gtt. 
j of a good tincture every hour (Da C). Quinine, 20 to 30 grains in single dose 
once or twice daily till temperature is reduced, with other appropriate remedies 
(B) ; 15 to 20 grains at most (Maclean); 30 to 50 or 60 grains in severe cases 
of pernicious remittents several times a day without regard to exacerbation (P, 
B). Warburg's Tincture, has achieved a very high reputation, but must be 
used in less dosage than directed, and supporting treatment given when its 
sudorific action commences (Wa). Gelsemium, exercises a really beneficial 
influence ; depresses temperature (B) ; valuable in bilious remittents of the 
South (Pf). Morphine, gr. % hypodermically to abort pernicious remittent 
fever (B). Purgation, by Calomel with Jalap or salines afterwards, is very 
necessary during the course of the disease (Da C). Quassia, an excellent 
tonic in convalescence, combined with mineral acids (Wa). Packing, -by wet 
sheet, is resorted to with advantage, except when hepatic or splenic congestion 
(Wa). 

Retina, Affections of. 

Mercury, in syphilitic retinitis is of great value ; Calomel gr. j-ij with Opium 
gr. X - /^ every 4 or 6 hours ; also mercurial inunction till the gums are affected 
or the disease yields (Wa). Potassium Iodide and Bromide, in combination, 
in retinal hemorrhage, to promote absorption of the effused blood, and benefit 
the congestion (C). Eserine, locally to contract pupil, and diminish the 
amount of light admitted to the eye (Wa). Iron, in full doses, generally the 
Tincture of the Chloride, in pigmentary retinitis ; seems to have a tendency to 
arrest the malady (C). Leeches, to the temple better than general bloodletting 
(Wa). When much local congestion present, depletion by artificial leech is 
almost always indicated (C). Pilocarpus, in detached retina and optic neuritis ; 
has been found a very useful remedy in retinal affections generally. [Com- 
pare Amaurosis.] 

Rheumatism, Acute. 

Plans of Treatment, may be resolved into three, viz., — (1) that by Salicylic 
Acid, (2) that by Alkalies, (3) that by Iron. Salicylic Acid or the Salicylates, in 
20-grain doses, to not less than 3\j m 24 hours, in solution with excess of 
alkali, is especially suited to vigorous, sthenic subjects, whose stomachs will 
bear it, in whom it often effects a cure in 3 or 4 days. Alkalies, for flabby, 
fat subjects ; alkaline carbonates, as Potassium Carbonate, ^jss, every 24 hours, 
alone or with a vegetable acid, until the urine becomes neutral or alkaline, 
when it may be reduced one-half, and so maintained for some days, when 
Quinine or Iron may be used ; if successful, this treatment brings about a 
cure in two weeks. Tincture of the Chloride of Iron, for feeble, anaemic, and 
nervous subjects, rr^xxx every 4 hours, with an occasional saline laxative, 
blisters around joints, and Atropine as an anodyne rather than Opium, used 
hypodermically in the vicinity of the affected joint (B). Iron and Salicylic 
Acid in combination, should be most valuable, but as heretofore prescribed 
has always made an insoluble precipitate ; this is overcome by Dr. Peabody 
in the formula given below, which makes a ruby-red mixture, and has ad- 
vantage of preventing the anaemia which results from the Acid given alone. 
Cardiac Complications require Ammonium Carbonate, in 5-grain doses fre- 
quently, also Infusion of Digitalis with hypodermics of Morphine, and a blister 
over the praecordium, followed by Iron and Quinine after the acute symptoms 
have subsided (B). 

Aconite, very serviceable when much heat and dry skin (B); subdues pain 
in inflamed joints and perhaps shortens the fever (R) ; in small doses fre- 
quently repeated of the greatest value, and if used from the start prevents 
organic cardiac disease (P) ; not reliable as a curative agent, but is a valuable 
adjunct to other remedies (Wa). Veratrum Viride, said to be useful (R) ; as 



RHEUMATISM, ACUTE. 693 

antipyretic, small doses, may be combined with Opium (P). Bryonia, has 
proved useful, especially for painful and stiff rheumatic joints (P). Salicin, gr. 
x-xxx every 2, 3, or 4 hours ; gr. xv every 3 hours in powder mixed with water 
(Maclagan), or same dose of Salicylic Acid, is of great benefit ; good effect 
generally experienced within 48 hours (R) ; the Acid is better than the Salicy- 
lates, but must be abandoned if not effective after 3 or 4 days (Da C). Salol, 
the great remedy, none superior (B) ; given in doses of 15 to 30 grains, up to 
3ij in 24 hours, and continued for some time after acute symptoms have sub- 
sided ; may prove toxic in large doses, with symptoms of carbolic acid poison- 
ing. Salophen, is said to be equally efficient and non-toxic, gj-5jss daily. 
Salipyrin, has been employed with excellent results, in 15-grain doses every y^ 
hour or hour, until about £ij have been taken, continuing with smaller doses 
for a long time after convalescence, to prevent relapses. Phenacetin, an effi- 
cient and safe antipyretic in poly-arthritis. Phenocoll, used for the pyrexia, 
with marked success. Oil of Gaultheria, as a substitute for Salicylic Acid, 
used very successfully in form of emulsion (B). Rhus Toxicodendron, 
positively invaluable in after-stage, also in subacute forms, muscular or ten- 
dinous, worse at night (P, Pf). Hydriodic Acid, the Syrup, in dessertsp. doses 
every 2 or 3 hours, the best remedy for acute and subacute rheumatism, reliev- 
ing pain and swelling in 18 to 24 hours (Craig). Cimicifuga, excellent reports 
from (B) ; has been much used, said to quell the pain speedily (R) ; found 
very serviceable (P). Dulcamara, recommended especially for persons who 
are subject to catarrhal affections in cold and damp weather (P). Ammonium 
Bromide, a very excellent treatment, followed by Quinine ; gives a very low 
proportion of cardiac complications ; gr. xv-xx every 4 hours (Da C) ; dis- 
agreeable but strongly recommended (B). Arnica, lowers pulse and tempera- 
ture, relieves articular pain and swelling, diminishes urea (P). Trimethyl- 
amine, ttijv-viij in Peppermint-water, often has remarkable power in acute 
rheumatism and gout (B). Spigelia Anthelmia, rheumatic pericarditis and 
endocarditis ; rheumatic fever with pain shifting from joint to joint (P) ; seems 
to fix the disease in certain joints, and prevent its shifting around (P). Sul- 
phurous Acid, by fumigation, patient covered with blankets exposed to strong 
fumes, produces perspiration, sleep and relief (R). Colchicum, alleviates the 
symptoms, and shortens their duration (Wa). Laville's Mixture, is said to be 
a tincture of Quinine and Colocynthine, but it is more than probable that Col- 
chicine is the active agent therein. [See N. Y. Med. Record, Dec. 5, 1885, page 
642.] Quinine, as antipyretic ; not so useful as wet pack or cold bath ; gr. ij-v 
after the more acute symptoms have subsided (B) ; is best for the head symp- 
toms (Da C). Opium, strongly recommended as anti-rheumatic; gr. j every 
2 or 3 hours, increased to gr. xij in 24 hours ; tolerance remarkable in this 
disease ; in rheumatic carditis it is indispensable (Wa) ; a very good remedy 
in moderate doses (Da C). Lithium Bromide, equally good in all forms, 
especially for insomnia, delirium, etc. (B). Digitalis, in powder, gr. ij every 
4 hours, usually effective after 2 to 7 days ; especially useful in cardiac 
complications with cyanosis and oedema. Iron, Tincture of Chloride very ser- 
viceable in pale, delicate subjects, rr^xx-xxx every 4 hours ; also as prophy- 
lactic where tendency (Anstie) ; harmful to the plethoric and overfed (B). 
Alkalies, the alkaline treatment is now seriously questioned; an injurious 
dyscrasia results from their use (B) : Potassium Bicarbonate, gr. xxx every 4 
hours, in a dilute solution, until joint-symptoms and fever disappear (Wa). 
Lime-juice, ^viij daily, Lemon-juice inferior (R). Blisters, are a very effec 
tive method ; a number of small blisters applied to vesication around a joint 
(B) ; large flying blisters around a joint (R). Water, cold baths for the hyper- 
pyrexia (Da C) ; the wet pack very efficacious in rheumatism, also a vinegar 
vapor bath (B) ; the wet pack, 20 or 30 minutes, and tepid (70 ) shallow bath 
1 or 2 minutes. Cold applications only when skin hot and dry, and tempera- 
ture high. Warm baths, or hot compresses very useful. Spongiopiline an 
excellent substance for applications. Diet, low during the fever, water, barley- 
water, milk-and-water, gruel, etc. All through use liquid food. Avoid malt 
liquors, port wine and sugar. Lemon-juice may be used freely. Blankets, 



< 



694 



RHEUMATISM, CHRONIC. 



instead of sheets to sleep in, and flannel underclothing are useful adjuncts. 
Pack the joints with cotton covered with rubber cloth or oiled silk. 



R. 



Olei Gaultheriae, 
Acidi Salicylici, . 
Sodii Boratis, . . 
Syr. Picis Liquidae. 
Aquae Anisi, 



Prescriptions. 



■ 3J- 

. gr. lxxx. 



M. Sig. — A dessertsp. every two hours 



R 



. Potassii Iodidi, gij. 

Vini Colchici Sem., 

Syr. Simplicis, ... aa % iv. 

Aquae Menthse Pip., . . . ^v. 
M. Sig. — Tablesp. every 4 hours. 

(A r ew Orleans Charity Hosfi.) 



R 



Propylamine Chlorid., . . gr. xxiv. 
Aquae Menthae Pip., . . . j|vj. 
M. Sig. — A tablesp. every two or three 
hours. {Tyson.} 



R. Acidi Salicylici, gij. 

Ferri Pyrophosphate . . . %]. 
Sodii Phosphatis, . . . . gr. xij. 

Aquae, J vj. 

M. Sig. — A tablesp. every 2 hours. 

(Peabody.) 

R. Ammonii Phosphatis, . . ^jss. 

Tinct. Colchici Seminis, . ^j. 

Tinct. Acoaiti, 55 ij. 

Syr. Simplicis, ^iij. 

M. Sig. — A teasp. every three or four 
hours. {Corson.') 

R . Sodii Salicylatis, . . . . ^ ss. 
Tinct. Lavand. Co., . . . giij. 

Glycerini, 3 v h 

Aquae, q. s. ad ^vj. 

M. Sig. — A tablesp. every three hours, 

well diluted. 



Rheumatism, Chronic. 

Arsenic, is very good in most cases, given in small doses steadily (Da C) ; 
with Guaiac instead of Sulphur in the Chelsea Pensioner (see ante, page 467), 
the latter is more efficient (Fothergill). Bryonia, is useful, especially for pain- 
ful and stiff joints (P). Rhus Toxicodendron, a very powerful agent in sub- 
acute muscular or tendinous rheumatism, worse at night (Pf) ; the tendons, 
ligaments, and fasciae are most benefited ; externally, as lotion on compresses ; 
also, internally, small doses every two hours (P). Potassium Iodide, especially 
when pains are worse at night, or of syphilitic origin (R) ; should always be 
fairly tried in chronic rheumatism (Da C) ; was Sir Astley Cooper's remedy. 
Cimicifuga, sometimes has wonderful success, yet often fails ; no indications 
(B) ; in rheumatic neuralgias and headaches, and rheumatism of uterus (P) ; 
signally beneficial in many forms (R). Mercury, and Morphine, the Oleate 
locally, for joint affections (R). Colchicum, is of decided advantage in neural- 
gia of chronic rheumatism (B). Mezereon, strongly recommended (P, R). 
Phytolacca, has been useful (B). Iodides often prove very satisfactory, especi- 
ally in strumous or syphilitic subjects (B). Aconite, the extract as plaster to 
joints is unquestionably very useful (P) ; is more useful in chronic than acute 
rheumatism (Wa) ; the liniment of the B. P. locally over the sciatic nerve 
when affected (Fothergill). Dulcamara, has been employed with advantage 
(P) ; Sulphur, locally, also Sulphides as baths (R) ; is certainly of benefit (B) ; 
Sulphur waters are undoubtedly efficient (Da C) ; Sulphur is an ingredient of the 
Chelsea Pensioner (see ante, page 467), an old English remedy for chronic 
rheumatism. Ichthyol, is invaluable given internally in pill, gr. x-xxx thrice 
daily ; also as ointment with Lanolin 50 per cent. (Illinsky) ; or as a liniment 
with Turpentine or an equal weight of a mixture of Lanolin and Olive Oil, 
with 30 per cent, of Chloroform. Iodine, for pain around joints (R). Lithium 
Bromide, gives excellent results, when smaller joints swollen, tender (B). 
Lithium Salicylate, in 15- to 20-grain doses every four hours, gives good 
results in lingering, subacute cases after acute attacks (Da C). Quinine, in 
rheumatism with debility, shown by night sweats, or sweats during sleep and 
only then (Wa). Arnica, the tincture and infusion are useful (P). Cajuput Oil, 
internally and externally in muscular rheumatism (P). Turpentine, benefits 
and relieves the pains; internally and externally as liniment (P). Guaiac, 



RHEUMATISM, GONORRHCEAL, MUSCULAR. 



695 



used with varying success (B) ; often gives excellent results ; the ammoniated 
tincture, 3j-ij in milk (Da C) ; is vile to the taste. Eucalyptus, the leaves 
wrapped around the affected part, renewing them daily for a week or more, 
often very efficient as a local stimulant, and will produce vesication if too long 
continued (Gibbons). Xanthoxylum, has long had deserved reputation, rr\,xv- 
5ij of fluid extract (B). Thuja Occidentalis, is useful for rheumatic pains (P). 
Manganese Sulphate, is one of the remedies (B). Belladonna, the extract 
locally very valuable for pains (P). Cod-liver Oil, internally and externally, 
exercises some influence (B). Chimaphila, may prove useful, especially when 
lithiasis (P). Lupulin, as an anodyne (P). Burgundy Pitch, as plaster locally 
(P). Aliment, avoid alcoholic and malt liquors, coffee, also starchy, animal 
and saccharine food ; the farinaceous vegetables and acid fruits suitable (B). 
Alkaline mineral waters have deserved reputation (B). Turkish Baths, in 
chronic muscular rheumatism (B) ; steam bath daily of great benefit, may be 
obtained at home by pouring water on hot bricks in a tub, the patient sitting 
on a board or chair above, enveloped in a blanket (Brick). Red Flannel next 
skin, very popular, but white better, as the red often gives rise to eruptions 
(Da C). [Compare Lumbago, Myalgia, Pleurodynia, Arthritis, Sciatica.] 



Prescriptions. 



R . Pulv. Resin. Guaiaci, 

Potassii Iodidi, ... aa %]. 

Tinct. Colchici Seminis, . 3 iij. 

Aquae Cinnamomi, 

Syrupi, . . . . aa q. s. ad ^vj. 
M. Sig. — A dessertsp. to a tablesp. 
thrice daily. (Pepper.) 

R. Tinct. Guaiaci ^Ether., . . ^j. 

Tinct. Colchici zEther, . . ^vj. 

Tinct. Cann. Ind. ^Ether., . gij. 
M. Sig. — 25 to 30 drops on sugar, every 
4 hours, for rheumatic and neuralgic symp- 
toms. {At lee.) 

R . Ac. Arsenosi, gr. iij. 

Pulv. Guaiaci, 3 iij. 

Pulv. Capsici, 3 ss. 

Pil. Aloes et Myrrhae . . . 3 iij . 
Ft. pil. no. cxx. Sig. — One thrice daily. 
The modified Chelsea Pensioner. 

(Fothergill.) 



R. 

M 
pain. 

R. 



M 



Linim. Aconiti (B. P.), 

Linim. Belladon., . . . aa £ij. 

Glycerini, ^ij. 

. Sig. — Apply locally over the seat of 
(Fothergill.) 

Olei Sinapis, £ss. 

Olei Terebinth., giij. 

Camphorae, 3™. 

Liq. Ammon. Fort., . . . 3 iij. 

Tinct. Capsici, ^iv. 

Alcoholis, . . . q. s. ad :§vj. 
Sig. — Russian Spirit, a liniment for 



rheumatism. 



M. 



Potassii Iodidi, gj. 

Potassii Nitratis, . . . . gss. 
Ext. Cimicif. Fl., 

Glycerini, aa t ^ss. 

Vini Colchici Sem., q. s. ad 3 ij. 
Sig. — A teasp. after each meal. 

{Potter. 



Rheumatism, Gonorrhceal. 

Opium, as Dover's powder, in the acute stage, full doses (Wa). Potassium 
Iodide, with tonics and stimulants, after the acute stage has passed, followed by 
friction, shampooing, and passive movements of the joints (Wa). Ammonium 
Chloride, in free doses, especially when the muscles are affected (Fuller). 
Potassium Chlorate, internally, and as urethral injection, until urethral dis- 
charge is entirely stopped, then rr\,xx of Tinct. Ferri. Chlor. 4 times daily, with 
gr. x of Quinine daily, and good food (Da C). Aspirate, when pus is discov- 
ered around the joints, as the case will be one of pyaemic rheumatism, and 
may involve more joints than one (Da C). 



Rheumatism, Muscular. 

Diaphoretics, as Dover's powder, with Potassium Nitrate, or Ammonium 
salts, with dry heat to'the part involved and rest in bed (Da C). Morphine 
and Atropine, gr. \ and gr. -^, together hypodermically, are of great service 



696 ROSEOLA SARCIN.E SCABIES. 

in most forms (R). Lithium Bromide, is almost specific (B). Jaborandi, or 
Pilocarpine hypodermically, to get the skin acting freely, a great desideratum 
(Da C). Potassium Iodide and Colchicum, or Quinine, gr. xij-xvj in 24 hours, 
if case lingers over a week (Da C). Liniments are of little use except to 
amuse the patient, but Chloral ^j in Jvj of Linim. Saponis, makes a good one 
(Da C). Capsicum, powdered, with Lard, £ij ad ^j, rubbed over the part, night 
and morning, with a gloved hand, is very efficient (Macdonald). Cimicifuga, 
is often very efficient in lumbago, myalgia, pleurodynia, and similar conditions 
(Wa). Xanthoxylum, gives relief in some cases of muscular rheumatism (B). 
Lithium, and its salts, where there is a uric-acid diathesis (B). Colchicine, 
5-minim doses of a y 1 ^ solution of Merck's, hypodermically into affected mus- 
cles, thrice daily, very effective in cases resisting other treatment. [Compare 
Lumbago, Myalgia, Pleurodynia, Torticollis.] 

Roseola. 

Scarcely any treatment called for; no local application needed, as the rash 
is but slightly irritating. Aconite or Belladonna, according to the symptoms, 
or Ammonium Carbonate, answers all the indications. [Compare Measles.] 

Sarcinae. 

Sulphites and Hyposulphites, have been employed to destroy sarcinae and 
torulae in the stomach (R) ; or Sulphurous Acid, diluted, before each meal 
(Wa). 

Scabies. 

Sulphur, a solution of Potassa Sulphurata gss-^j, as local application ; an 
extemporaneous Sulphide may be made by boiling one part of quicklime and 
two of Sulphur in ten of water (B) : Sulphurous Acid, as gaseous bath, the 
quickest method ; Hebra's mixture of Sulphur, Chalk, Tar, Soap and Lard, less 
irritating, and equally sure (R). Calcium Sulphide, as a bath (W). Sul- 
phuric Acid, internally, has cured when other remedies failed (Wa). Storax, 
equally serviceable and not irritating as is Sulphur, one part to two of Olive Oil, 
with a warm bath (R). Mercury, the Bichloride is very efficient, if used 
strong enough, but caution is required in its employment (B). [See formula 
below.] Staphisagria, a certain remedy ; 3 parts to 5 of Lard, boiled at 212 
F. for 24 hours, when cooled, after straining add a little essence ; friction with 
this 4 times daily (Wa). Balsam of Peru, the best of all applications, killing the 
acarus, relieving the itching and dermatitis, and disinfecting the parts ; rub in 
3j over the body after a warm bath (Bruce) ; is fatal to the itch-mite (Oldberg). 
Manganese, the Oxide, gij to %] Adipis as ointment (B). Copper Sulphate, 
as lotion (^j to Oj) has been used with great success, after crusts are thoroughly 
removed with soap-and-water (B). Alkalies, as soaps or ointments to remove 
cuticle and break up burrows (R). Carbolic Acid, -locally (B). [See Tinea 
for formula.] Cocculus Indicus, as ointment, useful (P). Tar Ointment, 
relieves itching quickly and cures disease in 10 to 12 days (P). Anise Ka- 
mala, as ointments, efficient (P). Benzoic Acid, gr. x-xx ad 0% aquae, as 
lotion, effectual for the pruritus (R). [See last formula on left-hand column, 
under Pruritus.] Beta-Naphtol, by far the best application (Shoemaker) ; 
in 3 to 5 per cent, alcoholic solution, or as a 10 per cent, ointment. Linen, 
should be immersed in boiling water ; other garments well fumigated with 
Sulphur vapor to destroy insects or their ova, or baked in oven (R). 

Prescriptions. 

R. Styracis Liquidis, . . . . gij. R. Sulph. Sublimat., . . . . gj. 

Ung. Sulphuris, giv. Balsam. Peruv., ^ss. 

Ung. Petrolei, . . q. s. ad %]. Adipis, . " Jj. 

M. Sig. — Apply after washing. M. Sig. — For children. (Duhring.} 



SCARLATINA. 



697 



R. Hydrarg. Chlor. Corr., . . gr. iv. 

Alcoholis, ^vj. 

Ammonii Chloridi, . . . gss. 

Aquae Rosae, . . q. s. ad ^ vj. 
M. Sig. — Lotion for scabies, phthiriasis, 
and tinea versicolor. [Fox.) 



R . Sulph. Sublimat., 

Olei Cadini, . , . . aa gij. 
Cretae Preparatae, .... ^ijss. 
Saponis Viridis, 

Adipis, aa %]. 

M. ft. unguentum. (Bulkley.) 



Scarlatina. 

Aconite, of the highest value for all marked increase of temperature (R) ; 
helps the development of eruption when due (P) ; in the early stage, when 
not decidedly adynamic, is very useful (W). Belladonna, during the eruptive 
stage, when depression exists, and rash is imperfectly evolved (B) ; as pro- 
phylactic has been recommended (R) ; is often efficacious as prophylactic (P) ; 
the preponderance of evidence is certainly in favor of such use of the drug 
(Pf ) ; this virtue is claimed by imposing authorities ; when so given its dose is 
gr. ^ several times a day (Tr). Mercury, gr. | of Gray Powder every hour has 
marked effect on inflamed tonsils (R). Ammonium Carbonate, feeble circula- 
tion, cyanosis, delirium (B) ; in all forms, especially if given early (R) ; one of 
the most reliable remedies ; gr. iij-vij, according to age, in milk or Cinnamon- 
water, every hour or two (Wa). Potassium Iodide, in full doses, a very satis- 
factory remedy (Mitchell). Mineral Acids. Muriatic, internally and as gargle ; 
Nitric, locally to sloughs in the throat (R). Salicylic Acid, given in 125 malig- 
nant cases, with mortality of only 3^ per cent. (Shakowaki). Carbolic Acid, in- 
ternally and as gargle, successfully used; [See Measles, for formula,] seems 
to exercise some influence as prophylactic (Wa) ; is good for the vomiting and 
for its general effect on the disease ; TiLss, every 2 or 3 hours (Da C). Veratrum 
Viride, in convulsions (R). Rhus Toxicodendron, of great service, if typhoid 
or rheumatic symptoms (P). Digitalis, very useful ; lowers temperature and 
maintains kidney action (B) ; the best antipyretic and diuretic, the infusion 
with dry cups for the renal dropsy in its inception ; later on, milk diet and 
Basham's Mixture (Da C). Potassium Permanganate, locally to throat, and 
internally (gr. %-] ter die) has undoubted benefit (B). Sulphurous Acid, by 
inhalation, spray, or fumigation, in malignant sore throat (R). Chlorine Water, 
in sloughing of throat (R) ; seemingly prophylactic (Wa). Quinine, small 
doses, in adynamic states, large in hyperpyrexia (B) ; very successful when 
used systematically from the start (Wa). Ferric Chloride, the tincture in 
doses of TrLx-xv, according to age, in advanced stage ; when with albuminuria 
and hematuria, is very valuable (Wa). Potassium Chlorate, in grain-doses 
every ]/ z hour, will not injure the kidneys, and will give equal results as larger 
doses on the throat inflammation (Smith). Asclepias, to promote the eruption 
(W). Zinc Sulphate, gr. ^ every 3 hours, believed to have specific influence 
on the disease (Hoyt). Sodium Benzoate, is highly efficient, having slower 
but more permanent effects on the fever than Quinine or the Salicylates (Klebs). 
Boric Acid, makes an excellent gargle (Da C). Juniper, as diuretic when dropsy 
(R). Magnesium Sulphate, as purgative, to prevent sore throat and other 
sequelae (R). Sodium Sulpho-carbolate, as a means of introducing Carbolic 
Acid into the system ; has been successfully employed (Wa). Mustard Bath, 
on recession of rash, to bring it back (R). Oil Inunctions, very grateful, espe- 
cially useful in desquamative stage ; Cacao-butter the most elegant (B). Ice, 
sucked, for the sore throat (R). Water, cold baths with oil are all that are 
needed in mild cases ; when temperature above 104 , urine scanty and rash 
retroceding, the cold wet-pack renders signal service (R) ; cold wet compress 
to neck, through the whole course, renewed every 3 hours (R). Diet, fruit, if 
ripe, in season, toast, gruel, etc., in simple cases; in malignant, extract of beef, 
stimulants as per pulse. Milk the most suitable aliment, both as nutrient and 
as diuretic. 



6 9 S 



SCIATICA. 



Prescriptions. 



$ , Ac. Borici 3 ss. 

Potassii Chloratis, . . . . 3; ij. 
Tinct. Ferri Chloridi, . . 3 ij. 

Syrupi, gij. 

Aquse, 3 ij. 

M. Sig. — Tablesp. every 2 hours, 



to 



child of five years. 



{Smith.) 



R. Acidi Carbol., 3 ss -j- 

Vaselini, ^iv. 

M. Sig. — By inunction to the entire 
surface. 



R. Acidi Salicylici, ^ij. 

Tinct. Aconiti, gtt. xij. 

Infusi Digitalis, ifj ss - 

Spt. Ammon. Aromat., . . giij. 

Syr. Aurantii Cort., . . . ^ ss. 

Aquae, 3jj. 

M. Sig. — Teasp. every 3 hours, for a 
child of five years. {Brown.) 



R . Acidi Borici, 
Glycerini, . 
M. Sig.— For 
gargle. 



pint 



• • • 3 "J- 
. . . ^iv. 
of water as a 
{Da Costa.) 



Sciatica. 

Aconite, locally (P) ; as ointment controls in some instances (R) ; valuable 
and efficient in many obstinate forms (Wa). Antipyrin, or Acetanilid, are 
efficiently analgesic. Salipyrin, in rheumatic sciatica, has been employed with 
excellent results. Rhus Toxicodendron, a very powerful therapeutic agent in 
various rheumatic affections of the fibrous tissues (P). Cimicifuga, is highly 
extolled (R). Nitroglycerin, in doses of rr\j thrice daily, gradually increased 
to rr\,v, of a one per cent, solution promptly curative in a long-standing and 
severe case (Lawrence). Turpentine, causes an exquisite sensibility along the 
track of the great nerves (Tr) ; occasionally of great value in sciatica, yet not 
a specific, nor have we scientific indications for its use (P) ; ^ss doses for 4 or 
8 successive nights (R). Sulphur, locally, believed to relieve the pain ; effect 
probably due to the flannel surrounding it (R) ; is worthy of trial after active 
symptoms are subdued (Wa). Phosphorus, in neuralgic form ; less satis- 
factory in sciatica than in other neuralgias (R). Nux Vomica, often successful 
in chronic (Wa). Belladonna, has afforded relief (R). Atropine, hypoder- 
mically, is curative ; large doses gr. ^ to g 1 ^ in vicinity of nerve (B). Cocaine, 
hypodermically along the nerve, has afforded instant relief (Wa). Veratrine, 
as strong ointment ; Veratrum Viride, as tincture is also recommended (R). 
Ammonium Chloride, in mild forms (R) ; occurring in the young (Anstie). 
Ether Spray, generally of temporary value (R) ; Chloroform, on flannel along 
course of nerve, covered with oiled silk (Wa) ; injected deeply into vicinity of 
nerve, gives the best results in old cases, rr^xv of the spirit hypodermically (B). 
Stramonium, gr. %-Yz every 3 or 4 hours for 4 or 5 doses, often affords 
decided relief, — stop when slightest symptoms of narcotism appear (P). Opium, 
internally and externally (Wa) ; Morphine, hypodermically is especially cur- 
ative in sciatica (B) ; 3 or 4 injections of gr. ye each may almost be regarded 
as a specific (Wa) ; a single application sometimes cures long-standing cases 
permanently ; if not it may be repeated every second day or so (R) ; should be 
injected deeply into the adjacent muscular structure (Pepper). Iodides, in 
syphilitic or metal poisoned subjects (B) ; often fails (R) ; Potassium Iodide 
in daily doses of 3j dissolved in Decoction of Sarsaparilla, most efficacious in 
subacute or chronic (Wa). Salicylic Acid, as paste locally, Z) with giy of 
Lanolin and 01. Olivae, q. s., also Rhus Tox., gtt. j. of a 1 per cent, solution of 
the fluid extract every 4 hours, cured one very obstinate case (Aulde). Salol, 
gr. vij in evening and gr. xv more at midnight, completely cured me after 3 
weeks suffering in bed, unrelieved by other remedies (Aschenberg). Cold of 
intense degree, produced by refrigeration of limb by Methyl Chloride, extremely 
efficient (Jacoby) ; has been found effectual when applied to the sound limb. 
Cantharides, as counter-irritant, to free vesication (R). Aquapuncture, has 
had extraordinary success (B). [See under Neuralgia.] Acupuncture, 
occasionally affords instant relief (B) ; often cures cases of long standing (R). 



SCLERODERMA SCLEROSIS SCROFULOSIS. 699 

Nerve-stretching, by forcibly flexing the thigh on the abdomen (Lange). Poul- 
tices, applied very hot (R). Turkish Baths, are often very useful (R). Elec- 
tricity, produces excellent results (B) ; does great good, but often aggravates ; 
the continuous current best, when stage of acute inflammation past (W) ; gal- 
vanism often quickly relieves the pain (Pepper). Cod-liver Oil, should always 
be tried in obstinate cases (W). [Compare Neuralgia, Rheumatism, 
Chronic] 

Prescriptions. 

R . Tinct. Colchici Sem., 
Tinct. Cimicifugae, 
Tinct. Belladonnae, 
Tinct. Aconiti, . . aa l\xv. 
M. Sig. — tt\jij every 3 to 6 hours. 



R . Tinct. Colchici Seminis, 

Tinct. Belladonnse, 

Tinct. Aconiti, ... aa ^j. 
M. Sig. — rr^vj every 6 hours. Remark- 
ably efficient. {Met calf.) 



Scleroderma. 

Cod-liver Oil, our sheet-anchor, used internally and locally (B). Electricity, 
is used successfully (B) ; with stimulating inunctions offers the best prospect of 
improvement (Bulkley). Strontium Iodide, has been used, with varied results. 



Sclerosis. 

Aurum preparations are among the remedies which are believed by some 
writers to retard the progress ; others being Arsenic in full doses, Silver Nitrate 
in X grain doses, Physostigmaand Ergot (Osier) : Gold is a specially curative 
agent in all forms of sclerosis, including cirrhosis of the liver, interstitial 
nephritis, cirrhosis of the lungs, etc. ; and Dr. Barclay's Liquor Auri et Arseni 
Bromidi is very efficient in these affections, and much superior to the Chloride 
of Gold and Sodium (E. A. Wood). [Compare the several titles mentioned in 
this article, also Locomotor Ataxia, Atheroma, Paralysis Agitans.] 



Scrofulosis. 

Ammonium Iodide, when glandular enlargement (Wa) ; Ferrous Iodide, 
when debility and emaciation, a powerful and efficacious remedy ; also in 
anaemia of scrofula, the syrup TT\,xx-5j ter die (Wa) ; useful in simple gland- 
ular hypertrophy, but disappointing in scrofulous (B). Strontium Iodide has 
been used with varied results in scrofulous otorrhcea. Iodine, tinct. or oint. 
applied over scrofulous glands — take care not to increase inflammation (R) : 
Iodine and Iron the best remedies, but all medicines utterly useless without 
strict hygiene (A). Aurum, the Bromide of Gold and Arsenic has rendered 
good service in a case of adenitis with enormous enlargement of the neck (E. 
A. Wood). Calcium Salts, the Chloride in doses of gr. x-xx in milk after food, 
when glandular enlargement of neck and chronic diarrhoea ; the Phosphate of 
great use for sores (R) ; is of eminent service as a palliative (Wa) [See Sul- 
phides belowj . Spongia Usta, formerly held in high repute ; has fallen into 
perhaps unmerited neglect ; contains Sodium Iodide, Magnesium Bromide, 
Calcium Phosphate, and Ferric Protoxide, in small quantities (Wa). Iron. 
Ferrum and Calcium Phosphates combined give good results, also chalybeate 
waters (B) ; must be long continued (R). Phosphates. [See above, under 
Calcium and Iron.] Sulphides, for sores, abscesses, suppurating glands ; gr. T l g- 
or 2V of Calcium Sulphide every hour or two (R). Coniine, gr. \ to Z] Almond 
Oil, locally, two or three times a day to conjunctivas in "scrofulous" photo- 
phobia; has proved very successful (P). Cod-liver Oil, the best remedy to 
promote assimilation (B) ; of great service in the various manifestations of this 
disease (R). Stillingia, a domestic remedy, used with much success (B). 



700 SCURVY — SEA-SICKNESS — SEBORRHCEA. 

Capsicum, in scrofulous and fistulous ulcerations, a weak infusion becomes a 
useful stimulant (P). Mezereum, strongly recommended (P). Sarsaparilla, 
useful by reason of its tonic and alterative properties (P). Hyoscyamus, the 
bruised leaves as cataplasm for scrofulous ulcers (P). Prunus Virginiana, is 
found very useful in the hectic (P). Chimaphila, holds a certain amount of 
reputation as a useful remedy (P). Tussilago, was employed by Cullen (P). 
Gentian, is valued ; the infusion a useful vehicle for chalybeates, etc. (P). 
Blisters, for scrofulous glands (R). Grape-cure, renders much service (B). 
Alcohol, no doubt as to its great value ; with Cod-liver Oil, or in small amounts 
at meals (Wa). Phosphorus, eminently serviceable in scrofuloderma, gr. x in 
Ol. Olivse %}, doses of Tttv-x, thrice daily after meals (Broadbent). Aliment, 
raw or broiled meat, the latter for children. Abundance of fresh air and sun- 
shine. Sea-air, sunlight, moderate exercise, and light digestible food are nec- 
essary. [Compare Cachexia, Glands, Coxalgia, Ophthalmia.] 



Scurvy. 

Citric Acid, used with great advantage, though inferior to Lemon-juice (Wa). 
Lemon- or Lime-juice, of the utmost value, both as preventive and a curative 
agent ; its efficacy believed to be due to its Potassium salts : Oranges are highly 
useful (Wa). Acids, especially Vinegar, to prevent scurvy, in the absence of 
lime-juice or fresh vegetables (R) ; dilute Muriatic Acid, gtt. v, thrice daily 
with juice of three lemons daily, vegetables and fresh meat (Da C). Potas- 
sium Chlorate, is probably a remedy of some value (Wa) ; is not (W). 
Cinchona, a decoction, or the dilute tincture with Myrrh or the Chlorates, a 
very useful gargle. Quinine, internally when much prostration, combined 
with mineral acids (Wa). Alcohol, diluted, as gargle (R). Atropine, hypo- 
derm, for salivation (R). Alum, a solution in water with Tinct. Myrrhae ^ss, 
several times daily as lotion for ulceration of the gums (W). Liquor Sodse 
Chloratae, gvj ad ^xij aquae, as a mild application to gums (Wa). Dietetic 
Treatment alone required; Lemon-juice plays no essential part in the treat- 
ment ; the full diet of an hospital, comprising fresh meat, vegetables, and milk, 
is generally sufficient. [Compare Cancrum Oris, Purpura.] 



Sea-sickness. 

Antipyrin, is successfully employed. Chloral, the most effective remedy ; 
gr. xv-xxx every four hours (R). Staphisagria, has given relief (P). Creo- 
sote, checks the vomiting (R). Chloroform, drop doses pure (R) ; ff\A)- v on 
sugar (B). Atropine, hypodermically, gr. y^o in epigastrium, will relieve (B) ; 
S r - mo t0 mo given with Strychnine, gr. y 1 ^ to -^ hypodermically, is really 
specific in most cases, and in some if given before sailing, will prevent for the 
whole voyage, though but one dose be administered. Cocaine, quite efficient, 
the Hydrochlorate in water, I to ioo, of which n\,iv-v on a bit of ice thrice 
daily (Otto). Morphine, gr. ^ to £ hypodermically, will often relieve severe 
cases (B) ; often fails (Wa). Amyl Nitrite, by inhalation (B) ; is strongly re- 
commended, but must be cautiously used. Champagne, iced ; tablesp. doses 
every quarter-hour (B). Calumba, a few drops of the tincture will some- 
times relieve (B). Spinal Ice-bag, often successful (R). Cocaine, is reported 
quite successful. Bromides, in full doses (Beard). [Compare Nausea, 
Vomiting.] 

Seborrhcea. 

Glycerin, especially useful ; with Lead Acetate, Borax or Zinc, diminishing 
secretion ; also acts efficiently when there is a want of sebaceous secretion 
(Wa). Zinc Oxide, Z), Plumbi Carbonat. gj, Cetacei gj, Ol. -Olivse q. s. Ft. 
unguent. (B). Oleate of Arsenic, is of benefit (Wa). Mercury, an ointment 



SHOCK SICK-ROOM SNEEZING. 701 

of the White Precipitate is servicable on the scalp, with an occasional shampoo 
with tar soap or soft soap in solution, followed later by mildly stimulating 
lotions (Bulkley). [Compare Acne, Pityriasis.] 



Shock, Surgical. 

Codeine, in large dose (gr. j) hypodermically, immediately after laparotomy, 
quiets pain, prevents intestinal contraction, and relaxes the tonic spasm of the 
vessels which forms the first stage of shock, shown by the small and rapid 
pulse, before the second stage, that of paresis of the vaso-motor system, sets 
in, as shown by the soft, compressible pulse ; — Morphine is the ideal relaxer of 
spasm, but has many objectionable qualities, which Codeine is free from (Boise). 
Amyl Nitrite and Glonoin, relax arterial spasm, and are indicated in the first 
stage of shock. Hot Water as clyster, a pint injected into colon, and repeated 
as required, after laparotomy, in which operation the handling of the intestines 
sets up irritation of the sympathetic system, and is a potent cause of shock ; — 
this acts as a sedative thereto, and restores fluid to the blood, allaying thirst 
and supporting patient. Normal Salt Solution, consisting of ^d of one per 
cent, of Sodium Chloride in sterilized water, intravenously, to raise the volume 
of the pulse, stimulate the heart and restore volume to the blood, renders good 
service in the second stage of shock. Strychnine hypodermically, is the best 
medicinal agent in the second or paretic stage of shock, when the vessels are 
relaxed and the pulse is soft and compressible ; a full dose (gr. -£q) is necessary, 
and may be repeated in y z hour (W). Digitalin, hypodermically, may also be 
of great service in the second stage. Alcohol, as Brandy or Whiskey, hypo- 
dermically or by enema, is exceedingly useful. Heat, is a potent preventive 
of shock; the room should be warmed to 72 F., exposed limbs should be 
wrapped in cotton batting, and hot water bottles wrapped in towels should sur- 
round the patient's body both during and after operation. 



Sick-room. 

Every home of any pretensions should contain a room especially arranged 
and kept ready for the use of sick members of the family. Such a room should 
be on the upper floor, and preferably in the south-east corner, so as to have 
the best sunny exposure ; or still better, should be itself the upper floor of a 
two-story annex, separate from the main building, but joined thereto by a 
light, latticed bridge. It should have no upholstered furniture, a bare but 
painted floor, and rough-plastered and painted walls and ceiling, without pic- 
tures or paper, curtains or hangings. It should contain no sink, wash-basin, 
water-closet or any other convenience which connects with the sewers, and 
should communicate with the kitchen by a dumb-waiter, or have connected 
with it a smaller room, furnished with a gas-stove and the other requirements of 
a diet-kitchen. It should contain everything requisite for nursing a case of 
typhoid fever, scarlatina, diphtheria, measles or small-pox ; and all its arrange- 
ments should be supervised by the family physician. The possession of such 
an appendage to the home would enable the owner to defy the hiandate of a 
Health Officer, in regard to removing an inmate thereof to a public pest- 
house ; as it could be shown to the satisfaction of any reasonable court, that 
therein a case of infectious disease could be better isolated, and more humanely 
treated, than in any " pest hospital " ever yet erected by our political adminis- 
trators of health laws (Potter). 

Sneezing. 

Arsenic, a drop of Liquor Arsenicalis three times a day in paroxysmal sneez- 
ing, allied to asthma (R). Potassium Iodide, gr. x, several times a day (R). 
Iodine, inhalations in paroxysmal sneezing, with itching of nose (R). Camphor, 



702 SOMNAMBULISM SPERMATORRHCEA. 

in incessant sneezing, with profuse running from eyes and nose ; the powder 
should be snuffed, or the alcoholic solution inhaled (R). [Compare Catarrh, 
Hay-fever, Influenza.] 

Somnambulism. 

Potassium Bromide, will give decided relief in the somnambulism of children 
allied to epilepsy, often with squinting, which may become permanent, generally 
the result of deranged digestion ; — the nightmare of adults will usually yield to 
the same drug (R). [Compare Nightmare.] 



Spasmodic Affections. 

Aconite, externally and internally for spasms not of a severe type ; Aconitine, 
as ointment in the most severe, as well as in the milder local spasmodic affec- 
tions ; in angina pectoris, spasmodic asthma, cough, etc. (P) : in spasmodic 
laryngitis has good effect (R). Camphor, in many forms said to relieve, as 
strangury, etc. (R). Belladonna, of value for spasms of sphincter muscles, 
especially of pelvic organs (P) ; Atropine hypodermically in local spasm (R). 
Strychnine, of great value in spasmodic asthma (P) ; also in tetanus, chorea, 
and epilepsy (Pf, S). Veratrine, as solution, brushed over lids once a day in 
painful spasmodic contraction of the orbicularis (Wa). Opium, very useful as 
an antispasmodic, especially if given with a stimulant, as Alcohol, Ether, or 
Chloroform (R). Ipecacuanha, in spasms of respiratory organs, of great value 
(P). Chamomile Oil, in spasms of hysterical persons, in 4- to 6-nr. doses, a 
very excellent remedy ; also useful in pseudo angina pectoris (P). Lobelia, a 
valuable antispasmodic in cautious hands (P). Lupulin, in gouty spasms (P). 
Tobacco, in spasmodic asthma, and for relaxation of muscular spasms (P). 
Sumbul, in gastric spasms is of use (P). Cardamom, is usefully employed in 
gastric spasms (P). Ammonia, useful in children's colic (R). Chloroform, 
inhaled for intestinal spasm (R). Sulpho-carbolates, in flatulent "spasm," 
sometimes Phosphorus better (R). Mustard Poultice, an excellent counter- 
irritant in spasmodic affections (P). [Compare list of Antispasmodics on page 
28, and in this section the titles Angina Pectoris, Asthma, Chorea, Colic, 
Cough, Convulsions, Croup, Dysuria, Epilepsy, Gastrodynia, Hydro- 
phobia, Hysteria, Laryngismus, Pertussis, Stammering, Tetanus, Tor- 
ticollis, Trismus.] 

Spermatorrhoea. 

Potassium Bromide, when due to plethora, erections normal, but persistent 
and teasing ; is harmful in debilitated states, or daily losses (B) ; with cold 
sponging and use of a hard bed (R). Digitalis, 3j or ij of the infusion twice 
or thrice daily ; few remedies are more successful in arresting spermatorrhea 
(R, P) ; when feeble erections, frequent emissions, cold hands and feet (B). 
Cantharis, deficient tone of seminal vesicles, erections feeble, sexual feeling 
torpid ; the tincture gtt. ij-iij ter die (R) ; with Iron internally in emissions (R). 
Phosphorus, for the induced physical and mental debility ; also, Hypophos- 
phites of Lime and Soda (R). Gelsemium, as anaphrodisiac, may be combined 
with Belladonna or Cimicifuga (B). Nux Vomica, relaxation and atony (B). 
Strychnine, in large doses, especially when impotence (R). Quinine, has been 
recommended (R). Belladonna, gr. % of extract with gr. jss of Zinc Sulphate, 
three or four times a day, often successful in nocturnal emissions (R). Atropine, 
relaxed genitalia, no dream or orgasm (B). Camphor Bromide, has been use- 
ful (W). Lupulin, is a good anaphrodisiac; with Camphor, when a genital 
sedative is required (B). Iron, the Iodide, useful in anaemic cases (B). Ergot, 
beneficial in relaxed state (B). Hydrastis, is a useful injection, gtt. x of the 
fluid extract through a urethral tube to the prostatic portion of the urethra (B). 
Cimicifuga, useful in weak, relaxed conditions (B) ; when hypochondriasis, 



SPINA BIFIDA SPINAL PARALYSIS. 703 

very beneficial (P). Silver Nitrate, a vesicating solution applied to perineum 
o-enerally useful, and without danger (B). Arsenic, when from weak and 
relaxed seminal vesicles. Kind Advice, frequently the best treatment, as this 
affection is often due to the phantasms of a morbid imagination. Bladder 
should be emptied after the first sleep. [Compare Emissions, also List of 
Anaphrodisiacs on page 48.] 

Prescriptions. 

R. Lupulini, gr. x. 

Pulv. Camphorse, . . . . gr. vj. 

Ext. Belladonnae, . . . . gr. ij. 



R . Potassii Bromidi, .... gj. 

Sodii Bicarbonat., . . . . gr. xv. 

Infusi Digitalis, % ss. 

Atropinae Sulphat., . . . . gr. -gL. 
M. Sig. — One dose, to be taken at bed- 
time. ( Gross.) 



R. Tinct. Gelsemii, £j. 

Tinct. Belladonna?, . . . . % ij. 
M. Sig. — 15 drops thrice daily. (B.) 



M. ft. pil. no. xij. Sig. — One pill thrice 
daily. (B.) 

J&. Tinct. Cantharidis, . . . . gij. 
Tinct. Ferri Chlor., . . . ^vj. 
M. Sig. — 20 drops in water thrice daily. 
In impotence with spermatorrhoea, of great 
utility. {H. C. Wood.) 



Spina Bifida. 

Iodine, injected into the sac, £ss f tincture, or gr. ss, with Potassium Iodide 
gr. v, aquae 3j, has cured numerous cases (B); Iodi gr. ^, Pot. Iod. gr. %, ad 
aquae Z) (Wa). Collodion, as a means of compression (B). 

Spinal Concussion. 

Lead-water and Opium, as lotion over the seat of injury (A). Leeches, if 
pain persistent (A). 

Spinal Congestion. 

Ergot, gives excellent results (Brown-Sequard). Turpentine, as hot epithems, 
useful (Wa). Antiphlogistic measures, with rest and absolute diet ; wet cups 
or leeches to the column ; cool affusions to the spine while patient in a warm 
half-bath (Ros). [Compare Meningitis.] 

Spinal Irritation. 

Aconite, as ointment locally (R). Belladonna preparations, locally, gen- 
erally are better than Aconite (B). Ignatia, in small doses diminishes irrit- 
ability of cerebro-spinal axis (Pf). Strychnine, persistently, will ameliorate 
wandering neuralgic pains due to irritability of nervous system (B). Ergot, 
large doses for congestion (Hammond). Conium, in functional derangement 
of the cord, with excessive irritability of the reflex function (Wa). Firing, 
sometimes very beneficial (B). Electricity. An inverse galvanic current 
gives much relief (Hammond). Blisters, with hot-water bag to spine, large 
doses of Strychnine, Phosphorus, Phosphoric Acid, and Opium, are the methods 
based upon the anaemic theory of the disease ; — out of 156 cases so treated 133 
were thoroughly cured (Hammond). [Compare Meningitis, Myelitis, Neu- 
ritis, Neurasthenia.] 



Spinal Paralysis and Softening. 

Ergot, to starve the inflammation by occluding the spinal arteries (Ham- 
mond). Electricity, best ; galvanic current from spine to nerves and muscles 
(Ros). Treatment must be palliative and supporting only, in softening (H). 



< 



704 SPLENIC AFFECTIONS STERILITY. 

Splenic Affections. 

Mercury Biniodide, gr. j to £>j of ointment, rubbed in before a hot fire, has 
given excellent results in chronic malarial enlargement of the spleen (Wa). 
Quinine, in simple malarial enlargement (B) ; gr. xv or xx or more daily, one 
of the most effectual remedies (Wa). Ergot, the most effectual remedy for 
enlarged spleen (Da C). Ammonium Iodide, effective in chronic splenitis, with 
Unguent. Hydrarg. Iod. Rubri externally; also small doses frequently repeated 
in all splenic derangements from malaria (B). Iodine, locally in chronic forms 
(B). [Compare Leucocyth^mia.] 

Sprains. 

Arnica, is very useful ; the infusion internally and externally (P) ; the tinc- 
ture diluted as lotion is very effectual (Wa). Aconite, the liniment to painful 
sprains, often affords speedy relief (Wa). Turpentine, as a liniment, (P). 
Ammonium Chloride, in solution, as lotion, or with bread as poultice, to re- 
move discoloration from sprains (W). Rhus Toxicodendron, the tincture £ss 
to Oj of water a good external application to sprains. Oil of Bay as stimulat- 
ing liniment (P). Cold Douche, salt may be added ; — the force must be regu- 
lated by the condition of the tissues (R). Rest, the most essential measure, 
should be perfect. Warm fomentations, or cold affusion, opiates, and plain 
diet (D). A roller bandage with splints, often required to secure rest of the 
part. 

Stains. 

Silver Nitrate Stains may be removed by washing with Potassium Cyanide 
gijss, Iodine, gr. xv, Water, ^iij ; or, after moistening the spots, drop on them 
a few drops of Tinct. Iodine, and wash out with a solution of Sodium Hyposul- 
phite, £ss to ^j (B). Blood-stains, if on dark-colored materials are best seen 
by an artificial light. After a few hours they become of a rusty, reddish-brown 
color, which they maintain for years. The microscope shows the characteristic 
corpuscles. These stains when on Iron are difficult to distinguish from rust ; 
the latter is not soluble in water, while blood is extremely so. Heat applied to 
the metal will cause the blood to peel off, unless the stain has been exposed 
long enough to have rust mingled with the blood. A solution of blood in water, 
heated, forms a coagulum which is soluble in hot caustic potash, the solution 
thus formed is green by transmitted light, and red by reflected light. Menstrual 
blood cannot be distinguished from that resulting from a wound (Husband). 

Stammering. 

Vocal Training, the rhythmical method, the most successful, the chief end in 
view being to regulate the precipitate, irregular form of respiration ; but long 
continuance necessary, six months, a year, or more, in special institutions 
(Ros). The patient must be taught the use of language anew, treated with 
especial kindness, and never subjected to mockery or punishment. [See 
Potter on Speech and its Defects, Lea Prize Essay, Philadelphia, 1882.] 

Sterility. 

Aurum, cures sterility when dependent on chronic metritis or amenorrhcea 
or coldness, more certainly than any other remedy ; the Chloride, gr. -^ (B). 
Potassium Iodide, when due to syphilis (R). Dilation of os and cervix care- 
fully when sterility depending on obstruction, with dysmenorrhcea (H). Ster- 
ility is frequently associated with uterine displacement (Meadows) ; less often 
with atresia. In persons of good health may be caused by an acid discharge 



STINGS AND BITES STOMATITIS. 705 

from the uterus, which kills the spermatozoa ; for this Vichy water internally 
and per vaginam, and alkaline baths (Charrier). Is due to aspermatism of the 
husband in more cases than generally believed (Gross). Many cases are due 
to blocking of the cervical canal with a morbid discharge from the cervical 
glands, and such may be relieved simply by repeated cleansing thereof with a 
cotton-wrapped probe or forceps. 



Stings and Bites. 

Ammonia or Alkalies, a weak solution, in stings of- insects, to neutralize the 
formic acid (R) ; Ammonia, as nervine stimulant in snake-bites, more useful 
than brandy or any other stimulant ; tt\,x-xx of Liquor Ammoniae in water or 
wine, every half-hour or oftener ; also externally or hypodermically, 1 part to 
2 aquas into a vein (Wa). Ammonium Carbonate, gr. v hypodermically, as for 
wounds by poisoned arrows. [See under Wounds.] Carbolic Acid, a weak solu- 
tion sponged over the body, to keep off mosquitoes (R). Salicylic Acid, 1 to 19 
of Flexible Collodion, locally for bites of insects ; allays pain at once, and only 
in rare cases is the neighboring tissue swollen. Mercury, the Bichloride, 1 to 
1000 of Flexible Collodion, is equally effective. Potassium Permanganate, in 
strong solution, 1 to 6, locally, is promptly efficient for all reptile-bites -and 
insect-stings ; if wound is small, make incision to enlarge it, and insert lint 
soaked in the solution ; if a rattlesnake-bite, inject the solution hypodermically 
above the wound (Dupon). Viola Cucullata, the common violet, is used as an 
internal remedy in Pennsylvania for rattlesnake-bite, and is successful in a 
remarkable degree, — the leaves are eaten, and a poultice of Indigo and salt is 
at the same time applied to the wonnd. Arsenic, 1 part to 5 of Black Pepper, 
is the Tanjore Pill, highly esteemed in India for bites of venomous snakes 
(Wa). Calcium Chloride, a filtered solution injected into wound from snake- 
bite, successful in seventeen cases (Binz). Silver Nitrate, the sharpened stick 
applied to every sinuosity of the wound; excision safer (Wa). Sugar, applied 
to stings of wasps, said to relieve almost instantly (Wa). Ipecacuanha, as poul- 
tice or paste, allays pain and irritation ; is regarded by some as almost specific 
(Wa). Stimulants, in snake-bites, freely, are most important ; Liquor Am- 
moniae the best (Wa) ; stimulants are indicated in snake-bites, but there is no 
remedy of any value therefor (Gross). Sting, should always be removed if 
left in the wound ; pressing upon it with the barrel of a small key will expose it. 
[Compare Wounds.] 

Prescriptions. 
R . 01. Picis Liquidae, 



01. Olivse, 

01. Hedeomse, . , . . aa ^j. 

Spt. Camphorae, 

Glycerini, aa ^ ss. 

Ac. Carbolici, 3 ij. 

M. Sig. — Shake well. Lotion against 
mosquitoes, for fishermen and hunters. 



R . Carbonis Vegetab., . . 

Potassii Nitratis, . . . 

Ac. Carbolici, .... 

Persian Insect Powder, . 

Mucil. Tragacanth., . . 
To make fumigating pastilles for use 
against mosquitoes. 



Stomatitis. 

Potassium Chlorate, locally and internally ; large doses necessary (gr. x-xx) ; 
in ulcerative stomatitis of nursing women, and aphthae ; of no value in mercu- 
rial form (R). Hydrastis, fluid extract, locally in mercurial and aphthous 
stomatitis (B). Glycozone, frequently applied, is of benefit in ulcerative 
stomatitis (Edson). Carbolic Acid, concentrated, in Glycerin, carefully, as a 
mild caustic in aphthous stomatitis (Wa). Alcohol, Brandy-and-water an excel- 
lent lotion (B). Mineral Acids, pure Hydrochloric on pine wood to ulcers (B). 
Eucalyptus, a decoction of the leaves an efficient local application (B). Gly- 

45 



706 STRABISMUS SYCOSIS. 

cerite of Tannin, in ulcerative stomatitis (R). Copper Sulphate, solution painted 
over edges of gums in ulcerative stomatitis ; generally dry Alum better (R). 
Alum, in ulcerative form, applied dry with the finger several times a day, es- 
pecially when disease affects one-half the jaw (R). Salicylic Acid, to ease the 
pam of catarrhal stomatitis ; one part (dissolved in sufficient Alcohol) to 250 
parts of water (R). [Compare Aphthae, Cancrum Oris.] 

Strabismus. 

Belladonna, for the strabismus of encephalitis (P). Atropine, with strong 
convex glasses, to suspend accommodation for months, or years if necessary ; 
may cure convergent strabismus in its earlier stages, in children of 3 years of 
age or younger (Green in C). Operation, required in most cases, especially 
when of congenital origin. Glasses, properly adjusted to sight, serve to 
strengthen the weak muscles in children, and to pull the axes right (Gould). 

Strophulus. 

Glycerin, locally combined with Bismuth, and Digitalis (Wa). Lancing the 
gums is proper (H). 

Sunstroke. 

Water, as cold affusion when patient is stricken down unconscious (R) ; 
absolute rest and quiet, free air, loose clothes. Potassium Bromide, in cold 
water enemata. Stimulants when frequent and feeble pulse. Chloroform, if 
convulsions. Leeching, in stage of reaction (Wa). Veratrum Viride, and 
Gelsemium, as sedatives, instead of stimulants, when pulse full and strong 
(Ely). 

Suppuration. 

Sulphides, small doses (gr. ss-j), frequently repeated, are very serviceable 
(B). Calcium Sulphide, when ichor secreted instead of pus ; also arrests sup- 
puration, or if that is impossible will hasten maturation (R). Quinine, recom- 
mended in profuse suppuration (R) ; to sustain system when suppuration pro- 
longed (B). Sarsaparilla, is very useful (P). Phosphates, Parrish's to repair 
waste from suppuration (B). Iron and Manganese Iodide, the Syrup in cachec- 
tic states resulting from suppuration (B). Hydrogen Dioxide, is a most ener- 
getic pus-destroyer ; the solution may be applied in full strength, or diluted 
with an equal part of water. Glycozone, acts similarly but more slowly ; after 
cleansing by Hydrogen Dioxide solution, the application of Glycozone stimu- 
lates healthy action and hastens the cure ; for which purpose it has no superior 
in the entire range of therapeutics (Edson). Bismuth Subiodide, dusted over 
a suppurating surface after cleansing, is highly efficient as an antiseptic and a 
stimulant of healthy granulation. [Compare Abscess, Boils, Carbuncle, 
Pyemia.] 

Surgical Fever. 

Aconite, quickly and repeatedly in early stages, during chill or soon after, 
the safest treatment (P). Salicylic Acid, or Sodium Salicylate, especially use- 
ful as an antipyretic (B). Chloral, gr. xx-xxx every 2 hours ; there is no better 
treatment (Wa). 

Sycosis. 

Nitric Acid, ^j to Oj aquse, as wash, used frequently (R). Boracic Acid, 
3jss finely powdered and incorporated with ^j of Vaselin, is found most use- 
ful (Wa). Salol, as an antiseptic powder, has done good service. Mercury, 



SYNCOPE — SYNOVITIS SYPHILIS. JOJ 

Citrine Ointment has been extensively employed, also the Oleate of Mercury, 
both with good results (Wa). Arsenic, the Oleate is found beneficial, and the 
Solution of Arsenic and Mercury, Donovan's solution, internally is highly 
useful. Mercurial Ointments are extensively employed (Wa). Sodium Sul- 
phite, 3j» Glycerin, ^j, Aqua, ghj, locally, when of parasitic origin (Wa). 
[Compare Condylomata, Mentagra.] 



Syncope. 

Nux Vomica, in drop doses of the tincture every 5 minutes, to restore the 
cardiac action in extreme cases of syncope approaching heart-failure, especially 
when of neurotic origin ; is promptly efficient (Macfarlan). Cinnamon, the Oil, 
as a powerful stimulant, sometimes employed (P). Alcohol, as brandy, or 
wine, when heart suddenly enfeebled from fright, etc. (R). Amyl Nitrite, in 
some forms, especially in anasmic subjects, its inhalation speedily restores con- 
sciousness (O'Neill). Atropine, gr. x^-- 1 ^ subcutaneously, the best means of 
resuscitation, there being no medicine which so promptly exalts the force and 
rapidity of the heart's action (Harley). Ammonia, internally, or breathed into 
the air-passages (R) ; the Carbonate as "smelling salts " (Wa). Lavandula, 
the compound tincture (Wa). Chloroform, internally, for hysterical people, as 
cardiac stimulant (R). Position, leaning forward, with head as low as possible 
(R). Galvanization of pneumogastric (B). Cold Water over the face, and 
volatile substances to the nose (B) : cold affusion always (Wa). [Compare 
Heart Affections.] 

Synovitis. 

Potassium Iodide, with Iron and Quinine, in syphilitic patients with consti- 
tution broken down (D). Iodine, in chronic synovitis, painted around joint ; 
the solution injected into white swelling (R). Quinine, and free stimulation in 
all cases of pyasmic synovitis, such as occurs in acute rheumatism of gonor- 
rhceal causation, occasionally in typhoid fever, and may result from a trifling 
injury in strumous subjects. Mercury, and Morphine, the Oleate locally (R) ; 
an elegant and efficient application (B) : in syphilitic cases Mercury internally 
when acute symptoms have subsided (D). Aconite, for pains in inflamed 
joints (R). Silver Nitrate, locally, to vesication almost, often very beneficial 
(Wa). Carbolic Acid, injected into joint (B). Alcohol, and water, equal parts, 
an excellent evaporating lotion (B). Blisters, a flying blister every night in 
chronic synovitis (R). Cod-liver Oil, in strumous cases (B). Surgical Treat- 
ment. Splints to keep limb motionless in all cases arising from injury ; during 
acute stage splint should be fastened at some distance above and below joint, 
and not touch the joint itself. Straight position, leeches to joint, or cupping 
near it ; ice, evaporating lotions or hot fomentations. Blisters inapplicable 
until acute stage subsides (D). If suppuration occurs the joint must be dealt 
with as any other abscess cavity (MacCormac). Heat, as fomentations or 
poultices in the acute form. Bandage, or Strapping, to cause absorption of 
fluid ; bandages (cold water) after alternate bathing with hot and cold water, 
in chronic synovitis. [Compare Coxalgia, Joint Affections.] 



Syphilis. 

Mercury, the mainstay in earlier and later stages ; the Protiodide in pills of 
gr. l /e each, one after each meal increased by one every third day, until teeth 
get sore or bowels disordered, then drop two pills from each dose (Keyes) : the 
best remedy for primary and secondary forms, not so in tertiary ; small doses 
are best, to stop short of ptyalism (B) : Blackwash, Calomel, or Citrine Oint. 
very useful in mucous sores, tubercles, and elevated indurations; in syphilitic 
ozsena, psoriasis, rashes, condylomata, etc., the Bichloride, gr. ij-v in ^j of 



708 ' SYPHILIS. 

Alcohol, painted over syphilitic mouth lesions daily (Keyes) : Mercury believed 
to be a true vital antidote against the virus (R) ; used for at least two years can 
eradicate it (Keyes): internal administration best because most practicable; 
the two great preparations are the Bichloride and Protiodide — of the former, the 
curative dose for a man is about l /z grain daily, for a woman ^ grain, below 
which the drug has no active effect on the disease ; dose of the Protiodide is 
larger, — for a man about 2 grains, for a woman gr. \]A, daily (Fournier). Nitric 
Acid, in secondary forms (R) ; holds a high place as an internal remedy (Wa); 
when sponginess of gums excessive, giv to ^ij aquae, teasp. 4 times daily ; 
also use locally (St.) ; as cautery for the initial lesion, the fuming acid, if used 
at all, should be applied early and thoroughly, followed by Blackwash locally 
on lint (Bulkley). Potassium Iodide, approached by no remedy in constitu- 
tional syphilis ; also for mercurial cachexia, syphiloma of nervous system, and 
many disorders of syphilitic origin ; will certainly arrest ulceration of nares, 
palate, etc., if given in large doses, gr. xx-^j every 4 hours (R) ; is of little 
value in early stages ; in later should be combined with Mercury (St). Rubi- 
dium Iodide, is more pleasant than Potassium Iodide, having a milder taste, 
and is borne far better, especially by the stomach, and in regard to the produc- 
tion of iodism and cardiac difficulties (Neisser) ; is indicated in patients in a 
low state with weak cardiac activity (Mering) ; in doses of ^jss to ^iij of a 
5 per cent, solution daily, gave the best possible results without troublesome 
disturbances (Bunge). 

Iodine, as gargle for ptyalism ; the tincture applied to syphilitic sores of the 
throat (R) ; or gss of tincture to ^iv Syr. Fusci., a teaspoonful well diluted ter 
die, after meals, when Pot. Iod. cannot be borne (St). Iodoform, powdered 
and dusted over ulcers (B). Aurum, after Mercury and the Iodides, in old 
cases of secondary and tertiary, ulceration of the throat, ozaena, phthisis, syph- 
ilitic bone-diseases (B) ; its beneficial action incontestable (Tr) : the Bromide 
of Gold and Arsenic has rendered good service in trifacial neuralgia diagnosed 
as due to syphilis (E. A. Wood). Stillingia, with Nitric Acid in chronic cases 
of broken-down constitutions from Mercury and Iodides has been most satis- 
factory (B). Cascara Amarga, is said to have remarkable powers as an altera- 
tive in syphilis, but to be useless if alcohol and tobacco are used at the same 
time. Sanguinaria, in secondary and tertiary, is held to be very useful (P). 
Sarsaparilla, a most important remedy, as adjunct to, and in abuse of Mercury 
(P) ; with Guaiac and Mezereon, as the Compound Decoction of Sarsaparilla, in 
tertiary form (B). [See Guaiac, below.] Belladonna, with Mercurial Oint- 
ment, for secondary ulcerations of rectum (P) ; tincture 3'w ad ^ij aquae, a tea- 
spoonful 4 times a day in water, instead of mercurials (St). Iron, the Iodide 
in constitutional syphilis, to promote constructive metamorphosis (B) ; where 
anaemia exists (R) ; the Potassio-Tartrate, gr. xv-xx, every 4 hours, especially 
in the gangrenous form (Otis). Guaiacum, in tertiary only ; or as vehicle for 
Potassium Iodide and Mercuric Chloride (B). Carbolic and Salicylic Acids, 
locally to syphilitic abscesses, Carbolic best (B). Zinc Chloride, Iodide, Nitrate, 
locally to syphilitic ulcers (R). Denutrition, the Arabic " hunger-cure " effici- 
cient, but unpopular (B). Turkish Baths, or wet packing, ameliorate and aid 
cure of constitutional syphilis (B). Hygiene, is of the greatest importance 
in syphilis (Bulkley). Cod-liver Oil, remarkably improves condition resulting 
from prolonged use of Mercury and Iodides, the syphilodermata, and squamae ; 
internally and by inunction (R). [Compare Chancre, Condylomata, Ul- 
cers, Pytalism.] 

Prescriptions. 



R. Hydrarg. Iodidi Rubri, . . gr. iij. 
Potassii Iodidi, 3^ iij — vj . 

Tinct. Aurantii Cort., 

Syrup. Aurantii Cort., . aagj. 

Aquae, % viij. 

M. . Sig. — A teasp. thrice daily after 



R- . Hydrar?. Bichloridi, . . . gr. iv. 

Tinct. Benzoini, ^ss. 

Aquae Cologniensis, . . . ^j. 

Aquae Rosae, ^ ivss. 

M. Sig. — Apply locally with sponge to 
skin for 20 minutes. For squamous syphil- 



meals. {Otis, for the Mixed Treat?7ient.) I ides. (S. W. Gross.) 



TABES TASTE TEETH TESTICLES. 



709 



R . Massse Hydrargyri 

Ferri Sulph. Exsiccat., 
Extr. Opii, . ... 
In pill, thrice daily. 



g r - H- 

[Otis.) 



R 



Hydrargyri Bichloridi, 

Ammonii Chloridi, . . aa gr. iij. 

Tinct. Cinchonas Comp., 

Aquae, aa^iij. 

M. Sig. — A teasp. thrice daily. Each 

3 contains gr. T X g of Corrosive Sublimate. 

(Bttmstead.) 



R. Hydrarg. Iodidi Rubri, . . gr. ij. 
Ammonii Carbonatis, . . gr. xx. 

Potassii Iodidi, 3 iij. 

' Tinct. Gent. Co., q. s., ad\\v. 
M. Sig. — A teasp. in water after each 
meal. {Fox, for the Mixed Treatment.) 



R. Hydrarg. Chlor. Mitis., 

Lycopodii, aa 3 ij. 

M. Sig. — Use as snuff thrice daily, in 
lesions of the nostrils. (Diday.) 



The Three Eights. 
R . Hydrarg. Chlor. Corr., . . gr. viij. 

Potassii Iodidi, 3 vn j- 

Syr. Sarsaparillae Co., . . ^ viij. 
M. Sig. — A teasp. thrice daily. 

R. Potassii Iodidi gij. 

Ammonii Carb., ^ss 

Tinct. Cinchonae Comp., . giv. 

Glycerini, j|j. 

Syr. Aurantii Cort., . . . ^jss. 
M. Sig. — A teasp. in plenty of water 
after each meal. (Keyes.) 



Tabes Mesenterica. 

Calcium, Chloride and Phosphate (R) ; the Chloride is a powerful remedy if 
kept up (Wa). [See Scrofulosis.] Iodine, by inunction with Cod-liver Oil 
(El) ; locally over glands ; carefully, lest inflammation be increased (R). Potas- 
sium Iodide in small repeated doses, valuable (Wa). Mercury, Corrosive 
Sublimate with bark (gr. j ad gij Tinct. Cinchona?) after meals, for chronic gland- 
ular disease (D). Phosphates, for malnutrition (B) ; the Hypophosphites act 
slowly but surely (Wa). Iron and Iodine, in various forms are the most useful 
remedies in scrofulosis, but medicine is powerless without strict hygienic meas- 
ures (A) ; the Iodide or Phosphate of Iron and Cod-liver Oil, as for tubercle 
elsewhere (El). Fel Bovinum, is worthy of trial, though at best a palliative 
(Wa). Cod-liver Oil, is the best remedy to promote assimilation (B) ; of great 
service (R). Chaulmoogra Oil, is of benefit, used by inunction (Wa). Aliment, 
raw meat, cream, chocolate, and cocoa, are valuable nutriments in these cases 
(El) ; peptonized foods are of inestimable value (Wa). Hygiene, change of 
air, especially to sea-air, is all-important (El). [Compare Scrofulosis.] 



Taste, Disordered. 

Mercury or Podophyllin, as purgative for cankery taste unconnected with 
alcoholism ; or half-glass of pure cold water daily half an hour before break- 
fast (R). 

Teeth. 

Potassium Iodide, in doses of gr. x, thrice daily, often cures looseness of 
teeth from periostitis of alveolar processes (Wa). Iodine, tincture painted over 
gums close to the teeth when the gums begin to recede ; also to remove tartar 
(R). Cinchona, powdered bark often used in tooth-powders (R). Collodion, 
on cotton, as stopping for carious teeth (P). Liquor Sodae Chloratae, £vj ad 
^xij aquae, a highly useful application in fetid discharges from carious teeth 
(Wa). [Compare Dentition, Gums, Odontalgia.] 



Testicles. 

Mercury, the ointment, locally in indurations and enlargements of testes 
(Wa). Corrosive Sublimate, with Cinchona or Sarsaparilla in sarcocele (D). 
Camphorated Naphtol, used hypodermically in tuberculosis of the testis with 



710 TETANUS THIRST THROAT, SORE. 

very gratifying results (Reboul). Water, cold applications in neuralgia of testes, 
with tonics and neuralgic treatment generally (D). Suspensory Bandage, with 
rest, in many affections of the testes (D). [Compare Hydrocele, Orchitis, 
Varicocele.] 

Tetanus. 

Strychnine, of decided service (P) ; cured 8 cases of traumatic form, in 
doses of gr. -^ to \ (S) ; is conclusively curative, especially in chronic and 
spontaneous, rather than in traumatic ; — Strychnine Sulphat., gr. g 1 ^ to ^ (B). 
Aconite, has benefited many cases (P) ; its success warrants further trial (W). 
Belladonna, successfully used in many cases ; the extract, internally, and 
locally to wound (Wa) ; gr. T ^ Atropine injected into muscle (B) ; bleeding, 
vapor-baths, and large doses of Belladonna have cured tetanus (Tr). Nico- 
tine, by rectum or hypodermically, appears to be useful in many cases (R) ; 
much evidence for it as the best remedy (P) ; effective but dangerous (B) ; 
Physostigma better (Wa). Potassium Bromide, not less than ^ss during the 
day, with Chloral at night as a hypnotic ; out of 21 cases but 3 died ; its physio- 
logical action indicates it to be the best remedy known (W). Chloral, in 
large doses (gr. xx) no remedy more effectual (B) ; has sometimes cured (R) ; 
best used in combination with Potassium Bromide (W). Gelsemium, cured 
several cases (P). Hyoscyamine, gr. -^ gradually up to gr. ^ 5 , ameliorates 
(B). Cocaine, and Morphine, of each a 5 per cent, solution, 3 syringefuls 
hypodermically, immediately relieved and finally cured a bad case of idiopathic 
tetanus unrelieved for 3 days by chloral, morphine, etc. (Lopez). Physostigma, 
has been used with excellent results (P) ; the fluid extract by mouth if possible, 
at very beginning, and must be pushed until just short of arresting breathing 
(B) ; evidence is discrepant ( W). Apomorphine, may prove antagonistic (P). 
Curare, hypodermically, has much evidence for its power (P). Cannabis Indica, 
used with marked success in traumatic form (P) ; it is difficult to obtain an active 
extract (W). Ether, by inhalation, to relieve pain (B). Chloroform, in small 
and frequently repeated doses, also by friction, has been useful in many in- 
stances (Wa). Amyl Nitrite, used in 3 cases with marked benefit as spinal 
sedative (W) ; has been used with success (R). Morphine, hypodermically, 
deeply into tetanized muscles (B) ; of no value (Wa). Conium, is indicated, 
but has not been successful (B). Water, as warm baths, and cold, or ice, affords 
only temporary amelioration (B). Spinal Ice Bag, extremely useful (R). 
Division, or stretching of any nerve-trunk connecting wound with spinal cord. 
[Compare Spasms.] 

Thirst. 

Acid Drinks, promote secretion of saliva in fevers (R). Tepid Drinks, are 
useful in the thirst of diabetes (R). Ice, sucked, allays thirst (R). 



Throat, Sore. 

Aconite, when temperature high, half-drop doses of tincture, every % hour 
for 2 hours, then every hour, will almost certainly prove efficacious (R) ; valu- 
able in ordinary sore throat (P). Belladonna, is very admirably adapted to the 
treatment of ordinary sore throat; when much fever, combine with Aconite 
(R, P). [See Catarrh, Acute.] Mercury, in acute tonsillitis, which see (R). 
Nitre, dissolved in mouth, to abort a sore throat (Wa). Tannic Acid, as pow- 
der, gargle, spray (P). Glycerite of Tannin, after acute inflammation ; in ulcer- 
ation of aphthous sore throat daily when tendency to catarrh (R). Ipecacu- 
anha, the wine as spray, in non-inflammatory sore throats and hoarseness from 
congestion of vocal cords (R). Capsicum, 3j of tincture to 0)4 aquae as gar- 
gle, in some sore and malignant sore throats (R, P). Potassium Chlorate, in 
grain doses every half-hour (Smith). Alum, dry, or in solution (R). Myrrh, as 



TIC DOULOUREUX TINEA. 



711 



gargle in ulcerated sore throat (P). Cimicifuga, in simple (P), and malignant 
forms when mucous membrane dry and spotted with inspissated mucus (R). 
Arsenic, in medicinal doses, for sloughing of throat or malignant sores (R) : 
the Iodide is an excellent remedy for the so-called diphtheritic sore throat, gr. 
iij triturated with gr. xx of sugar of milk, one-half of which dissolved in ^iv of 
water, and a teasp. given every hour or so. Methylene Blue, in simple, non- 
diphtheritic ulceration of the throat, patients would express themselves with 
delight as being cured, after one or two applications of the solution (Rose). 
Iodine, the tincture, locally to sores, whether syphilitic or not (R). Rhus 
Glabra, a very efficient gargle is a decoction, ^j ad Oj, boiled to 0}(, with 
Potassium Chlorate, ^ss (W). Nitric Acid, undiluted, to sloughs (R). Silver 
Nitrate, locally, in early stage of inflammation may cut it short (R). Sulphur- 
ous Acid, by inhalation, spray, or fumigations for malignant sore throat, scar- 
latinal or otherwise (R). Water, cold compress nightly, to harden the throat 
when tendency to catarrh (R). Ice, constantly sucked (R). [Compare Ton- 
sillitis, Pharyngitis, Diphtheria, and Formulae for Gargles, on page 474.] 



Presc7-iptions. 



R- . Tinct. Guaiaci Ammon., 

Liq. Potassae, aa^iij. 

Tinct. Opii, sjij. 

Aq. Cinnamomi, . q.s. ad ^ viij. 
M. ft. gargarysma. 

Sig. — To be used as a gargle, every hour, 
in clergyman's sore throat. {Garner.) 



R . Hydrarg. Bichlor., . . . . gr. iv. 

Alcoholis, ^ ij. 

Solve, et adde — 

Decocti Cinchonse, Mellis Rosse, 

Tinct. Myrrhae, . . . . aa !| ij. 

M. ft. gargarysma. Gargle, to be diluted 

if too severe. For ulcerated forms of 

syphilitic sore throat. [Sir Chas. Bell.) 



Tic Douloureux. 

Arsenic, cures by influencing nutrition (B). Phosphorus, useful, gr. y^ to T ^- 
every 3 hours (R). Belladonna, Aconite, Spigelia, Iodides, Morphine, Cimici- 
fuga, Gelsemium, Turpentine, Galvanism (B). [See under Neuralgia.] 
Croton-Chloral, palliative in doses of gr. v every % hour till gr. xxx taken 
(W). Salicylates, in large doses, cured a case of 12 years' standing. Stramo- 
nium, gr. X t0 l A every 3 or 4 hours for 4 or 5 doses, often affords decided 
relief; stop if narcotic symptoms appear (P). Laurocerasus, sometimes re- 
moves (P). [Compare Hemicrania, Neuralgia.] 



Tinea Circinata — (Ringworm of the Body). 

Mercury, the Bichloride, 1 part to 250 of water, as parasiticide solution, after 
depilation (A). [See also T. Tonsurans.] Carbolic Acid, a very efficient 
application ; gj ad ^j Glycerini, locally (B) ; or equal parts of Carbolic Acid 
and Glycerin, is a very efficient application. Sulphurous Acid, better and 
safer (A); must be fresh to be of use (Bulkley). Cocculus Indicus, the decoc- 
tion locally, after washing the skin well (P). Oil of Cade, the best depilatory 
known (A). Arsenic will not cure, but may do service as a nerve tonic or an 
improver of nutrition, in connection with other remedies (Bulkley). Cuprum 
Acetate, gr. x ad ^j Adipis, as ointment, is very effective (B). Sodium Hypo- 
sulphite, ^j ad ^xij aquse, locally, used by Dr. Tilbury Fox. Mercury, Calo- 
mel ointment (3j ad Jj) useful (B); Hydrarg. Nitrate, as strong Citrine Oint- 
ment, rubbed in twice daily, often effectual ; Hydrarg. Oxid. Rubrum, as oint- 
ment, often cures ringworm on body or limbs, when other remedies fail (Wa). 
Cocculus, as ointment from the kernels, or decoction (P). Iodine, as liniment 
once applied (R) ; with Oil of Tar (1 to 4 of latter) locally, is excellent (Wa). 
Kamala, used locally by the Hindoos (P). Tar Ointment, is used with good 
effect (P). Acetic Acid, applied to cut it short (R). Cod-liver Oil, a powerful 



< 



712 TINEA TONGUE. 

auxiliary in weakly and cachectic subjects (Wa). Diet and Hygiene, are im- 
portant ; food should be nutritive and abundant, especially animal fats ; daily 
baths, out-of-door exercise. Fungus, is the Tricophyton tonsurans (A). 



Tinea Decalvans — (Alopecia Areata). 

Parasiticide Lotions, must be used after epilation and washing of head daily 
with soft or black soap. Stimulants (as Collodium, with Ether Cantharidalis, 
equal parts), after fungus is destroyed (A). Tonics are necessary, especially 
to the nervous system (Bulkley). Fungus — Microsporon Audouini (A) ; but I 
have never seen it, though having made repeated and thorough searches 
(Bulkley). 

Tinea Favosa — (Favus). 

Mercury, as Hydrarg. Chlor. Corr. gr. xx ; Cerat. Simplicis ^j ; efficient 
when used early (B) ; or gr. ij ad gj aquse after each epilation (R). Sulphur- 
ous Acid, Sulphites, and Hyposulphites, as parasiticides ; Sodii Hyposulphitis 
^iij ; Ac. Sulphurosi Dil. ^ss ; Aquae q. s. ad ^xvj (Startin). Carbolic Acid, 
and Cod-liver oil, locally (B). Oils, to facilitate removal of scabs ; head to be 
greased freely to prevent spreading ; a mild mercurial pomade, or Quinine in 
Glycerin are best (R). Cleanliness, and free use of soap and water, is a sine 
qua non, and in some cases of tinea may be alone sufficient to produce cura- 
tive results. Isolation of person, and brushes, towels, etc., necessary to pre- 
vent infection. Fungus — Achorion Schonleinii (A) ; a very rare affection in 
this country (Bulkley). 



Tinea Tonsurans — (Ringworm of the Scalp). 

Mercury, Hydrarg. Chlor. Corr. gr. xx ad ^j Unguent. Simplicis, an effective 
application when used early (B) ; must be employed with great caution. Sul- 
phurous Acid, with Glycerin (R). Carbolic Acid, 3j ad ^j Glycerini (B). Viola 
Tricolor, the leaves are employed in Italy for tinea capitis (P). Cocculus 
Indicus (P). [See T. Circinata.] Potassium Sulpho-cyanide, ^ss with %} 
Glycerini, ^viij Aqua?, as lotion (R). Iodine, gij ad ^j of Oil of Wood Tar 
(R). Arsenic Iodide, the best constitutional remedy ; gr. ^ increased to gr. ^ 
for an adult : gr. ^ to -^ for children, with alkaline lotions locally (Wa). 
Lead, in chronic porrigo capitis ; the Ointment of the Iodide (B) ; will com- 
plete a cure after alkaline lotions (Wa). Fungus — Tricophyton tonsurans (A). 
[Compare Tinea Circinata.] 

Tongue. 

Potassium Chlorate, gr. v internally and 3j-ij ad Oj aquae locally ; in ulcers 
of tongue (Wa) ; also in rawness of tongue in advanced phthisis. Potassium 
Iodide, in syphilitic ulcers of tongue (D) ; and in hypertrophy (A). Potassium 
Bromide, oj to ^vj water as wash, may soothe morbid sensibility of the tongue 
(A). Borax, Sodii Borat., gr. xl, Glycerini, ^j, Aquae, ^iv, as application in 
cracked tongue (Wa). Iodine, the tincture locally by a fine brush, or as a 
gargle with 7 or 10 parts of water and some honey, has given uniform success 
in malignant ulcers (Wa). Conium, thought to act specifically with benefit 
in ulcer of the tongue (Wa). Cinnamon, the Oil as a powerful stimulant in 
paralysis of tongue (P). Ginger, Cochlearia, Pyrethrum, as gargles, Cloves, 
Mezereon, Pepper, as masticatories, in paralysis (P). Frsenum, should be 
divided in tongue-tie ; use blunt-pointed scissors, directing the points down, 
close to the jaw, so as to avoid wounding the ranine artery (D) ; better to cut 
as little as possible, and that directly backwards, as the artery of the fraenum 
may proceed from the sublingual (Holmes). [Compare Glossitis, Ranula.] 



TONSILLITIS TONSILS. 713 

Tonsillitis. 

Aconite, when accompanied by fever and elevated arterial tension, relieves 
greatly, gtt. ss-j of tincture every }4-hour or hour (B) ; every i^-hour for 2 hours, 
then every hour, will almost certainly prove efficacious (R). Belladonna, of 
surprising efficacy, gtt. v of tinct. every 3 hours in ^ss aquas (P). Mercury, 
often speedily removes, Calomel, gr. ^, or Hydr. cum Creta, gr. £ every 2 
hours ; not in chronic forms (B) ; gr. % of Gray Powder every hour when 
tonsils almost meet, has marked effect; the Oleate of Mercury and Morphine 
in obstinate and painful tonsillitis (R). Silver Nitrate, locally may abort, if 
applied early (R) ; the solid stick, once thoroughly applied in first stage, rarely 
fails to prevent suppuration (Howard). Guaiac, disagreeable, but very effec- 
tive (P) ; ^ss doses of tincture every 4 hours has remarkable power ; should 
be given in emulsion with mucilage or yolk of an egg (B) ; makes an excellent 
gargle, [See page 474 for formula] : Tinctura Guaiaci and Glycerin, equal 
parts, in teaspoonful doses every hour or two, gives excellent results in acute 
tonsillitis. Opium, gr. v-x of Dover's powder at bedtime, is in many cases 
curative (Shoemaker). Cocaine, in 10 per cent, solution, locally, at intervals of 
15 minutes, removes pain at once and promotes resolution; a very efficient 
application in 5 or 10 per cent, solution, but causes temporary paralysis of 
palatal muscles, so that liquids regurgitate through nose (Bceckel). Alum, dry 
or in solution (R). Potassium Iodide, locally (gr. j-v ad %), is useful (B). 
Potassium Chlorate, in grain doses every half-hour, very efficient (Smith). 
Capsicum, the dilute tincture in a gargle, or in powder applied on a swab, is 
useful in severe tonsillitis, especially in that accompanying scarlatina (W). 
Quinine, gr. x-xv will sometimes abort (B). Tannic Acid, is useful (P) ; as 
gargle. [See page 474.] Ice and wet pack, extremely grateful (B). Hydrogen 
Dioxide, the solution as gargle, is used with great benefit. Cold Wet Com- 
press, around neck, covered with oiled silk and a dry bandage, nightly is very 
useful. Incision of the tonsils gives immediate and marked relief in all cases 
especially those which are not amenable to ordinary treatment. Sodium 
Bicarbonate, locally by wetted finger to surface of tonsils every five minutes 
for J^-hour, then every hour during the same day, will prevent necessity for 
lancing (Lyon Medical). 

Prescription. 



R . Tinct. Aconiti, 3 ss. 

Tinct. Guaiaci, 

Syr. Zingiberis, . . . . aa^ss. 

Syr. Simplicis, ^ij. 



M. Sig. — g ss-ij every 2 hours, accord- 
ing to age. In severe cases, with high 
fever, bounding pulse, severe headache. 

(Shoemaker.} 



Tonsils, Enlarged. 

Ammonium Iodide., gss in %j Glycerin, applied every night by a camel's-hair 
brush, very efficacious (Wa). Baryta Iodide, in hypertrophy of the tonsils, 
effects a rapid diminution in their size, even when indurated for years (Hale). 
Liquor Ferri Chloridi, 3j-ij ad ^j, painted over tonsils twice daily, is one of 
the most effective astringents (Mackenzie). Aluminum Sulphate, a saturated 
solution applied daily by a brush, as a mild caustic (W). Ergot or Ergotin, 
injections into tonsils (Meigs). Zinc Chloride, as caustic, the most efficient and 
least annoying method ; a saturated solution applied on a wire cotton-holder 
to each crypt and held there a few seconds ; a few applications will shrink the 
gland in a week. Tannin, a strong solution touched daily to tonsils (H); a few 
sips of a saturated solution (^ss in ^iij aquas) slowly sipped, will stop bleeding, 
if profuse (A) ; gr. xx to 3J aquas, hypodermically, as in nasal polypus. Silver 
Nitrate, touched daily to tonsils, will sometimes make them shrink (H). Cate- 
chu, a serviceable astringent gargle ; the infusion ^vj with Tincture of Kino 
Z'l), as gargle (Wa). Oxgall, locally, is praised (Wa) ; is of real utility (W). 
Citric Acid, rubbed daily to tonsils, is highly praised in enlargement thereof. 
Excision of a part of tonsil (H). Mackenzie's double guillotine removes both 



714 TONSILS TORTICOLLIS TUMORS. 

tonsils at once ; hemorrhage seldom happens, ice will generally check it (A). 
Surgical measures should receive unprejudiced consideration, as the medical 
treatment is tedious in the extreme. 



Tonsils, Ulcerated. 

Coptis, the infusion as a gargle (B). Sulphurous Acid, dilute, locally by 
spray, or a solution of Sodium Sulphite in water (Sj-^j) (B). Potassium Iodide, 
will arrest syphilitic ulcerations at once (B). Carbolic Acid, a 5 per cent, wash 
with Tincture of Myrrh, a good application by sponge to throat (Wa). Cimi- 
cifuga, a decoction of the root as a gargle (Wa). 



Torticollis. 

Cimicifuga, has curative efficacy (P). Capsicum, a handful of the crushed 
pods infused for 36 hours in a pint of hot or cold water, and applied on lint 
covered with gutta-percha (R) ; gives striking results (Wa). Opium, as lini- 
ment with friction, or an opium plaster, is often serviceable (Wa). Galvaniza- 
tion of affected muscles, and faradization of opposed ones quickly relieves (B). 



Trichiniasis. 

Benzol, in doses of ttix, every hour or two, up to gjss daily, followed by a 
brisk laxative, has been very successful in 27 cases, treated simultaneously 
(Putter). Purgatives, as Rhubarb and Senna, or an occasional dose of Calo- 
mel, to thoroughly evacuate the gastro-intestinal canal. Glycerin, in large 
doses, to destroy the worm by its hygroscopic qualities, has been recommended. 
The indications, in the stage of invasion, are to relieve the pains, to secure 
sleep, to combat the fever, and to support the patient's strength ; there are no 
medicines which have any influence upon the embryos in their migration 
through the muscles (O). 

Trismus. 

Aconite (A), Atropine (R), hypodermically. Cannabis Indica, has been 
used successfully in trismus neonatorum (B). Opium, rr\,^ doses of Laudanum, 
with Castor Oil and warm bath, in trismus infantum. Treatment of any kind 
seldom effectual (D), never (El). Ether, Chloral, Gelsemium, Physostigma 
(B). [See Tetanus.] 

Tumors. 

Mercuric Bromide, in yi gr. doses, has benefited abdominal tumors (Wa). 
Chloroform, in diagnosis of abdominal tumors when deep-seated, and when 
walls of the belly are hard and rigid ; also in phantom tumors (R). Pepsin, 
hypodermically, to dissolve them. Hyoscyamus, the leaves as cataplasm or 
fomentations to painful tumors, afford great relief (Wa). Iron, the Liquor 
Ferri Chloridi is found to be valuable as a curative application to fungous or 
hemorrhoidal tumors (Wa). Galbanum, as plaster to indolent, non-malignant 
tumors, to diminish or cause their absorption (Wa). Electrolysis, is employed 
with more or less benefit in sebaceous, lipoma, bronchocele, enlarged glands, 
etc. (Wa). Apostoli's method is now generally adopted for the dispersion of 
fibroid tumors ; it will dissipate pain, improve nutrition, and diminish size 
without danger to life (Bigelow) ; the treatment of fibroid tumors by the gal- 
vanic current has of late been universally recognized by the profession 
(Massey) ; solid tumors, as goitre, enlarged glands and similar growths have 
been repeatedly cured by electrolysis (B). [Compare Cancer, Cysts, Gland- 
ular Enlargement, Goitre, Polypus, Uterine Tumors, Wen.] 



TYMPANITES TYPHLITIS TYPHOID FEVER. 715 

Tympanites. 

Turpentine, often greatly benefits (P, Wa) ; 3j every 6 hours in tympanites of 
typhoid, with prostration but without diarrhoea (R). Asafcetida, in hysterical, 
internally or as enema, beneficial (P) ; also in that of fever (Wa). Capsicum, 
gr. ss-ij, every 4 hours (P). Cocculus Indicus, a few doses of tincture will often 
succeed in the tympanites of peritonitis and enteric fever (P). Ginger, with 
drastic purgatives (P). Aspiration, in extreme cases and as a last resort. [Com- 
pare Typhoid Fever, Peritonitis.] 

Typhlitis. 

Opium, of undoubted curative power (B). Purgatives, are inadmissible ; 
Epsom salt may be used, but no drastics (B). Leeches, should never be 
omitted when tenderness and fever begin (B). Ice-bag, over the swelling (B). 

Typhoid Fever. 

Antipyrin or Phenacetin or Acetanilid, are extensively used as antipyretics ; 
for the dangers depending on the extensive employment of the latter drug see 
ante, page 60. Phenocoll Hydrochloride as an antipyretic, is used with marked 
success. Thymol may also be employed, in doses of gr. ss-ij in solution (DaC). 
Arnica is highly extolled; its "picture " shows definite powers in this disease 
(P) ; small doses .in asthenic conditions (B) ; when vital powers are greatly 
depressed (Wa). Baptisia is very useful in the early stage (W). Copper 
Arsenite, in daily doses of gr. y^, divided, commenced early and continuously 
used, will maintain a moderately low temperature, a good pulse-rate, compara- 
tive freedom from great abdominal pain and tympanites, and will lessen 
materially the number of stools, while it greatly improves their character and 
consistence (Aulde) ; used in 90 cases with but one death ; leaves an excel- 
lent condition of the alimentary tract after the fever is Over (Thomas). Salol 
is of great value as an intestinal disinfectant, promoting healing and prevent- 
ing reinfection. Salophen has proven equally efficient. Carbolic Acid, gj, 
with Tincture of Iodine Z'\}> of which tt\j" — iij every 2 or 3 hours, is a very good 
plan of treatment (Da C). Turpentine, invaluable, when hemorrhage and 
extreme tympanites (P, R) : HLxxx-lx in Starch mucilage, ttlx of Tinct. Opii 
(P) ; tt^v-x frequently for hemorrhage or rr\,x every 2 hours in advanced stage, 
with dry tongue (R) ; when coma, stupor, etc. ; often arouses the vital powers 
(Wa) ; TiLvij with gr. -^ of Morphine ; of especial value when marked fever 
and congested lungs, as well as for the tympany (Da C). Chloral, is the best 
drug for nervous symptoms, but must not be used when the heart is weak (Da 
C). Mineral Acids, are very useful generally, especially HC1 acid (Wa). 
Nitro-hydrochloric Acid, is to be preferred over all other plans of treatment, 
20-drop doses in simple elixir ; Sulphuric is useful for intestinal hemorrhage 
(Da C). Sulphurous Acid, is highly praised by Dewar, and has real antidotal 
power ; ttLijss-rr\,xx every 4 hours according to age, continued for a week or ten 
days, until the patient's complaints show him to be saturated ; if diarrhoea be 
present, add Sulphuric Acid and Opium (Wilks). [See formulae below.] 
Opium, small doses at night, for insomnia with delirium; also as injection for 
the diarrhoea (R) ; in one case when vital powers seemed hopelessly depressed, 
gr. }4 Opii caused improvement (Wa) ; for spreading tenderness (peritonitis), 
give 10-minim doses of the deodorized tincture, also gr. j in suppository every 
four hours (Da C). Veratrum Viride, to reduce temperature (R) ; for delirium 
ferox (B) ; strongly recommended (Wa) ; its efficacy difficult to believe (S). 
Cinnamon, efficiently used to abort the disease. [See ante, page 199.] Potas- 
sium Bromide, is as much a specific for typhoid fever as Quinine Sulphate is 
for ague, aborting the fever in 8 or 10 days (Hawkins). Belladonna, when 
contracted pupils, low, muttering delirium (B) ; is thought to counteract the 
poison of typhoid (Wa). Mercury, Corrosive Sublimate gr. y^ every 2 or 3 



716 



TYPHOID FEVER. 



hours for the diarrhoea ; Calomel in small doses at onset (R), gr. x in one dose 
the first day, gr. iij per diem for 3 or 4 days, the German " specific treatment " 
(B). Bismuth, gr. x-xxv of the Subnitrate with gr. y 2 -] of Opium every 3 
hours for the severe diarrhoea (Da C). Ergotin, gr. ij-vj hypodermically, or 
Z] of the fluid extract of Ergot, for intestinal hemorrhage (Da C). Tartar 
Emetic, with Opium, when wakefulness and delirium; minute doses (gr. y 1 ^), 
frequently, are of great service (B) : Antimony cuts the disease short with such 
certainty that it is almost doubtful whether the lesion of typhoid is specific or 
is not rather incidental or adventitious (Lawrie) ; should be given with cardiac 
tonics. Digitalis, of value in many cases as a sustainer of heart power, but 
may be dangerous in the later stages (Anstie, Murrell) ; used by the Germans 
when there is no cardiac weakness ; gr. xj-xxij, as antipyretic, over a period of 
36 hours (P). Quinine, may have efficacy in typho-malarial fever, is less effec- 
tive as the typhoid element predominates, useless in purely continued fevers 
(B) ; is justly abandoned, but may be used to maintain the circulation, in tonic 
doses, gr. vj-x in the 24 hours (Da C). Serpentaria, useful when much depres- 
sion exists, cautiously, if intestines at all irritable (B). Hydrastine, when copi- 
ous sweats (P). Lead Acetate, with Opium, for the purging (R) ; also Alum 
(R). Ergot, for intestinal hemorrhage, hypodermically, if symptoms urgent 
(R). Sodium Chloride, should not be withdrawn from the food (Wa). Aro- 
matic Spirit of Ammonia, for great accumulation of mucus in the throat (Da C). 
Copper Sulphate, gr. T ^, with Opium, gr. ]/ z , for the diarrhoea (Da C). Strych- 
nine, is the remedy for the functional palsies (Da C). Purgatives, only 
the very mildest, and they with the greatest caution (Wa). Water, a most 
important agent, cold baths when temperature above 102 (B) ; in mild cases, 
cold wet compresses or wet sheets, or washing with cold water ; in severe cases, 
affusion, shower, or general cold bath, 50 to 55 Fan., or better 95 cooled 
gradually to 6o° (R). Medicine will never abort a case of true typhoid, its 
natural duration is from 28 to 30 days (Sir William Jenner). Stimulants, 
freely, with Quinine, for pyaemic cases, showing joint complications. [See 
under Synovitis.] Aliment, by Milk alone, or alcohol with milk, eggs, broth 
(B) ; Coffee, a better stimulant than alcohol (P) ; Alcohol is needed to sustain 
the heart's action (Da C) ; Milk must be used with great caution, if the curd be 
undigested great evils arise; give essence of meat alone (Sir W. Jenner). 
Avoid the extremes ; an absolute milk diet required if intestinal symptoms are 
grave ; no solid food until health is restored fully ; a, scalded-milk diet exclu- 
sively may be depended on. Adjuvants, water, especially the abdominal 
compress, cleanliness, ventilation, absolute rest and quiet. Discharges should 
be received in vessels containing Carbolic Acid or a solution of Corrosive Sub- 
limate, and buried instantly. [Compare Hemorrhage Intestinal, Rectal 
Ulceration, Tympanites.] 

Prescriptions. 

R • Tinct. Iodi, 

Ac. Carbolici, . , 



R 



Ant. et Potassii Tartrat., 

Morphinae Sulphat., . . 

Aquae Laurocerasi, . . 

M. Sig. — A teasp. every 

hours. 



• gr- J-iJ. 

. gr. ss. 

• 5J- 

2, 3 or 4 



R. 



. gr. x. 



s. ad J vj. 



Quininae Sulphatis, 
Ac. Hydrochlor. Dil. 
Vel Ac. Sulphurici Dil., 
Syr. Aurantii, . . . 
Aquae Carui, . . q. 
M. Sig. — A tablesp. in an equal quan- 
tity of water, every 3 or 4 hours. 

(Murchison.) 

R. Ac. Sulphurosi, £ij. 

Syr. Aurantii, . . . . . 3 iij. 

Aquae, q. s. ad Jvj. 

M. Sig. — l /e every 4 hours. ( Wilks.) 



. . aa p. aeq. 
M. Sig. — gtt. j-ij every 4 or 6 hours. 
In typho-malarial fever. 



R . Ac Sulphurosi, 

Ac. Sulphurici Dil., . aa gij. 

Tinct. Opii Deodor., , Tt^xx. 

Syr. Aurantii, . . . . . . 3 iij. 

Aquae, q. s. ad 1$ vj. 

M. Sig. — One-sixth to be taken every 
4 hours. ( Wilks.) 

R . Ac. Sulphurosi, tt\,xv. 

Syr. Aurantii, ^ iij . 

Aquae, q. s. ad §j. 

M. Sig.— For infants, one-sixth every 4 
hours. (Wilks.) 



TYPHUS FEVER ULCERS AND SORES. J \J 

Typhus Fever. 

Phenacetin, is extensively used for the pyrexia. Baptisia, is said to have 
proved very useful (W). Belladonna, to cleanse and moisten the tongue ; 
controls the delirium, slows and strengthens the pulse, reduces the tempera- 
ture, shortens course of disease (R, P) ; in the early stages, relieves severity 
of symptoms (P) ; give when contracted pupils (Wa). Arnica, very highly ex- 
tolled (P, Wa). Hyoscyamus, for mild brain symptoms (P). Opium, fulfils 
many important indications ; never give when pupils are contracted (Wa). 
Mineral Acids, their use recommended in all countries (Wa). Tartar Emetic, 
with Opium in the delirium with insomnia (R). [See Typhoid.] Chloral, to 
produce sleep, and allay violent delirium (R, Wa) ; its use has often been 
followed by amelioration of the symptoms (Wa). Antipyrin or Quinine, as 
antipyretics, it being more necessary than in typhoid to keep the temperature 
within safe limits (B). Podophyllin, gr. yc,-% as mild laxative at onset, when 
constipation, congestive headache, biliary derangement (P). Digitalis, in 
large doses, a favorite remedy in Germany (P). Rhatany, as tonic, in ad- 
vanced stages (P). Serpentaria, in low stages, delirium, watchfulness, tongue 
dry and brown, or black; combine with Ammonium Sesquicarbonate (P) ; is 
given occasionally to excite diaphoresis, and support the vital powers (Wa). 
Camphor, a remedy of considerable value, but contraindicated when flesh-red 
tongue, tender abdomen, diarrhoea (Wa). Purgatives. [See Typhoid Fever.] 
Coffee, better than alcohol for the adynamia (P). Stimulants, are not needed 
under the use of mineral acids and a supporting diet, in many cases (Wa) ; 
are needed sooner than in typhoid, as the adynamia is more profound and 
appears sooner (B). Diet, nutritious persistently, beef-tea, egg-nog, nutrient 
enemata. Isolation, imperative, as the disease is eminently contagious (B). 
[Compare Delirium, Typhoid Fever.] 



Ulcers and Sores. 

Arsenic, improves rodent ulcer (B). Belladonna, has a remarkable influ- 
ence over various ulcerative processes (P). Mercury, Calomel Ointment or 
Black Wash in scrofulous, or tuberculous lupus, and in open scrofulous sores 
(R) ; Corrosive Sublimate, in i per cent, solution, as application to syphilitic 
ulcers (Fox) ; the Ung. Hydrarg. Nitratis, for serpiginous ulcerations diluted 
one-half, or the Iodide, gr. xx-xl ad ^j Vaselin, in syphilitic ulcerations (Keyes). 
Lime, as Carbonate or Lime-water to check discharge ; the Sulphide when thin 
ichorous discharge ; the Phosphate has influence on scrofulous sores (R). 
Phytolacca, as a local application (B). Hamamelis, employed with satisfaction 
in varicose ulcers (Pf ). Opium or Morphine, with Glycerin, as an application 
to relieve pain (R) ; gr. j-ij, daily, also locally, has a decidedly curative value 
in phagedenic and indolent ulcers ; not so useful in so-called " irritable " ulcers 
(Pf, P). Ichthyol, pure as oint. or with Lanolin, has done excellent service in 
ulcers of the leg. Thiol, the dry form, as dusting powder, has been of great 
benefit. Piperazin, in i per cent, solution, locally to gouty sores, relieves the 
pain and reduces the inflammation. Resorcin, in strong or supersaturated 
solution, locally applied to tuberculous and other ulcerations of the larynx, is 
efficient and painless (Tymowski). Tannin, or Glycerite of Tannin, to coat 
over wounds, or discharging sores (R). Potassium Chlorate, in solution as a 
wash to clean and stimulate foul ulcers (R) ; in impalpable powder, a better 
application than Iodoform (B). Cinchona, powdered Bark dusted over foul, 
indolent, sloughing, and gangrenous ulcers, promotes healing (R). Conium, 
locally, by means of a poultice, will ease pain and improve the sore (R). 
Chlorine Solution, as a wash for sloughing and indolent sores (R). Iodide of 
Starch, cold, as a poultice (R). Lead, the soluble salts as lotions to unhealthy, 
over-secreting sores (R). Pyrogallic Acid, an excellent application in venereal 
ulcers (Vidal). Chloral, in lotion, gr. v-xx ad ^j aquae, for sluggish sores 
(Keyes). Nitric Acid, as escharotic, applied with a glass rod, Oil to protect 



7 i8 



URAEMIA. 



surrounding tissues ; arrest by alkaline wash ; %j to Oj is a good acid lotion for 
washing (B) ; the lotion to indolent and painful ulcers (R). Hydrastis, internally 
and externally, employed with excellent results in rodent ulcer, and ulcers of 
legs, rectum, and uterus (R). Sanguinaria, locally, to repress fungous granulations 
of indolent ulcers, I to 80 parts of Glycerin (P). Carbolic Acid, and Salicylic, 
locally (B) ; the Glycerite of Carbolic Acid a good application to fetid sores 
(R). Badsams of Peru and Tolu, excellent (P). Camphor, dusted over in- 
dolent sores (R). Charcoal, locally to sloughing sores (R). Alcohol, locally 
to cover sores with thin protecting layer of coagulated albumen (R). Alum, 
dry or in solution, applied to relaxed and abundantly-secreting sores (R). 
Turpentine, internally for ulceration of bowels (P). Collodion, as protective 
covering (P). Capsicum, a weak solution useful as a stimulant in scrofulous 
or fistulous sores (P). Savine, as acrid (not chemical) caustic (P). Potassa 
Fusa, or the milder Vienna paste, as escharotic ; to arrest its action a dilute 
acid (B). Zinc Chloride, the most efficient escharotic consistent with safety 
(B). Zinc Sulphate, dried, dusted over sores (R). Iodoform, dusted over sur- 
face (B) ; prevents granulation in all ulcers, and does no good except to relieve 
pain (Gross). Aristol, is highly praised ; an excellent substitute for Iodoform, 
being quite as efficient, and odorless ; has given excellent results in treatment 
of indolent soft ulcers, syphilitic ulcerative processes, etc. (See Potassium 
Chlorate above.) Silver Nitrate, as caustic, quickly rubbed over surface (B) ; 
applied to unhealthy ulcers, also ulcers of the mouth (R). Copper Sulphate, 
to indolent ulcers ; touch with a crystal, or frequently apply a solution, gr. ij-x 
ad ^j (R). Coptis, the infusion has high reputation (B). Chimaphila, Copaiba, 
Catechu, Myrrh, Rhatany, Rhubarb, Storax, Benzoin, Tar-water, locally, are 
useful (P). Oxygen, to atonic, painful ulcers (R). Galvanic Couplet (B). 
[See Bedsores.] Yeast, as poultices (R). Section of exposed nerve-filament, 
in irritable ulcer, by bistoury passed beneath the sore (Hilton on Rest and 
Pain). Cod-liver Oil, especially for ulcerations of the glands, or indolent 
ulcers with excoriated edges, lupus, etc. Water, is sufficient as dressing in the 
majority of cases. Rest and support of great value ; cleanliness, bandaging 
and recumbent position in ulcer of legs, facilitate recovery ; also daily washing 
to restore the lost vitality of parts ; elastic stockings, and the Esmarch bandage 
in chronic cases. [Compare Chancre, Chancroid, Bedsores, Throat, 
Gastric, Intestinal, and Uterine Ulceration, Syphilis.] 

Prescriptions. 



B; • Iodoformi, gij. 

Mucil. Acacise, l^xv. 

01. Menthae Pip, Tr^ij- 

Glycerini, . rr^xx. 

M. Sig. — For unhealthy ulcers. 

(Pronson.) 



R. Emplas. Plumbi, ^ij. 

Ung. Hydrargyii, . . . . % ss. 

Olei Cadini, 5jij. 

M. Sig. — Spread on linen, and apply to 
inflamed patches on palms from syphilis. 
[Pumstead and Taylor?) 



R- . Hydrarg. Chlor. Cor., . . gr. xv. 

Ac. Carbolici, rn^xxv. 

Aquae, . . . . . q. s. ad £ iv. 
M. Sig. — For syphilitic ulcers, pack on 
cotton, and renew daily. [Pox.) 



R . Ung. Petrolei, ^ ij. 

Ung. Hydrargyri, . . . . giv. 

Olei Cadini, ^ij. 

M. Sig. — Apply after removing scales 
to chronic palmar and plantar lesions. 

{Pumstead and Taylor I) 



Uraemia. 

Digitalis, the infusion, or a poultice of the leaves to the abdomen and back 
(B). Jaborandi, as diaphoretic, eliminates urea (B) ; or Pilocarpine hypoder- 
mically. Opium, Scanzoni and Loomis urge Morphine, hypodermically, as 
the most efficacious agent (B) ; in acute, not in chronic uraemia (Pf ). Colchi- 
cum, as diuretic (B). [See Dropsy.] Saline Cathartics, active ones are 
required (B). Hydragogue Cathartics, 01. Tiglii (gtt. j-ij), or Elaterium (gr. 



URETHRITIS URINARY DISORDERS. 719 

^ to I), to procure free watery evacuations, — cautiously ! (B). Transfusion, in 
urasmic eclampsia (B). Water, the vapor bath, or hot wet-pack to induce 
powerful diaphoresis (B). [Compare Bright's Disease, Puerperal Con- 
vulsions, Scarlatina, and the list of Diuretics and Diaphoretics, on pages 44 
and 46.] 

Urethritis. 

Aconite, is used to advantage in urethral fever ; also for prevention of chill 
after passage of sound (Pf, W). Strophanthus, efficient in preventing rigors 
after instrumentation on the urethra, the tincture in doses of 5 minims (Fen- 
wick). Silver Nitrate, locally, very efficient in chronic urethritis in females 
(W). Tannin, on bougies, once a week for 15 minutes, most efficient for 
urethritis in the female (Wa). Zinc Sulphate, cast in sticks, for introduction 
into the urethra (Wa). Potassium Bicarbonate, with Potassium Acetate, aa 
gr. x in a large cup of flaxseed tea or a glass of Vichy water, every 4 to 6 
hours ; with absolute rest in bed, a calomel purge, and urination under hot 
water, sufficient for most cases of urethritis, which may arise from lithiasis, 
leucorrhcea in females, etc.; many cases of aborted gonorrhoea (so-called) were 
really simple urethritis (Otis). [Compare Gonorrhoea.] 



Urethral Stricture. 

Aconite, is of great service in spasmodic stricture (P). Cocaine, locally by 
catheter (Smith). Buchu, in irritable urethra, spasmodic stricture, and gleet 
(P). Opium, in full dose or an opiate suppository, with fomentations and a 
warm bath, will often suffice in spasmodic stricture (CI). Catheterization, 
under an anaesthetic in spasmodic stricture if other measures fail to relieve ; 
also for gradual dilatation in organic stricture, the safest and most generally 
applicable treatment (CI). Oil, injected before dilatation (Wa). Thorough 
Division, by a dilating urethrotome the best operation for a radical cure ; 600 
cases thus treated without a death or permanent disability (Otis). Electricity, 
a weak galvanic current, with negative pole to the stricture, will destroy it in 
2 or 3 sittings by electrolysis, and if carefully done, is the most efficient and 
least painful method of treatment for radical cure. 



Urinary Disorders. 

Aconite, of great service in sub-inflammatory retention from chill (P). Tur- 
pentine, in hematuria and chronic catarrh of the bladder, incontinence from 
atony, etc. (B). Strychnine, sometimes employed with marked benefit in 
retention or incontinence of the old (P). Cantharis, frequent or involuntary 
micturition, especially when coughing, in women from weakness of sphincter ; 
one or two drop doses (R). Cannabis Indica, in retention from spinal dis- 
eases (R). Diuretin, a remarkably efficient diuretic in cardiac and renal 
dropsy, 15 grains several times daily will increase the urine three and fourfold. 
Digitalis, holds high rank as a diuretic, 3] or ij of the infusion night and morn- 
ing, or oftener if necessary ; in sudden suppression from cold or damp, or after 
scarlatina if danger threatens (P). Benzoic Acid, or Sodium Benzoate, in 10 
to 15-grain doses, to render alkaline urine acid, and check the formation of 
phosphates (B). Thymol in chyluria, due to the presence of filaria in the 
blood ; doses of one grain, gradually increased to five grains, every four hours, 
cured two cases (Lawrie). Nitro-hydrochloric Acid, dilute, gtt. x-xv thrice 
daily in water, for phosphatic deposits (Mears). Ammonium Carbonate, in 
6-grain doses, 3 or 4 times a day, to make acid urine alkaline. Triticum 
Repens, a favorite remedy with Sir Henry Thompson, in pint doses daily of its 
infusion or decoction (^ij-iv ad Oj), for strangury, cystitis, and many other 
complaints, connected with the urinary apparatus. Alkalies, to neutralize acid 



720 



URTICARIA UTERINE CANCER. 



urine, and control chronic cystitis ; the Liquor Potassas preferable to the bicar- 
bonates, tartrates, and citrates, which all have diuretic action and increase the 
frequency of micturition ; Liquor Potassae mixed with the tinctures of Hyoscy- 
amus or Belladonna, may undergo chemical changes, but the combination 
materially controls painful and frequent micturition in bladder troubles 
(Thompson). Buchu, renders more help than any drug known in inconti- 
nence or retention from catarrh of bladder implicating the ureters, and even 
the kidneys (P). Water, copious injections are beneficial in some cases of 
suppression (R). [Compare the list of diuretics on page 44 : — and in this sec- 
tion see Bladder Irritable, and Paralysis of ; Cystitis, Diabetes In- 
sipidus, Dysuria, Dropsy, Enuresis, Hematuria, Lithiasis, Nephritis, 
Oxaluria, Uraemia, Urethral Stricture.] 



R. Pulv. Scillse, 

Pulv. Digitalis, 

Hydrarg Chlor. Mitis, . aa gr. xij. 
M. ft. pil. no. xij. Sig. — One pill as a 
diuretic twice daily. {Sir A. Clark.) 

R. Potassii Citratis, ^j. 

Sodii Bicarbonat., . . . . ^v. 

Syr. Limonis, §j. 

Aquae, q. s. ad. ^ iv. 

M. Sig. — A teasp. every 2 hours, to 
render the urine alkaline. {Roberts.) 



Prescriptions. 



R. Tinct. Digitalis, ... . gss-j. 
Spt. ^Etheris Nitrosi, . . . giij. 
Liq. Ammon. Acetat., . . Jss. 

Aqua;, q. s. ad. J vj. 

M. Sig. — One-sixth every 3 hours, to 
re-establish the renal secretion. 

{Good eve.) 



R. Potassii Bicarb., ^iijss. 

Acidi Acetici, gyj. 

Aquas, Jiij. 

M. Sig. — Teasp. doses as required, as 
a diuretic. Each dose contains about gr. 
x of Potassium Acetate. 



R. Acidi Benzoici, gij. 

Sodii Boratis, ^iij. 

Aquae, s| xij. 

M. Sig. — A teasp. in water, thrice 
daily, to keep urine acid. {Emmett.) 



R. Ext. Belladon. FL, . . . . ^ss-j. 

Ext. Buchu Fl., . . . . . % j. 

Spt. ^Etheris Nitrosi, . . . J ij. 
M. Sig. — A teasp. 3 or 4 times daily, 
for dysuria in women. 



Urticaria. 

Antipyrin, internally, is promptly efficient in urticaria, also in the urticaria- 
like eruptions of children. Chloroform, as ointment to allay itching (R). 
Potassium Cyanide, or Hydrocyanic Acid (R). [See Prurigo.] Nitric Acid, 
as dilute wash, controls itching and prevents wheals (R). Benzoin, the com- 
pound tincture painted on the skin for itching (R). Sodium Salicylate, gr. ij 
every l / z hour, is remarkably efficient (Smith) ; gr. xx thrice daily is effective. 
Copaiba, in full doses will produce urticaria, but drop-doses every ]/ 2 hour will 
sometimes control it (Smith). Strychnine, with emetics and purgatives, when 
the affection is chronic (Guibout). Colchium, in gouty persons (R). Lead, in 
lotions to ease itching (R). Alkalies, (R). [See Prurigo.] Warm Baths, 
may be employed with benefit. 

Prescriptions. 



R 



Acidi Benzoici, 
Aquae, 



M. Sig. — Lotion for urticaria. 



gr. vnj. 
3iv. 

{Squire.) 



R. Atropinae Sulphat., . . . gr. */£. 
Aq. Destil., Glycerini, . aa^ss. 
Pulv. Tragacanthae, . . . q.s. 
Ft. pil. no. x. Sig. One bis die. 



Uterine Cancer. 

Conium, useful as a palliative, 3hj-iv ad Oj aquas, as injection for the ex- 
treme pain of uterine cancer (Wa). Arsenic, small doses for a long time, with 
a strong solution of Iodine and Glycerin locally (Atlee). Opium, stands first 



UTERINE CONGESTION AND HYPERTROPHY. 72 1 

in the list of palliatives, quieting irritation, allaying pain (Wa). Morphine, the 
specific action thereof upon the uterine circulation should be utilized in hope- 
less cases of this disease (Lutaud). [See page 317.] Carbolic Acid, a weak 
solution as injection, an excellent cleanser, healer, disinfector and allayer of 
pain (R). Bromine, the best escharotic for destruction of the mass (E). 
Glycerite of Tannin, checks discharge and stench ; is still better if mixed with 
Glycerite of Carbolic Acid (R). Iodoform, with Cocoa-fat as bolus inserted 
into excavation produced by cancer (R) ; gr. v-x in each bolus (W). Iodine, 
the saturated tincture thoroughly applied to the entire surface of the mass, is 
frequently of great use in checking hemorrhage, and seems to temporarily 
check the extension of the disease (E). Chloral, as anodyne, will agree with 
most persons (E) ; relieves the pains (W). Chloroform Spray, for some minutes 
(R). Cannabis Indica, to allay the pain (W). Surgical Measures, advisable ; 
medicine can only palliate. 



Uterine Congestion and Hypertrophy. 

Aurum Salts, often beneficial in chronic metritis with scanty menstruation 
(B). Ergotin, long continued, successful in chronic metritis ; lessens con- 
gestion (B) ; long continued has produced remarkable results in fibroids and 
polypi and chronic metritis, large, spongy, subinvoluted uterus (P) ; by inter- 
stitial injection into the cervix, has been of great benefit (G). Carbolic Acid, 
undiluted, on cotton-wrapped probe, no better treatment for uterine catarrh (B). 
Iodine, has proved the most valuable of all remedies as a local stimulant, and 
a reliable alterative (E) ; and excitant of uterine contraction ; use a saturated 
tincture to any part not exposed to the air (E) ; may be injected into cervix (G). 
Iodo-tannin, or Iodoformi 3j, Ac. Tannici ^j, a servicable application in many 
inflammatory and hypertrophic conditions ; Iodoform suppositories in chronic 
metritis (P). Potassium Bromide, our main stand-by in uterine troubles ; 
apart from its soothing properties it seems to divert the blood from the womb, 
and to lessen uterine congestion (G) ; a specific cure for simple subinvolution, 
the benefit being derived from the potash (Tait). Digitalis, in subinvolution 
(B). Glycerin, on cotton tampon to cervix as local hydragogue (Thomas). 
Glycozone, as an application in tumefied conditions of the cervix and uterus, 
is far superior to pure glycerin (Edson). Potassa, Caustic Potassa and Potassa 
cum Calce, are said to be effective in chronic metritis ; must be used cautiously 
(B). Chromic Acid, a strong solution to interior of uterus, a very useful appli- 
cation. Ipecacuanha, in subacute metritis of the puerperal state (Tr). Iron, 
locally in uterine catarrh (R) ; as a tonic, Iron and other restoratives, a cardinal 
rule in the treatment of all uterine disorders, with Ergot, Quinine, Arsenic or 
Potassium Bromide, whenever the womb as a whole is congested or hyper- 
trophied ; Syr. Ferri Iodidi, with Cod-liver Oil, wins half the battle (G). Zinc 
Valerianate, in 2- to 4-grain doses thrice daily, is one of the best nervines in 
these cases (G). Scarification, after dry cupping, in chronic metritis (Thomas). 
Electricity, in chronic congestive enlargement, a galvanic current of moderate 
intensity, slowly interrupted (B). Water, hot injections or douche, also cold 
alternately, one of the most effective measures, a gallon very hot, ter die (R) ; 
— especially valuable in congestion, which is generally venous; — elevated hips 
a necessary part of treatment (E) ; cold water is often better than hot (G). 
Rest, to the patient and the organ, is of prime importance, abdominal band- 
age, skirt-supporters, pessary if anteversion or retroversion, abstinence from 
sexual intercourse (Thomas). 

Prescriptions. 



i 



R. Ext. Humuli, 3jj. 

Elix. Ammon. Valerianate 

Syr. Lactucarii, aa^ss. 

M. Sig. — A dessertsp. at bedtime, or 
during the day when needed, as an anti- 
spasmodic. (Goode//.) 
46 



R. Iodi, 

Potass. Bromidi, . . . aa gr. xx. 

Tinct. Iodi, £j. 

Aq. Destillat, . . q. s. ad 3 iv. 
M. Sig. — rr\,xxx to be injected into the 
cervix by 3-5 punctures. (Goode/l.) 



722 UTERINE DISEASES UTERINE TUMORS. 

Uterine Diseases. 

Cimicifuga, to prevent miscarriage in irritable uterus and prolapsus (R) ; 
promises to be a valuable remedy in uterine affections (Wa) ; is remarkably 
efficient in neuralgia and sympathetic pains arising from an irritable uterus, no 
matter what their precise character (P). Belladonna, with Tannin, as supposi- 
tory in uterine neuralgia (R) ; as vaginal or rectal injections, in neuralgic or 
inflammatory pains (Tr). Arsenic, in irritable uterus, of decided benefit; gr. 
■£$ ter die, after meals (Wa). Carbonic Acid, injection up vagina for neuralgia 
(R). Opium, with Starch as injection into the rectum, will subdue the pain of 
uterine diseases (R) ; gives more speedy relief than any other remedy in irrita- 
able uterus, but long-continued is one of the worst (Wa). Iodized Phenol, has 
proved the most generally efficient agent for intra-uterine use during eight 
years' experience, applied by hard rubber probes wound with cotton-wool; it 
removes cervical mucus, gives freedom from pain, softens and dilates the cervix, 
heals abrasions, removes induration and villosities, regulates the menses, im- 
proves appetite and digestion, acts as a general alterative, overcomes barren- 
ness, etc., if used long enough, but rapid results are not attainable by any 
method of treatment (Battey). Lead, as plaster for pain in the back due to 
uterine disease (R). Chloroform, spray, in uterine neuralgia (R). Aquapunc- 
ture, has had extraordinary success in uterine colic (B). Baths of warm salt 
water remarkably useful in nervous or inflammatory hysteralgia (Tr). [See 
Abortion, Amenorrhcea, Climacteric, Dysmenorrhea, Endometritis, 
Hemorrhage Post-partum, Leucorrhcea, Menorrhagia, Menstrual 
Disorders, Metritis, Metrorrhagia, Prolapus Uteri, etc.] 



Uterine Displacements. 

Anteversion without prolapsus, is not a mal-position (E). Ice, locally when 
parts inflamed (R). Hot-water injections, to give tone to the vessels, essential ; 
also valuable after reduction of mal-positions (E). Mechanical Means, only 
reliable or safe in retroversion and prolapse ; the sound, as a means to restore 
a retroverted uterus to position, cannot be regarded as free from risk, even in 
skillful hands (E). Pessaries, harmful unless expertly fitted ; should be adjusted 
so as to restore the uterus to the normal line, where the circulation will be least 
obstructed, not too high ; should never be employed while cellulitis exists (E). 
Cotton Roll, as a substitute for the orthodox pessary, is far superior; use 
Borated Cotton in flat sheets, rolling it into a roll 2 inches long by 1 inch 
diameter, and saturating in Boroglyceridi ^j, Aluminii Acetatis 3J, Glycerini 
Pur. q. s. ad Oj ; if an astringent is required, the Acetate may be replaced by 
Alumini Sulphas (Wylie). [Compare Prolapsus Uteri.] 



Uterine Tumors. 

Mercury, the Bichloride in small doses, long continued, of undoubted value 
in treatment of fibrous or polypoid growths; gr. y 1 ^ every 6 hours, sometimes 
restrains the hemorrhage, when other remedies fail (Wa). Calcium Chloride, 
in 30-grain doses thrice daily, has by prolonged use cured uterine fibroids 
(Hewitt); calcifies uterine arteries, also those of the body generally, and is 
dangerous thereby (Tilt, Wells). Ergotin, hypodermically for fibrous tumor 
(R) ; gr. ij-vj, on alternate days, give excellent results (B) ; nine cases of 
fibroid treated thus by Hildebrandt with good results (P) ; this method often 
causes great pain and severe local inflammation (W) ; one grain each of 
Ergotin and Ferri Sulphas Exsiccat, in pill thrice daily, persistently, for uterine 
fibroids, using for the hemorrhages a tampon saturated with Tincture of Iodine 
or Monsel's Solution (Parvin). Opium, has specific action upon the uterine 
circulation, and in bleeding from hopeless cases of cancer or from fibroid 
tumors, should be used freely, regardless of danger of opium habit. (Editorial, 



UTERINE ULCERATION VAGINITIS. 723 

N. Y. Med. Rec, Dec. 10, 1887.) Ammonium Chloride, in fibrous tumors, 
gives more benefit than any other remedy, gr. x, twice or thrice daily, for weeks 
and months consecutively (Atlee). Ferrous Subsulphate, injected to restrain 
bleeding, — Cautiously ! (B). Saline Mineral Waters, especially those at St. 
Catherine's, Canada, are useful (B). Aliment, carefully regulated, chiefly ani- 
mal food, with recumbent posture while flowing, and long-continued use of 
Ergot in small doses, may accomplish something (E). [Compare Cysts.] 



Uterine Ulceration. 

Hydrastis, quickly improves ; the fluid extract undiluted as topical applica- 
tion in uterine and vaginal leucorrhcea, ulcerations and erosion of cervix (B). 
Carbolic Acid, pure, over the surface twice a week in simple ulceration (R). 
Silver Nitrate, a serviceable application, but is often abused (B) ; the solid stick 
applied to surface, after cleansing and drying with cotton-wool (Wa). Alum, 
as hip-bath, (ft) j ad C j,) and vaginal injection, is of great utility in ulcerations 
of the os uteri, or of the uterine cavity (Recamier). Glycerin 25, Alcohol 12^, 
and pure Creosote 1 part, an excellent application to ulcers of the neck. Gly- 
cozone, as an application to ulcerated cervix, is far superior to pure glycerin 
(Edson). See under Leucorrhcea, for manner of application. Bismuth Sub- 
nitrate, with enough Glycerin to make a thick cream, is the best of all appli- 
cations for ulceration of the os and cervix uteri (Suesserott). Vegetable 
Astringents, infusions or decoctions of Galls, Oak-bark, Hamamelis, Geran- 
ium, Alum-root, etc, ; the Glycerite of Tannin, or Iodoform and Tannin, 
packed around cervix (B). 

Uvula. 

Tannin, Rhatany or Zinc, as astringent lozenges, for relaxed uvula (A). 
Amputation, of elongated part (A). 



Vaccination. 

Aconite, with Belladonna Ointment for erysipelatous redness after vaccina- 
tion (R). Zinc Oxide, dusted over, to allay the subsequent local irritation 
(Wa) ; with Pulv. Amyli, equal parts, over the surface. Lead Acetate, 3j to 
Oj water, as lotion for irritable pock (Foster). Carbolic Acid, 3j to Oj water, 
as lotion for excessive redness, with burning and itching. 



Vaginismus. 

Ether, as anaesthetic, to ascertain cause, usually a displacement, fissure, or 
cellulitis (E). Hygiene, sun-baths, hot-water injections, fresh air, removal from 
husband, etc. (E). Operation (Sims'), removal of hymen with scissors and 
insertion of glass plug till parts are healed, when the cicatrix is to be divided, 
etc. (E). Tents to gradually dilate vagina, may be impregnated with various 
sedatives (Gallard). Iodoform in a suppository, when redness and excoriation. 
Belladonna, the extract, 1 part with 8 or 9 of fresh Lard, if only pain (Gallard). 



Vaginitis. 

Tannin, the Glycerite in chronic vaginitis of children (R). Silver Nitrate, 
gr. xl to %] aquae, applied within cervical canal, and over the vaginal mucous 
membrane (E). Emollient Injections, with Opium (Goodsell). [Compare 
Gonorrhoea, Leucorrhcea.] Pinus Canadensis, the concentrated extract 
(colorless), locally, has a very soothing influence in acute vaginitis. 



< 



724 VARICELLA VARIOLA. 

Varicella. 

Diet, no animal food, milk best, which, with careful attention to the bowels, 
patient to be kept cool with light covering, and use of a mattress rather than a 
feather bed, is all the treatment required (A). Saline Mixture, if high fever 1 . 
Quinine, during convalescence. Complications to be treated symptomatically. 



Varicocele. 

Hamamelis, appears to have permanently cured one case (R). Ergot, gr. 
ij-vj of Ergotin hypodermically, the needle to be inserted among the affected 
veins, care being taken not to puncture a vein, is effective ; severe pain follows 
for a few hours (R). Water, cold douche to the perineum and buttocks, with 
suspension of testicles in cold water (R). Radical Cure, consists in obliterating 
the veins by wire ligatures, etc. (CI). 



Varicosis. 

Hamamelis, is employed with satisfaction in varicose veins and ulcers (Pf ). 
Digitalis, by fomentation, in acute inflammation from varicose ulcers (R). 
Ergotin, injected alongside of vein, but not within it, has cured (B). Bandage, 
or elastic stocking; with cold sponging and rubbing upwards, as palliatives 
(CI). [Compare Hemorrhoids, Ulcers.] 



Variola. 

Cimicifuga, is given internally by some, who assert that it prevents pitting 
(R). Mercury, in ointment or plaster, to prevent pitting in semi-confluent, or 
barely confluent cases (Wa); formerly used (R). Camphor, is said to restore 
the eruption, if retrocedent; in confluent malignant smallpox, camphor alone, 
or with Opium, may be used for great depression of the vital powers (Wa). 
Belladonna, successfully used both as prophylactic and curative agent (Erasmus 
Wilson) ; gr. Yz-) every 3, 4 or 6 hours, to dilatation of pupil and some stupor, 
found effectual (Wa). Carbolic Acid, is used with decided advantage (Wa) ; 
[See Measles.] has been much used on theoretical grounds, but not with 
success (B). Ammonium Carbonate, has had cheering success (Wa). [See 
Scarlatina.] Quinine, small doses in adynamic states, larger in hyperpyrexia 
(B). Chloral, temperature high, much delirium, and restlessness (B). Opium, 
low, muttering delirium ; not so much used now as formerly (B) ; Morphine in 
the insomnia of the advanced stage, once or twice only, but not when copious 
salivation or mucous expectoration (Wa). Silver Nitrate, on a sharp-pointed 
stick, inserted into each vesicle after rupture, to prevent pitting (B) ; or simply 
paint skin with a solution of gr. xx to the |j (R). Iodine, the tincture to pre- 
vent pitting, is painted ten times over face if on first day of eruption, 12 if on 
the second day, 12-16 times if on third day (B). Collodion, or solutions of 
India-rubber or Gutta-percha in Chloroform, to prevent pitting ; or cotton-wool 
dipped into Lime liniment, applied to face or neck (R). Water, as cold baths 
and cold pack, of great utility (B) ; packing especially on retrocession of rash 
(R). External Applications, as powdered starch, flour, or Zinc Carbonate, 3 
parts to 1 of Zinc Oxide with Olive Oil ; cold or tepid water with vinegar, 
sponged over body twice or thrice daily (Wa). Diet, tea and dry toast, raw 
eggs beaten in cold milk, beef-tea, grapes, roasted apples, ripe fruits in season ; 
cold water may be drunk freely. Fats, bacon-fat smeared over the face, to 
allay itching and prevent pitting. [Compare Vaccination.] 



VERTIGO VOMITING. 725 

Vertigo. 

Digitalis, in small doses, alternately month by month with Tincture of 
Larch, and a long course of Iron Citrate, and Strychnine, in essential ver- 
tigo, without any other" head symptoms, and with general depraved nutrition, 
the most effectual treatment (Wa). Potassium Bromide, often controls par- 
oxysmal vertigo, without coexistent spasm, or organic brain-disease (Wa). 
Ammonium Bromide, in an effervescing form with Cascarilla, for vertigo from 
overwork, where there is usually restlessness, insomnia, depression of spirits, 
with a sense of impending evil (Wa.) Alkalies and Bitter Tonics, give the 
best results in vertigo of gastric origin. Sodium Bicarbonate, after meals, 
tonics before meals. Strychnine with Iron, thrice daily, gives good results. 
Corrosive Sublimate, in small doses, with attention to the bowels and diet. 
Cod-liver Oil, for giddiness of the aged, when no serious brain- disease (R). 
The affection is mostly symptomatic of disorder of the stomach, or of the 
liver (cholaemia), sometimes of general debility, rarely of disease of the brain 
(H). Nitro-glycerin, gives good results in epileptic vertigo (Br). 



Vomiting. 

Arsenic, in many forms of stomach vomiting, especially that of alcoholism, 
and chronic ulcer (B), and in the vomiting of cholera (R) ; gtt. ss of Fowler's 
solution, every y z hour for 6 or 8 doses, often relieves vomiting after a debauch, 
the A. m. vomiting of drunkards, and that of pregnancy (Smith). Nux 
Vomica, stands next to Arsenic, is useful in many ways (B) ; may be given 
with Ipecac, especially when tongue coated (R). Ipecacuanha, in small doses, 
will arrest certain kinds — a curious fact ; especially useful in certain forms, 
Tr\j of Vinum Ipecac every Yx hour or more (B, R, P) ; in sick stomach of 
nervous origin, minute doses are of undoubted value (W). Cocaine, in doses 
of gr. % thrice daily, controlled the vomiting of gastric carcinoma, after all 
other means failed (Meigs) ; 10-minim doses of a 4 per cent, solution every 
hour, of inestimable value in the vomiting of yellow fever (Jennings). Potas- 
sium Nitrate, one of the surest remedies against vomiting and nausea, gr. )i 
in ^ss of cold water every 4 or 5 minutes, until relieved, in all cases, except 
reflex ones, and those due to irritant poisons (Moore). Mercury, gr. )/$ of Gray 
Powder every two hours, especially in children with clayey stools (R) ; Calomel, 
gr. j to Oj aquae, first dissolved in 3J of Lime water — a teasp. every ten minutes 
for the regurgitation of food in nursing children (Smith). Opium, will arrest 
many kinds, best in that of biliary or renal calculi, dysmenorrhcea, sea-sick- 
ness, pregnancy ; Morphine, hypoder., gr. ^ to yi (P). Bryonia, bilious vomit- 
ing and headache (P). Veratrum Album, in vomiting and purging of summer 
diarrhoea (R). Hydrocyanic Acid, often very serviceable in nervous vomiting, 
acts promptly if at all (R). Hydrobromic Acid, gss m ^j f wa ter, four times 
daily, useful for the vomiting due to gastric ulcer. Chloroform, tt\,ij-v, on sugar, 
for non-inflammatory vomiting (R) ; [See Yellow Fever for formula.] 
Bromides, in cerebral vomiting only ; not in the gastric form (B) ; Potassium 
Bromide in that of uterine disease (W) : Strontium Bromide is excellent in 
vomiting due to various causes ; gr. x-xv twice daily with meals. Phenocoll, 
with Piperazin, gr. xv of each daily in a pint or more of carbonated water, was 
of great service in a case of uncontrollable vomiting which had resisted every 
known remedy. Menthol, has successfully checked persistent vomiting after all 
the usual remedies had failed, in the hands of many well-known observers ; 
tt\,x of a 20 per cent, solution in Olive Oil, dropped on powdered sugar, each 
dose being about 1 grain (Weil). Sulphurous Acid, niv-gj, well diluted, or 
less effectively, Sodium Sulphite ; Sulphites often curative in vomiting of sar- 
cinse and acid matter, due to acid fermentation of starchy elements (B). 
Cocculus Indicus, efficient in cephalic vomiting (P). Iris, in vomiting with 
blinding right supraorbital pain, liver deranged (P). Bismuth, in many forms 
of vomiting in children, especially when from gastric catarrh (R). Carbolic 



/26 VOMITING OF PREGNANCY. 

Acid, with or without Bismuth (B) ; in nervous vomiting (W). Creosote, in the 
vomiting of cancer, gastric ulcer, etc. (R) ; gtt. j-ij (W). Cinnamon or Cloves, 
will check vomiting (P). Calumba, in vomiting from kidney disease and renal 
calculi ; frequently allays that of pregnancy and dentition (P). Serpentaria, 
for bilious vomiting (P). Cerium Oxalate, in that of pregnancy and from 
cancer (B) ; gr. j every three hours (R). Sodium Bicarbonate, £>ss-j to a pint 
of milk, for infants, especially if constipated (R). Ammonium Carbonate, 
may relieve when vomited matter is acid (B). Milk and Lime Water, often re- 
lieves when other methods fail; also the effervescing soda powders in the 
vomiting of acute diseases, and the exanthemata (B). Alcohol, iced brandy 
or champagne in spoonful doses every y z hour in vomiting of cholera, preg- 
nancy, and delirium tremens (B). Counter-Irritation, at epigastrium (R). 
Nutrient Enemata (B). [See Enemata.] Ice, sucked, with horizontal posture, 
absolute rest and quiet (Wa) ; iced champagne, ^ss every % hour (B). Pepsin, 
fqr vomiting of food after meals ; gr. x-xv before or during meals. Kumyss, 
has proved efficacious when no other food would remain on the stomach. 
[Compare the list of Anti-emetics, on page 37, also the articles entitled 
Hematemesis, Nausea, Sea-sickness, Vomiting of Pregnancy.] 

Prescriptions. 

R. Ac. Hydrocyan. Dil., . . . £j. I 

Aquae Laurocerasi, . . . . l§ij. R. Ac. Hydrobromici Diluti, . ^ ij. 

M. Sig. — A teasp. every 2 hours, for Sig. — Half a teasp. in a winegl. of 

nervous vomiting. I water, 4 times daily. 



Vomiting of Pregnancy. 

Ipecacuanha, or Nux Vomica, either will generally succeed where the other 
fails (R) ; no other remedy of equal value to Ipecac (P). Nux Vomica, is use- 
ful but often fails, gtt. ss-j every hour or two in water (R) ; in very minute 
doses (S) ; gtt. ij-iij of the tincture every two or three hours, or gtt. x before 
each meal, with very hot water as a drink, is the best treatment (Parvin). 
Arsenic, Fowler's solution, gtt. j before each meal, will often relieve, when 
vomiting of food, retching and straining, with blood and pain (B). Creosote, 
checks the vomiting (R). Carbolic Acid, drop-doses of crystals liquefied by 
heat, in mucilage ter die (Wa). Staphisagria, has subdued when other reme- 
dies failed (P). Cerium Oxalate, gr. j every three hours (R) ; ordinary doses 
far too small, give as high as 10 grains (B). Morphine, hypodermically in 
severe vomiting (R). Pepsin, has been used with success. Ingluvin, seems 
almost specific (B). Potassium Bromide, is often efficacious (W) ; 5>ss doses 
thrice daily, exceedingly effective in the combined diarrhoea and vomiting of 
pregnancy. The first dose should be given an hour before rising. Strontium 
Bromide, proved entirely successful in severe cases ; gr. xv in water, with 
meals, twice daily, for a month. Hydrocyanic Acid, often the best remedy (P). 
[See ante, Vomiting.] Copper Sulphate, sometimes effective, not more than 
gr. ■£$ ter die (B). Iodine, n^v of the tincture in !fss of sweetened water 
repeated in ]/ 2 hour, of magical effect in a bad case which had resisted every 
other treatment ; is often useful (B). Menthol, has proven very successful in 
obstinate cases. [See formula below.] Cocaine, locally to cervix, promptly 
cured a most intractable case of several months' duration, though it failed 
when used internally (Boys) ; has given excellent results when used internally. 
[See formula below, or may use tablet triturates of gr. ^ each.] Calumba, as 
tincture often useful, drop-doses every hour or two (B). Bismuth, and Car- 
bolic Acid, are effective (B). Atropine, frequently effective (R) ; never failed 
to give relief in many years of using it (Boys). Ether, sprayed over the epi- 
gastric region and the corresponding part of the spinal column, for 3 to 5 
minutes every 3 hours, gives immediate relief (Lubelsky). Pop-corn, is a god- 
send in this complaint, having acted marvellously in several cases in which I 



VULVA VULVITIS WARTS. 



727 



have used it (Sweringen). Aconite, in full doses, is often very successful (W). 
Dilatation, of the cervical canal, by the index finger, is regarded as extremely 
efficient, and reasonably safe ; it may bring on abortion, if too extensive, but 
from records of several cases since 1875, ^ ma y De sa ^ that it is a safe and 
sure remedy (Copman). Ice-bag to spine, an efficient measure (R). Vesica- 
tion, a single blister over the 4th and 5th dorsal vertebrae, never failed for 
many years to put an end at once to the sickness of pregnancy for the whole 
remaining period of gestation (Harkin, in Lancet). 



Prescriptions. 



R. Atropinae Sulphatis, . . . gr. j. 

Morphinse Sulphatis, . . . gr. iv. 

Acidi Sulphunci Aromat, . 3 iij. 

Aquae, 3 V. 

M. Sig. — Ten to twenty drops, thrice 
daily. {Boys.) 

R . Bismuthi Subnitrat., . . . gr. clx. 
Cerii Oxalatis, gr. xl. 

Morphinae Sulphatis, . . . gr. jss. 
Syrupi, et Acacias, q. s. 'ad ^ij. 
M. ft. emulsum. Sig. — A teasp. every 
hour until vomiting ceases. ( Van Vatzak.) 



R . Mentholi, gr. xx. 

Alcoholis, % vjss. 

Syr. Simplicis, . . q. s. ad Hjij. 

M. Sig. — 3 j every hour. {Potter?) 



R 



R 



Cerii Oxalatis, 
Ipecacuanhae, 
Creosoti, . . 
M. ft. pil. no. xij. 



Sig. 



. . . gr. xi]. 
. . . gr. xv. 
. . . gr. xxiv. 
-One every hour. 
{Good ell?) 



Cerii Oxalatis, . . 
Ext. Hyoscyami, . 
M. ft. pil. no. xij. Sig. 
daily. 



. . gr. xxiv. 
. . gr. xxxvj. 
-One pill twice 
(Goodell.) 



R. Cocainae Hydrochlor., . . gr. xv. 

Acidi Carbolici, Tl\x. 

Aq. Cinnamomi, . . . , j| ss. 

Syr. Zingib., . . . q. s. ad £]. 
M. Sig. — 10 drops gradually increased 
to 20, in a little water every hour until re- 
lieved, then every 2 or 3 hours. (Potter.) 



Vulva. 

Sodium Hyposulphite, an unfailing remedy in lotion for aphthae of the vulva 
(R). Arsenic, much used for eczema (T). Lead Acetate, a concentrated solu- 
tion in Glycerin, for eczema of vulva (T). [Compare Pruritus, Prurigo.] 



Vulvitis. 

Alum, as lotion in vulvitis of children ; gr. lx-Oj aquae, or less strong if found 
to increase discharge (R). Lead, solutions of the Acetate as wash, after the 
acute stage has subsided. Lime Water, as wash (R). [Compare Vaginitis.] 



Warts. 

Thuja, worthy of recommendation in the highest terms, for the cure of warts 
with a narrow base and pendulous body ; a strong tincture locally three times 
a day, for one or two weeks, with 5 drops in a wineglassful of water internally, 
night and morning (P). Iron, Tincture of the Chloride and dilute HC1 Acid, 
equal parts applied night and morning, very effective (Bulkley). Nitric Acid, 
3j-ij of the dilute acid to a pint of water, as wash, to keep small syphilitic warts 
constantly moist (R). Sabina, as caustic (P) ; j to ij parts of Alum (Wa). Rue, 
the Oil, with honey, locally (P). Arsenous Acid, as a caustic; enough to be 
used to excite active inflammation; or Liq. Arsenicalis painted over warts (R); 
may be taken internally (B). Mercurial Ointment, containing 5 per cent, of 
Arsenic, or a plaster having in each 8 square inches 154 grains of Arsenic and 
yy grains of Mercury (Unna). Tannin, and Burnt Alum, equal parts, pow- 



( 



728 WEN WORMS. 

dered over warts twice daily, gives good results. Chromic Acid, gr. 100 to ^j 
aquae, with a glass rod, to saturate diseased growth ; remove any superfluous 
acid, dress with dry lint (R, Wa). Mercuric Nitrate, locally (R). Silver 
Nitrate, as caustic, but is usually too superficial (R). Dermal Curette, is much 
used in Vienna to remove warts by enucleation. Strangulation, by tying a 
string tightly around the base, will cause them to drop off in a few days. Heat, 
is a most thorough measure for their radical removal ; it may be best applied 
by touching the wart 3. or 4 times daily with the hot end of a cigar ; the first 
few applications only give pain. Caustic Alkalies, locally (R) ; a saturated 
solution of Potassa Fusa, carefully applied by a brush or sponge fastened to the 
end of a stick, is to be preferred (Wilson). [Compare Condylomata.] 



Wen. 

Extirpation, the least troublesome and most speedily effective method. Run 
a scalpel through it, seize the cut edge of the cyst, and gently tear it out with a 
touch or two from the knife. Dressing of lint and Carbolic Oil to cause suppu- 
ration and contraction (D). 

Worms. 

Naphtalin, an excellent all-round anthelmintic, of high value for ascarides 
and taenia, thoroughly reliable for all kinds of intestinal worms, giving prompt 
and complete results invariably, with entire absence of all unpleasant symp- 
toms ; a single dose of gr. xv removed tape-worms entire (Mirowicz) : for 
adults a dose of Castor Oil should follow, but for children it is preferable to 
give both together. Filix Mas to be taken on an empty stomach, for tape- 
worm, and followed by a purge (P). Pepo, ^ij as emulsion, taken fasting, one 
of the most efficient remedies against taenia (B). Santonin, the best anthel- 
mintic, a laxative in the morning, fast all day, a dose (gr. ss-v) of Santonin and 
Calomel, or Troches of Santonin ( j-x), at bedtime, a Senna draught next morn- 
ing, for ascarides (P) ; for round and thread- worms, give in Castor Oil by mouth, 
or as injection (R). Iron, the Syrup of the Iodide internally and a solution of 
the tincture locally, for ascarides (B) ; the Tinct. Ferri Chlor. ^ss ad Oj aquae, 
a good injection for thread-worms, coagulating their albumen (R). Quassia, 
the infusion an effectual injection, conjoined with simple bitters internally, for 
ascarides (R). Pelletierine, the alkaloid of Granatum, is by far the best vermi- 
fuge for a tape-worm, repeated after a week for a second worm, as many as 3 
having been found in one patient (Da C) : gr. xv-xx of the Tannate, followed 
in a few hours by Castor Oil (R). Chloroform, a very efficient taeniafnge, 5j i n 
^j of mucilage, after 20 hours' fasting, followed one hour later by ^j of Castor 
Oil, this is an adult dose, 3j should never be exceeded (Wilde). Lime Water, 
as injection for thread-worms (R) ; ^iij-iv repeated, for ascarides (Wa). Sodium 
Chloride, in gss doses on empty stomach, expels ascarides and prevents repro- 
duction (Wa). Quinine, as a tonic, also cold sponging, out-door exercise and 
judicious diet; useful probably by preventing the production of the abundant 
mucus which favors the growth of worms (R) ; especially useful for ascarides, 
also as injection for thread-worms and taenia (Wa). Ignatia, for convulsive 
symptoms (P). Kamala (Rottlera), excellent for taenia, requires no purge (P) ; 
gr. cl-clxxx for an adult (Wa). Eucalyptus, as injection, for ascarides (B). 
Aloes, are efficacious for ascarides (P). Ailanthus, decoction of fresh bark, 
for taenia (B). Tonics, as Cod-liver Oil and Iron to restore intestinal canal to 
healthy condition (R). Turpentine, as poison to tape- and thread-worms (R) ; 
also for taenia (Wa). Scammony, for thread-worms in rectum (R) ; with Calo- 
mel, effective (Wa). Tannin, as Catechu, Kino, Red-gum, Rhatany, Haema- 
toxylum, in injections to destroy thread-worms (R). Alum, as solution, for 
injection (R). Ammonium Chloride, to prevent formation of thick mucus which 
serves as nidus for worms (R). Valerian, especially when convulsions (R). 
[Compare the List of Anthelmintics on page 41.] 



WOUNDS. 



729 



Prescriptions. 



R . Chloroformi, 

Ext. Filicis Maris, . . . aa^j. 
Emuls. 01. Ricini (50 per 
cent.), §iij. 

M. Sig. — One dose after 24 hours' fast- 
ing. Does just as well if Male Fern be 
omitted. [Smith.) 

R. Ext. Spigelise Fl., .... gj. 

Ext. Sennse Fl., J ss. 

M. Sig. — A teasp. to a child of 3 to 5 
years. {Smith.) 

R . Ext. Spigelise et Sennre FL, ^j. 

Santonini, gr. viij. 

M. Sig. — A teasp. to a child of 5 years. 
(Smith.) 



R. Granati Corticis, . . . . Hjij. 

Ft. infusum. Sig. — To be taken before 
1 1 A. M. — and followed after 2 hours by — 

R. 01. Ricini, giij. 

Ol. Terebinth., gj. 

Ext. Filicis Maris yEther., 3J. 
M. ft. haustus. 

Fasting unnecessary. ( Wilde.) 



R. Magnesii Sulphat., . . . . ^ij. 

Sodii Chloridi, ^ ss. 

M. Sig. — An ounce in half a glass of 
water, with gtt. v of Carbolic Acid, night 
and morning, for ascarides. Persevere. 

(Barkley.) 



Wounds. 

Arnica, very useful for external bruises and cuts, also for internal injuries ; 
unites surfaces very rapidly after amputations ; the infusion or decoction best 
(P) ; very effectual (Wa). Aconite, valuable in surgical fever (P). Carbolic 
Acid solutions check suppuration, and correct fetor (B). Bismuth Subiodide, 
dusted into a wound, one of the most efficient antiseptics, non-irritant, and a 
prompt stimulant of granulations ; an excellent dressing for wounds after 
approximation of the edges, the powder to be dusted thickly over the edges, 
and thoroughly smeared with Flexible Collodion. Dermatol (Bismuth Sub- 
gallate), is an excellent non-irritant vulnerary, having great stability, and 
valuable drying and bactericidal qualities. Europhen, is an ideal application 
to sores and wounds, also for the many protective requirements of minor 
surgery ; is used as a dusting powder, or as a 5 to 10 per cent, ointment, with 
Lanolin as a base. Aristol, is very efficient, or a mixture of Aristol and 
Europhen, equal parts of each. Ammonium Carbonate, gr. v hypodermically 
in the vicinity of wounds caused by poisoned arrows, repeatedly used with 
success in saving life, by Dr. Parke, the surgeon to Stanley's last expedition in 
Africa. Sulphurous Acid, in solution, diluted or not, constantly applied (R) ; 
in solution or by fumigation, is regarded by some as superior in efficacy to 
Carbolic Acid, and less irritant (Wa). Salicylic Acid, Thiersch prefers it to 
Carbolic ; may be applied pure in powder to gangrenous and sloughing wounds 
(B). Mercury, the Bichloride, gr. vijss to quart j of hot water, stirred with a 
stick, makes a solution of 1 to 2000 ; the best of all antiseptics, for washing a 
wound or cavity, and for saturating the dressings. [See List of Antiseptics on 
page 52]. Boracic Acid, also applicable as Carbolic Acid (B). Balsam of Peru, 
excellent for closing recent wounds (P). Benzoin, the basis of healing " Bal- 
sams " (P). Aloes, topically as a slight stimulant; often purges (R). Gum 
Tragacanth, a thick aqueous solution to granulating surfaces, to protect them 
from the air (Wa). Opium, to quiet intestinal movements in w r ounds of the 
abdomen (R) ; forwards the reparative processes (P). Tannin, or Glycerite of 
Tannin, to coat over wounds (R). Collodion or Liquor Gutta-perchae, to secure 
primary union of incised wounds (B) ; as protective covering (P). Iodoform, 
powdered and dusted over sloughing wounds, irritable and ill-conditioned 
ulcers and sores (B) ; Iodoform 1, Collodion 9 parts, painted on a superficial 
wound while edges are held together (Gross) ; may be painted over edges when 
stitched together ; gives excellent results. Aristol, an excellent substitute for 
Iodoform, and odorless. Galvanic Couplet, to wounds of indolent form (B). 
[See Bedsores.] Nitric Acid, as escharotic for gangrene (B). Turpentine, 
one of the most efficient applications in hospital gangrene (B). Aloes, pul- 
verized fine, as a dressing for wounds, favoring cicatrization and closing them, 



< 



730 YELLOW FEVER. 

also relieving the pain at once ; requires removal only at long intervals (Millet). 
Poultices, are often abused ; of Yeast or Charcoal best for foul wounds (B). 
Alcohol, an excellent antiseptic dressing when suppuration ; also favors cica- 
trization of open wounds (B). Water, in universal use as dressing; cold 
water often abused, hot-water dressing as advocated by Hamilton, promises 
better results (B). Turkish Baths, for pain in the seat of old wounds (R). 
Ice and Salt, applied to wounds prevents inflammation (R). [Compare 
Hemorrhage, Inflammation, Pyemia, Surgical Fever, Gangrene, 
Ulcers.] 

Prescriptions. 
R . Acidi Tannici, 3 ij. 

Alcoholis Absolut., . . . Jfss. 

yEiheris, % ijss. 



Collodii, £ xij. 

M. Sig. — Styptic Collodion. 



R. Collodii, £j. 

Olei Ricini, 

Acidi Carbolici, . . . aa ^ ss. 
M. Sig. — Carbolized Collodion, for 
wounds. 



Yellow Fever. 

Treatment must all be done at the beginning, no time to be lost, — Cold 
sponging early and frequently repeated, Calomel, Quinine and Salines at the 
start, Potassium Acetate for the kidneys, Morphine for gastric irritation, the 
feet to be in mustard water (Da C). Diaphoretics and Diuretics, also Laxa- 
tives, are very important throughout the disease (Da C). Pilocarpine, in dose 
of gr. )l hypodermically, in first stage, carried to the induction of emesis and 
catharsis, as well as that of diaphoresis, the most efficient treatment known, 
absolutely jugulating the paroxysm (Habersmith). Mercury, a Calomel purga- 
tive, gr. ss, 2 or 3 times on the first day, followed by a warm-water enema, is 
good treatment (B) ; has many advocates, and many opponents (Wa) ; should 
generally be abstained from (S). Duboisine, gr. -g 1 ^, subcutaneously, the most 
efficient hypnotic and calmative (B). Turpentine, when cardiac weakness, 
depression of vaso-motor system, dissolved state of the blood ; ttLx-gss ; small 
doses, with Tinctura Ferri Chloridi, in hemorrhagic form (B). Quinine, has 
some strong evidence in its favor as an abortive agent, one large dose (gr. 
xxx-xl) with Opium, at outset (Wa) ; is not a specific ; may hasten recovery in 
mild cases (S) ; gr. xx per rectum, to reduce temperature (B). Liquor Calcis, 
with milk, has been found efficient for the vomiting (Wa). Capsicum, to obvi- 
ate the black vomit, is highly spoken of (Wa). Cocaine, for the vomiting, 
nothing equals it in efficiency, it also acting as a diuretic, 10-minim doses of a 
4 per cent, solution, by mouth, every hour for 2 or 3 doses, acts like a charm 
(Jennings). Chloroform, for the vomiting, a few drops to prepare the stomach 
for reception and retention of food ; its effects transitory, has to be repeated 
before each meal (Wa) ; the Ammoniated Chloroform in zymotic pyrexia, its 
action is sedative, analgesic and antipyretic (Richardson). Carbolic Acid, by 
stomach and hypodermically, remarkably efficacious, even after the ominous 
"coffee-grounds" vomit (Lecaille). Chlorodyne, is excellent for restlessness, 
insomnia, irritability of stomach (A). Veratrum Viride, gtt. j-x hourly, accord- 
ing to age, till pulse and temperature subdued ; successfully used in connection 
with Mercury, etc. (White and Ford). Stimulants, only in typhus form (B) ; 
in 3d stage must be bold, prompt and continued (Da C). Diet, of the blandest 
description (A) ; Milk and Lime-water, half and half, in small quantities, is the 
best aliment ; in convalescence, the utmost care is necessary in giving aliments 
(B). Rest is very important (Da C). Iced Champagne, in tablespoonful doses 
every % hour, for the vomiting (B). Purgation, throughout the disease (Da C). 
[Compare Remittent Fever.] 

Prescriptions . 
R. Potassii Carbonat, . . . gr. xx. 



Tinct. Opii Camphorat., . zj. 

Aquae, ^ viij. 

M. Sig. — Jlj every hour or two, as 
diaphoretic. {Dickson. 



R . Chloroformi, 

Tinct. Camphorge, . . . aa ^ ss. 
M. Sig. — Two drops as required for the 
vomiting. 



APPENDIX 



LIST OF CONTRACTIONS AND LATIN "PHRASES USED IN 
WRITING PRESCRIPTIONS, WITH THE CORRESPONDING 
ENGLISH EQUIVALENTS. 



Contraction. 


Word or Phrase. 


English Equivalent. 


A., aa. 


Ana 


Of each. 


Abd. 


Abdomen 


The belly. 


Abs. feb. 


Absente febre 


Fever being absent. 


Ace. 


Accurate 


Accurately. 


Ad 


Ad 


To, or up to. 


Ad 2 vie. 


Ad duas vices 


At twice taking. 


Ad sec. vie. 


Ad secundum vicem 


To the second time. 


Ad 3 tiam vie. 


Ad tertiam vicem 


For the third time. 


Add. 


Adde 


Add. 


Add. 


Addantur 


Let (them) be added. 


Add. 


Addendus 


To be added. 


Add. 


Addendo 


By adding. 


Ad def. an. 


Ad defectionem animi 


To fainting. 


Ad grat. acid. 


Ad gratam aciditatem 


To an agreeable sourness. 


Adbib. 


Adhibendus 


To be administered. 


Adjac. 


Adjacens 


Adjacent. 


Ad lib. 


Ad libitum 


At pleasure. 


Admov. 


Admove 


Apply. 


Admov. 


Admoveatur 


Let (it) be applied. 


Admov. 


Admoveantur 


Let (them) be applied. 


Ad sat. 


Ad saturandum 


To saturation. 


Adst. feb. 


Adstante febre 


The fever being on. 


Adv. 


Adversum 


Against. 


Mg. 


yEger 


The sick one, the patient. 


Aggr. feb. 


Aggrediente febre 


While the fever is coming on. 


Agit. vas. 


Agitato vase 


The vial being shaken. 


Aliq. 


Aliquot 


Some. 


Alt. 


Alter 


The other. 


Alt. hor. 


Alternis horis 


Every other hour. 


Aluta 


Aluta 


Leather. 


Alv. 


Alvus 


The belly. 


Alv. adst. 


Alvo adstricta 


The bowels being confined. 


Amp. 


Amplus 


Large. 


Ampul. 


Ampulla 


A large bottle. 


App. 


Appone 


Apply, Lay or put on. 


Aq. 


Aqua 


Water. 


Aq. astr. 


Aqua astricta 


Frozen water. 


Aq. bull. 


Aqua bulliens 


Boiling water. 


Aq. com. 


Aqua communis 


Common water. 


Aq. ferv., vel calid. 


Aqua fervens, vel calida 


Hot water. 


Aq. fluv. 


Aqua fluviatilis 


River water. 


Aq. font. 


Aqua fontana, vel fontis 


Spring water. 



< 



73 1 



I 



732 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Aq. mar. 


Aqua marina 


Sea water. 


Aq. niv. 


Aqua nivialis, vel nivalis 


Snow water. 


Aq. pluv. 


Aqua pluvialis 


Rain water. 


Aqualis 


Aqualis 


Pertaining to water. 


Aut 


Aut 


Or. 


B. A. 


Balneum arenas 


Sand-bath. 


B. M. 


Balneum maris 


Salt-water bath. 


B. V. 


Balneum vaporis 


Vapor-bath. 


Bals. 


Balsamum 


Balsam. 


B. B. 


Barbadensis 


Barbadoes. 


Bene 


Bene 


Well. 


Bib. 


Bibe 


Drink (thou). 


Bid. 


Biduum 


Two days. 


Bis 


Bis 


Twice. 


Bis die 


Bis in die, vel dies 


Twice a day. 


Bol. 


Bolus 


A large pill. 


Bull. 


Bulliat, 2^/Bulliant 


Let boil. 


But. 


Butyrum 


Butter. 


C. 


Cum 


With. 


Cc. 


Centimeter cubicum 


Cubic centimeter. 


Cserul. 


Cseruleus 


Blue. 


Calef. 


Calefactus 


Warmed. 


Cal. 


Calomel, vel Calomelas 


Mild Chloride of Mercury. 


Cap. 


Cape 


Take (thou). 


Cap. 


Capiat 


Let him take. 


Capsul. 


Capsula 


A capsule. 


Caute 


Caute 


Cautiously. 


Ccu. 


Cucurbita 


A cupping-glass. 


Chart. 


Chart a 


Paper. 


Chartul. 


Chartula 


A small paper. 


Cib. 


Cibus 


Food. 


Coch., Cochleat. 


Cochlear, vel Cochleare, 


A spoonful, By spoonfuls (£j). 


Coch. amp. 


Cochleare amplum 


A dessertspoonful (,^ij). 


Coch. mag. 


Cochleare magnum 


A tablespoonful (^ss). 


Coch. med. vel mod. 


Cochleare medium, vel 
modicum 


A dessertspoonful (gij). 


Coch. parv. 


Cochleare parvum 


A teaspoonful (gj). 


Coct. 


Coctio 


Boiling. 


Col. 


Cola 


Strain. 


Colatur. 


Colaturse 


To the strained liquor. , 


Colat. 


Colatus 


Strained. 


Colet. 


Coletur 


Let it be strained. 


Colent. 


Colentur 


Let them be strained. 


Collut. 


Collutorium 


A mouth-wash. 


Collyr. 


Collyrium. 


An eye-wash. 


Coloret. 


Coloretur 


Let it be colored. 


Comp. 


Compositus 


Compound, compounded. 


Con., Concis. 


Concisus 


Cut. 


Conf. 


Confectio 


Confection. 


Cong. 


Congius 


A gallon. 


Cons. 


Conserva 


A conserve, also Keep (thou). 


Cont. rem. 


Continuentur remedia 


Let the medicines be continued. 


Contus. 


Contusus 


Bruised. 


Coq. 


Coque, Coquantur 


Boil, let them be boiled. 


Coq. ad med. con- 


Coque ad medietatis con- 


Boil to the consumption of half. 


sump. 


sum ptionem 




Coq. S. A. 


Coque secundem artem. 


Boil according to art. 


Coq. in S. A. 


Coque in sufficiente aquae 


Boil in sufficient water. 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



733 



Contraction. 


Word or Phrase. 


English Equivalent. 


Cor. 


Cor, cordis 


The heart. 


Cort. 


Cortex, corticis 


The bark. 


Cox. 


Coxa 


The hip. 


Crast. 


Cras, Crastinus 


To-morrow. 


Cras mane sumend. 


Cras mane sumendus 


To be taken to-morrow morning. 


Cras nocte 


Cras nocte 


Tomorrow night. 


Cras vesp. 


Cras vespere 


To-morrow evening. 


Crast. 


Crastinus 


For to-morrow, early. 


Cru. 


Cruor 


Blood, gore. 


Cucur. 


Cucurbita 


A cupping-glass. 


Cuj. 


Cuj us, Cujus-libet 


Of which, of any. 


Cum 


Cum 


With. 


Cyatho these 


Cyatho these 


In a cup of tea. 


Cyath., C. vinar. 


Cyathus, vel C. vinarius 


A wine-glass ( ^j-ij). 


D., Det. 


Da, Detur 


Give, let be given. 


De 


De 


Of, or from. 


Deaur. pil. 


Deaurentur pilulae 


Let the pills be gilded. 


Deb. spiss. 


Debita spissitudo 


A proper consistence. 


Deb. 


Debitus 


Due, proper. 


Dec. 


Decanta 


Pour off. 


Decern. 


Decern, Decimus, 


Ten, The tenth. 


Decoct. 


Decoctum 


A decoction. 


Decub. 


Decubitus 


Lying down. 


De d. in d. 


De die in diem 


From day to day. 


Dein. 


Dein vel Deinde 


Thereupon. 


Deglut. 


Deglutiatur 


Let be swallowed. 


Dej. alv. 


Dejectiones alvi 


Stools. 


Dent. 


Dentes 


The teeth. 


Det. in dup. 


Detur in duplo 


Let twice as much be given. 


Dext. 


Dexter, Dextra 


The right. 


Dieb. alt. 


Diebus alternis 


Every other day. 


Dieb. tert. 


Diebus tertiis 


Every third day. 


Diluc. 


Diluculo 


At break of day. 


Dil. 


Dilue, Dilutus 


Dilute (thou), Diluted. 


Dim. 


Dimidius 


One-half. 


D. P., vel Dir. prop. 


Directione propria 


With a proper direction. 


D. in p. seq. 


Dividatur in partes 
sequales 


' Let it be divided into equal parts. 


Divid. 


Dividendus, -a, -um 


To be divided. 


Dol. 


Dolor 


Pain. 


Don. 


Donee 


Until. 


Don. alv. bis. dejic. 


Donee alvus bis dejicia- 


Until the bowels have been twice 




tur 


evacuated. 


Don. alv. sol. ft. 


Donee alvus soluta fuerit 


Until the bowels shall be opened. 


Don. dolor neph. 


Donee dolor nephriticus 


Until the nephritic pain is removed. 


exulav. 


exulaverit 




D. 


Dosis 


A dose. 


Dr., 5 


Drachma 


A drachm (60 grains). 


Dur. dolor. . 


Durante dolore 


While the pain lasts. 


Ead. 


Eadem (fem.) 


The same. 


Eburn. 


Eburneus 


Made of ivory. 


Ejusd. 


Ejusdem 


Of the same. 


Elect. 


Electuarium 


An electuary. 


Em. 


Emesis 


Vomiting. 


En. 


Enema 


A clyster or enema. 


Enem. 


Enemata 


Clysters. 


Et 


Et 


And. 


Evan. 


Evanuerit 


Shall have disappeared. 


Exbib. 


Exhibeatur 


Let it be exhibited. 



734 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Ext. 


Extende 


Spread. 


Ext. sup. alut. moll. 


Extend e super alutem 
mollem 


Spread upon soft leather. 


Ext., Extr. 


Extractum 


An extract. 


Extr. 


Extrahe 


Extract thou. 


F. 


Fac 


Make. 


Ft. 


Fiat, Fiant (//.) 


Let it [or them) be made. 


F. pil. xij 


Fac pilulas duodecim 


Make 12 pills. 


Far. 


Farina 


Flour. 


Fas. lint. 


Fascia lintea 


A linen bandage. 


Fascic. 


Fasciculus 


A small bundle. 


Febr. 


Febris 


Fever. 


Febr. dur. 


Febre durante 


During the fever. 


Fem. intern. 


Femoribus internis 


To the inner thighs. 


Ferv. 


Fervens 


Boiling. 


Ft. cataplasm. 


Fac cataplasmatem 


Make a poultice. 


Ft. cerat. 


Fiat ceratum 


Let a cerate be made. 


Ft. chart, xij 


Fiant chartulse xij 


Let 12 powders be made. 


Ft. collyr. 


Fiat collyrium 


Let an eye-wash be made. 


Ft. emp. vesic. 


Fiat emplastrum vesica- 
torium 


Let a blister be made. 


Ft. emuls. 


Fiat emulsum 


Let an emulsion be made. 


Ft. en. 


Fiat enema 


Let an enema be made. 


Ft. inject. 


Fiat injectio 


Let an injection be made. 


F. L. A. 


Fiat lege artis 


Let it be made by the rules of art. 


Ft. mas. div. in pil. 


Fiat massa, et divide in 


Let a mass be made, and divide it 


xij 


pilulas xij 


into 12 pills. 


Ft. pil. xij 


Fiant pilulae xij 


Let 12 pills be made. 


Ft. pulv. 


Fiat pulvis 


Let a powder be made. 


Ft. pulv. xij 


Fiant pulveres xij 


Let 12 powders be made. 


Ft. pulv. in chart, xij 


Fiat pulvis in chartulas 


Let a powder be made to be divided 


div. 


xij dividenda 


into 12 little papers. 


Ft. sol. 


Fiat solutio 


Let a solution be made. 


Ft. suppos. iv 


Fiant suppositoria iv 


Let 4 suppositories be made. 


Ft. troch. xxiv 


Fiant trochisci xxiv 


Let 24 troches be made. 


Ft. ung. 


Fiat unguentum 


Let an ointment be made. 


Ft. venesec. 


Fiat venesectio 


Let a bleeding be done. 


Fict. 


Fictilis 


Earthen. 


Filtra 


Filtra 


Filter (thou). 


Filt. 


Filtram, Filtrum 


A filter. 


Fistul. arm. 


Fistula armata 


A syringe ready for use. 


Fluid., Fl. 


Fluidus 


Liquid. 


Form. 


Formula 


A prescription. 


Frust. 


Frustillatim 


In small pieces. 


Fuerit 


Fuerit 


Shall have been. 


Garg. 


Gargarysma 


A gargle. 


Gelat. quav. 


Gelatina quavis 


In any kind of jelly. 


Ging. incid. 


Gingivas incide 


Lance (or cut) the gums. 


Gm. 


Gramma 


A gramme. 


g r - 


Granum, Grana 


A grain, grains. 


gr. vj pond. 


Grana sex pondere 


Six grains, by weight. 


Grad. 


Gradatim 


By degrees, gradually. 


Grat. 


Gratus 


Pleasant. 


Grum. 


Grumus 


A clot (of blood). 


Gtt. 


Gutta, Guttse, Guttas 


A drop, Drops. 


Guttat. 


Guttatim 


By drops. 


Gtt. quibusd. 


Guttis quibusdam 


With a few drops. 


H. 


Hora 


An hour. 


Har. pil. sum. iij 


Harum pilularum suman- 
tur tres 


Let three of these pills be taken. 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



735 



Contraction. 


Word or Phrase. 


English Equivalent. 


Haust. 


Haustus 


A draught. 




H. p. n. 


Haustus purgans noster 


My own purgative draught. 




Hebdom. 


Hebdomada. 


A week. 




Herb. 


Herba 


An herb. 




Herb, recent. 


Herbarum recentium 


Of fresh herbs. 




Heri 


Heri 


Yesterday. 




Hie, Haec, Hoc 


Hie, Hsec, Hoc 


This. 




Hirudo 


Hirudo 


A leech. 




Hirud. app. 


Hirudines appone 


Apply leeches. 




Hor. som. 


Hor a somni 


At the hour of sleep. 




Hor. xj raatut. 


Hora. undecima. matutina. 


At the eleventh hour of the morning. 


Hor. decub. 


Horse decubitus 


At bedtime. 




Hor. j spat. 


Horae unius spatio 


After one hour. 




Hor. interm. 


Horis intermediis 


In the intermediate hours. 




Id. 


Idem 


The same. 




Idon. 


Idoneus 


Proper. 




Imp. 


Impone 


Lay on, Apply. 




Impr. 


Imprimis 


First. 




Inc. 


Incide, Incisus 


Cut (thou), Being cut. 




Ind. 


In dies 


Daily, or From day to day. 




Infun. 


Infunde 


Pour in. 




Infus. 


Infusum 


An infusion. 




Injec. 


Injectio 


An injection. 




Injic. enem. 


Injiciatur enema 


Let a clyster be given. 




In pulm. 


In pulmento 


In gruel. 




Instar. 


Instar 


As big as. 




Inter 


Inter 


Between. 




Int. 


Internus, -a, -um 


Inner, or Internal. 




Intus 


Intus 


Inwardly. 




Jam 


Jam 


Now. 




Jul. 


Julepus, Julepum 


A julep. 




Juscul. 


Jusculum 


A broth. 




Jux. 


Juxta 


Near to. 




Kal. ppt. 


Kali prseparatum 


Prepared Potash, Potassium 
bonate. 


Car- 


Lac. 


Lac, Lactis 


Milk, of Milk. 




Lag. 


Lagena 


A flask, or bottle. 




Lan. 


Lana 


Flannel. 




Lang. 


Languor 


Faintness. 




Lat. dol. 


Lateri dolenti 


To the painful side. 




Lb., lb 


Libra 


A pound. 




Lect. 


Lectus 


Abed. 




Lig. 


Ligatura 


A ligature. 




Linim. 


Linimentum 


A liniment. 




Lint. 


Linteum 


Lint. 




Liq. 


Liquor 


A solution. 




Lot. 


Lotio 


A lotion. 




M. 


Misce 


Mix (thou). 




M., Man. 


Manipulus 


A handful. 




M., Min. 


Minimum 


A minim. 




Mac. 


Macera 


Macerate. 




Mag. 


Magnus 


Large. 




Mane 


Mane 


In the morning. 




Mane primo 


Mane primo 


In the very early morning. 




Manus 


Manus 


The hand. 




Mass. 


Massa 


A mass, or pill-mass. 




Matut. 


Matutinus 


In the morning. 




Med. 


Medius 


Middle. 




Mens. 


Mensura 


By measure. 





73^ 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Mic. pan. 


Mica panis 


Crumb of bread. 


Min. 


Minimum 


A minim. 


Minut. 


Minutum * 


A minute. 


Mis. 


Misce 


Mix (thou). 


Mist. 


Mistura 


A mixture. 


Mit. 


Mitte 


Send. 


Mit. 


Mittatur 


Let (it) be sent. 


Mit. 


Mittantur 


Let (them) be sent. 


Mit. sang, ad uncias 


Mitte sanguinem ad uncias 


Take away blood to 12 ounces at 


xij salt. 


duodecim saltern 


least. 


Modic. 


Modicus 


Middle-sized. 


Mod. praesc. 


Modo praescripto 


In the manner prescribed. 


Mor. 


Mora 


Delay. 


Mor. diet. 


More dictu 


In the manner directed. 


Mor. sol. 


More solito 


In the usual manner. 


Mort. 


Morturarium 


A mortar. 


Ne tr. s. num. 


Ne trades sine nummo 


Do not deliver without the money. 


Necn. 


Necnon 


Also. 


Nisi 


Nisi 


Unless. 


Non 


Non 


Not. 


Non repetat. 


Non repetatur 


Let it not be repeated. 


Noc, Noct. 


Noc, Noctis 


The night, of the night. 


Noct. maneq. 


Nocte maneque 


At night and in the morning. 


Nucha 


Nucha 


The nape of the neck. 


No. 


Numero, Numerus 


In number, A number. 


Nux Mosch. 


Nux Moschata 


A nutmeg. 


0., Oct. 


Octarius 


A pint ( ;§ xvj). 


Octav. 


Octavus 


Eighth. * 


Octo 


Octo 


Eight. 


01. Lini sine ig. 


Oleum Lini sine igne 


Cold-drawn Linseed Oil. 


01. 0. opt. 


Oleum olivse optimum 


Best olive oil. 


Omn. hor. 


Omni hora. 


Every hour. 


Omn. bih. 


Omni bihorio 


Every two hours. 


Omn. quadr. hor. 


Omni quadrante horae 


Every ^ hour. 


Omni mane 


Omni mane 


Every morning. 


Omn. noct. 


Omni nocte 


Every night. 


Op. 


Opus 


Need, or occasion. 


Ov. 


Ovum 


An egg. 


p. 


Pondere 


By weight. 


P. P. A. 


Phiala prius agitata 


The bottle having been first shaken. 


Pan. 


Pannus 


A rag. 


Par., Pt. 


Pars, Partis 


A part, Of a part. 


Pt. aeq. 


Partes gequales 


Equal parts. 


Part. vie. 


Partitis vicibus 


In divided doses. 


Parv. 


Parvus 


Little. 


Parvul. 


Parvulus 


An infant, A parvule. 


Pastil. 


Pastillus, Pastillum 


A pastille. 


Pediluv. 


Pediluvium 


A foot-bath. 


Penicil. cam. 


Penicillum camelinum 


A camel' s-hair pencil or brush. 


Per 


Per 


Through, By. 


Peract. operat. emet. 


Peracta operatio emetici 


When the emesis is finished. 


Per deliq. 


Per deliquium 


By deliquescence. 


Per fistul. vit. 


Per fistulam vitream 


Through a glass tube. 


Perg. 


Pergo, Pergere 


To go on with. 


Permit, vir. 


Permittentibus viribus 


The strength permitting. 


Phil. 


Phiala 


A vial, or bottle. 


Pil. 


Pilula 


A pill. 



* This is medical Latin, or 
irs hor a. 



bog-Latin." The proper Latin for a minute of time is Sexagesima. 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



737 



Contraction. 


Word or Phrase. 


English Equivalent. 


Pocill. 


Pocillum 


A little cup. 


Pocul. 


Poculum 


A cup. 


Pon., P. 


Pondere 


By weight 


P. civ. 


Pondus civile 


Civil weight (avoirdupois). 


P. med. 


Pondus medicinale 


Medicinal weight. 


Pone aur. 


Pone aurem 


Behind the ear. 


Post sing. sed. liq. 


Post singulas sedes liquidas 


After every loose stool. 


Pot. 


Potus 


Drink. 


Prsep. 


Prseparata 


Prepared. 


Primo mane 


Primo mane 


Very early in the morning. 


Primus 


Primus 


The first. 


Pro 


Pro 


For. 


Pro rat. set. 


Pro ration e setatis 


According to the age of the patient. 


P. r. n. 


Pro re nata 


Occasionally. According to circum- 
stances (or need). 


Pug. 


Pugillus 


A pinch. 


Pulm. 


Pulmento 


Gruel. 


Pulv. 


Pulvis 


A powder. 


Pulvz. 


Pulverizatus 


Powdered. 


Pyx. 


Pyxis 


A pill-box. 


Quad. 


Quadrans, — antis 


A quart. 


Q. lib. 


Quantum libet 


As much as you please. 


Q.p. 


Quantum placet 


tt it tt tt a 


Q.q. 


Quoque 


Also. 


Q.v. 


Quantum vis 


As much as you please. 


Q. vol. 


Quantum volueris 


«( tt it it tt 


Q.s. 


Quantum sufficiat 


As much as is sufficient. 


Q. s. 


Quantum satis 


tt tt a tt tt 


Qq. 


Quaque 


Each, or Every. 


Qq. hor. 


Quaqua hora 


Every hour. 


Quart. 


Quartus 


Fourth. 


Quat., Quater 


Quatuor, Quater 


Four, Four times. 


Quibus 


Quibus 


From which. 


Quinq. 


Quinque 


Five. 


Quint. 


Quintus 


The fifth. 


Quoq. 


Quoque 


Also. 


Quor. 


Quorum 


Of which. 


Quotid. 


Quotidie 


Daily. 


& 


Recipe 


Take. 


Ratio 


Ratio 


Proportion. 


Rec. 


Recens, -entis 


Fresh. 


Red. in pulv. 


Redactus in pulverem 


Let it be reduced to powder. 


Redig. in pulv. 


Redigatur in pulverem 


it a tt tt 


Reg. umbil. 


Regio umbilici 


The umbilical region. 


Reliq. 


Reliquus 


Remaining. 


Rept. 


Repetatur, Repetantur 


Let it (or them) be repeated. 


Respond. 


Respondere 


To answer. 


Retin. 


Retinere 


To keep. 


Saltern 


Saltern 


At least. 


Saltim 


Saltim 


By leaps. 


Sat. 


Saturatus, -a, -um 


Saturated. 


Scarif. 


Scarificare 


To scarify. 


Scarif. expl. 


Scarificatione expiicata 


Scarification having been effected. 


Scat. 


Scatula 


A box. 


Scil. 


Scilicet 


Namely. 


Scrup, or 9 


Scrupulum 


A scruple (20 grains). 


S. A., Sec. art. 


Secundum artem 


According to art. 


S. N., Sec, nat. 


Secundum naturam 


According to nature. 


Secund. 


Secundus 


Second. 



47 



738 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Sed. 


Sedes 


The alvine evacuation. 


Semel 


Semel 


Once. 


Semidr. 


Semi-drachma 


Half a drachm. 


vSemih. 


Semi-hora 


Half an hour. 


Sept. 


Septem 


Seven. 


Septim. 


Septimana 


A week. 


Sesqh. 


Sesquihora 


An hour and a half. 


Sesunc. 


Sesuncia 


An ounce and a half. 


Sex, Sext. 


Sex, Sextus 


Six, Sixth. 


Si 


Si 


If. 


Sig. 


Signa 


Write, or Mark (thou). 


Sig. nom. prop. 


Signatur nomine proprio 


Let it be written upon with its 
proper name. 


Simul 


Simul 


Together. 


Sin. 


Sine 


Without. 


Sing. 


Singularum 


Of each. 


Si non val. 


Si non valeat 


If it does not answer. 


Si op. sit. 


Si opus sit 


If necessary. 


Si vir. perm. 


Si vires permittant 


If the strength will bear it. : 


Sit 


Sit 


Let it be. 


Sol. 


Solus 


Alone. 


Solv. 


Solve, Solvere 


Dissolve (thou), To dissolve. 


Solut. 


Solutus 


Dissolved. 


Som. 


Somnus 


Sleep. 


Spt. 


Spiritus, -us 


Spirit. 


Spt. vin. rect. 


Spiritus vini rectificatus 


Rectified spirit of wine (Alcohol). 


Spt. vin. ten. 


Spiritus vini tenuis 


Proof spirit. 


Spt. vinos. 


Spiritus vinosus 


Ardent spirit (of any strength). 


Ss. 


Semis, Semissis 


A half. 


St. 


Stet, Stent 


Let it (or them) stand. 


Stat. 


Statim 


Immediately. 


S. S. S. 


Stratum superstratum 


Layer upon layer. 


Subact. 


Subactus 


Subdued. 


Sub. fin coct. 


Sub finem coctionis 


When the boiling is nearly done. 


Subind. 


Subinde 


Frequently. 


Sum. tal. 


Sumat talem 


Let him take one like this. 


Sum. 


Sume 


Take. 


(t 


Sumat 


Let him take. 


u 


Sumatur 


Let it be taken. 


a 


Sumantur 


Let them be taken. 


n 


Sumendus 


To be taken. * 


Summit. 


Summitates 


The summits. 


Sup. bib. haust. 


Superbibendo u haustum 


Drinking afterwards this draught. 


Supra 


Supra 


Above. 


Syr. 


Syrupus, -i 


Syrup. 


Tab. 


Tabella 


A lozenge. 


Tal. 


Talis 


Such a one. 


Temp. 


Tempus, -oris 


Time, or Temple. 


Tempor. dext. 


Tempori dextro 


To the right temple. 


Ter 


Ter 


Thrice, or Three times. 


T. i. d., velT. d. 


Ter in die, vel Ter die 


Thrice daily. 


Tere 


Tere 


Rub. 


Tere sim. 


Tere simul 


Rub together. 


Tert. 


Tertius 


Third. 


Tinct. vel Tr. 


Tinctura 


Tincture. 


Tinct. Herb. Recent 


Tincturae Herbarum Re- 
centium 


Tinctures of Fresh Herbs. 


Tres 


Tres 


Three. 


Trid. 


Triduum 


Three days. 






PRONUNCIATION VERBS. 



739 



Contraction. 


Word or Phrase. 


English Equivalent. 


Trit. 


Tritura 


Triturate. 


Troch. 


Trochiscus, Trochisci 


A lozenge, or troche, Lozenges. 


Tus. 


Tussis 


A cough. 


Ult. prgesc. 


Ultimo (vel Ultima) prse- 
scriptus 


The last ordered. 


Una 


Una 


Together. 


Unc, or £ 


Uncia 


An ounce. 


Ut diet. 


Ut dictum 


As directed. 


Utend. 


Utendum 


To be used. 


Uto, Uti 


Uto, Uti 


To make use of. 


Vas vit. 


Vas vitreum 


A glass vessel. 


Vehic. 


Vehiculum 


A vehicle, or menstruum. 


Vel 


Vel 


Or. 


Vensesec. brach. 


Vensesectio brachii 


Bleeding in the arm. 


Vesp. 


Vesper, -eris 


The evening. 


Vic. 


Vices 


Turns. 


Vin. 


Vinum 


Wine. 


Vir. 


Vires 


Strength. 


Vitel. 


Vitellus 


Yolk. 


Vit el. ovi Sol. 


Vitello ovi Solutus 


Dissolved in the yolk of an egg. 


Vitel. ovi 


Vitellus ovi 


Yolk of egg. 


Vitr. 


Vitreum, Vitrum 


Glass. 


Vom. urg. 


Vomitione urgente 


Vomiting being severe. 



For the Dangerous Abbreviations, see ante, page 444, under the title Prescriptions. 



Pronunciation. 

Attention is particularly directed to the accentuation of words commonly mispronounced ; 
as, for example, acetas, atropa, chimaphila (kwia), chloridum, codeia, conium, enema, 
iodidum, radicis, ricinus, sinapis, syrupus, eczema, umbilicus, abddmen, bromidum, 
paresis. 

Verbs. 

The Verbs used in prescription writing are nearly all in the imperative mood, giving 
directions to the compounder, and having their object in the accusative case. Such are — 



Adde, add 
Cola, strain. 
Divide, divide. 
Extende, spread. 



Fac, make. 
Filtra, filter. 
Macera, macerate. 
Misce, mix. 



Recipe, take. 
Signa, write. 
Solve, dissolve. 
Tere, rub. 



A few verbs are found in the subjunctive mood, taking their subject or predicate in the 
nominative case. The most usual are — 



Fiat, let be made. 
Fiant, let be made. 
Coletur, let be strained. 
Coloretur, let be colored. 
Sumatur, let be taken. 



Bulliat, let boil. 
Capiat, let take. 
Detur, let be given. 
Dividatur, let be divided. 
Sit, let it be. 



740 



PARTICIPLES GENITIVE CASE-ENDINGS. 



Participles. 

Participles or Verbal Adjectives are occasionally used, and should agree with their 
respective nouns in gender, number and case. Such are the following, viz. : — 

Dividendus, -a, -urn, to be divided. 
Sumendus, -a, —um, to be taken. 
Adhibendus, -a, -um, to be administered. 

Prepositions. 

Those in the first column require the noun following to be in the accusative case, — 
those in the second column require the ablative case. 

Ad, to, up to. Cum, with. 

In, into. Pro, for. 

Supra, upon. Sine, without. 

Ana, of each, — governs the genitive case. 



Sundry Words and Phrases, in most frequent use. 



Bene, well. 
Bis, twice. 
Dein, thereupon. 
Et, and. 

Gradatim, gradually. 
GiUtatim, by drops. 
In dies, daily. 
Da, give. 



Non, not. Ad saturandum, to saturation. 

Humerus, number. Numero, to the number of. 

Octarius, a pint. Quantu??t sufficiat, as much as necessary. 

Seme/, once. Pro re nata, according to need. 

Simul, together. In partes-cequales, into equal parts. 

Statim, at once. Redactus in pulverem, let be pulverized. 

Ter, thrice. Sectindum arte?n, according to art. 

Quater, four times. Non Repetatur, let it not be repeated. 



GENITIVE CASE-ENDINGS. 



Nom. 


Gen. 


Exceptions. 


a 


as 


Cataplasma, Enema, Physostigma, Aspidosperma and Gargarysma, all have the 
genitive in -atis. Coca is unchanged, though the genitive Cocas is 'written by 
some authorities. Folia is plural, gen. Foliorum. 


us 

um 

OS 

on 


v 


Rhus, Rhois ; Flos, Floris ; Bos, Bovis; Limon, Limonis; Erigeron, -ontis. 
Fructus, Cornus, Quercus, Spiritus, Haustus, Potus, do not change, being of 
4th declension. 


as 


atis 


Asclepias, -adis ; Mas, Maris. 


is 


idis 


Pulvis, -eris; Arsenis, -itis ; Phosphis, -itis; Sulphis, -itis, and all salts ending 
in -is, have genitive in -itis. 





onis 


Mucilago, -inis ; Ustilago, -inis ; Solidago, -inis. 


1 


-lis 


Fel, Fellis ; Mell, Mellis ; Sumbul, Sumbuli. 


en 
ps 
rs 

r 

X 


inis 
pis 
rtis 
ris 
cis 


Words which do not change in the Genitive. 

*Amyl. *Coca. Haustus. .Quercus. 
Azedarach. Cundurango. Hydrastis. Sassafras. 
Berberis. Cornus. Jaborandi. Sago. 
Buchu. Curare. Kino. Sinapis. 
Cannabis. Digitalis. Matico. Spiritus. 
Catechu. Fructus. Potus. 

* But some authorities give Amylis, Cocae. 



HYPODERMIC FORMULA. 



741 



HYPODERMIC FORMULAE. 



Apomorphine. 
R . Apomorphinae Hydrochlor., . gr. j. 

Div. in pulv. xvj. One to four in TT^xx 
of water as required. 



Aqua-puncture. 

R. Aquae Destillatae, ^j. 

Sig. — 3SS-3J hypodermically. 



Arsenic. 



R . Liq. Potassii Arsenitis, . . . q. s. 
Sig. — rr\jj-x, hypodermically. 



R . Liq. Arsen. et Hydr. Iodidi, q. s. 
Sig. — TTLv-xx, hypodermically. 



Amyl Nitrite. 

R. Amyli Nitrit., gj. 

Sig. — TT\^iij— v at a dose, which may be 
repeated in y^ an hour if necessary. 



Atropine. 
R. Atropinae Sulphatis, . . . . gr. j. 

Aquae Destillatae, §j. 

Solve. Sig. — For hypodermic use, tt\vj 
= g r - *V> **!> = g r - jh- 



R 



Caffeine. 

. Caffeinae Citratis, gr. xxiv. 

Aquae Destillatae, ^j. 

Solve. Sig. — TT^xx contain gr. j. 



Carbolic Acid. 
R . Ac. Carbol. Purif., . . . . gr. x. 

Aquae Destil., ^j. 

M. Sig. — TT^viij contain gr. y^ of the 
acid, which may be given up to gr. ij or iij. 



Chloral. 



R . Chloralis Hydratis, . . . . % iv. 

Aquae Destil., ^j. 

M. Sig. — n\xxx contain gr. xv of 
Chloral Hydrate. 



Chloroform. 
R. Chloroformi Purif., . . . . ^ss. 

Sig. — TT\v-xv can be used as one deep 
injection. (See ante, page 656.) The 
spirit is safer, in somewhat larger doses. 



Coniine. 
R. Coniinae Hydrobromat., . . gr. j. 

Aquae Destillat., |j. 

M. Sig. — n\x contain gr. ^. 



Cocaine. 
R . Cocainae Hydrochlorat., . . gr. v. 

Aquae Destillatae, gij. 

Solve. Sig. — TT^xij contain gr. ss. 



Curare. 

R. Curare (Merck), gr. j. 

Acidi Acetici, n\v. 

Aquae Destillatae, . q. s. ad TT^c. 
M. et filtra. Sig. — n\x contain gr. ^. 



R. Curarinae Sulphat., . . . . gr. j. 
Aquae Destillat. , \ ss. 



Daturine. 
R. Daturinae, gr. ss. 

Aquae Destil., ^ j. 

Solve. Sig. — rryv contain gr. ^ . 
Dose, rtyv-x. 



gr. ss. 



Digitalin. 

R . Digitalini, 

Alcoholis, 

Aquae Destil., aagij. 

Solve. Sig. — mjv contain gr. T |g. 
Dose, TTLiv-viij. 



Duboisine. 
R. Duboisinae Sulphat., . . . gr. j. 

Aquae Destil., ^j. 

M. Sig. — rnjv contains gr. T |^. 



Ergot and Ergotin. 
R. Extr. Ergotae Fluid, . . % . gss. 
Filtra. Sig. — Dose, rx\x. 



R. Extracti Ergotae (Squibb), . gj. 

Aquae Destillat., Jj. 

Solve et filtra. Sig. — Tr^x contain gr. j. 
Dose, n\x-xx. 



Hydrocyanic Acid. 
R . Acidi Hydrocyan. Dil., . . q. s. 
Sig. — V^jv, a maximum dose. 



1 



742 



HYPODERMIC FORMULAE. 



Hyoscine, Hyoscyamine. 
. Hyoscinae Hydrobrom., vel 

Hyoscyaminae Hydrobrom., gr. j. 

Aquae Destillatae, . . . . t ^j. 
M. Sig. — TT\x contain gr. J-q. 



R 



Mercury. 
. Hydrarg. Chlor. Corr., . 
Aquae Destillat., .... 
M. Sig. — tt\x contain gr. -£-%, 



gr.j- 
Eh 



R. 



Hydrarg. Chlor. Corrosivi, 
Ammonii Chloridi, . . . aagr. iij. 

Misce et solve in — 

Aquae Destillatae, 3J SS » 

Dein adde — 

Albuminis Ovi, £> j ss - 

Aquae Destillatae, . . . . ^v. 

Filtra, et adde — 

Aquae Destil., . . . q. s. ad gx. 

Sig. — Try contains gr. ^\^. Dose, rryij-x. 



R . Hydrarg. et Sodii Iodidi, 
Aquae Destillatae, .... 
Solve. Sig. — tr^x contain gr. 
V\x every second day. 



gr. nj. 
ghjss. 

'. Dose, 



R. 



g r - 



Morphine. 
Morphinae Sulphatis, . . . gr. xvj. 

Acidi Carbolici, ^"j- 

Aquae Destillat., !| j. 

Solve et filtra. Sig. — TTLvijss contain 
{Antiseptic Magendie's.) 



Morphine and Atropine. 

R. Morphinae Sulphatis, . . . gr. xvj. 

Atropinae Sulphatis, . . . gr. ss. 

Acidi Carbolici, TT\_iij. 

Aquae Destillat., !|j. 

Solve et filtra. Sig. — TT\vijss contain gr. 
j£ of Morphine Sulph., and gr. T L of 
Atropine Sulphate. 



R . Morphinae Sulphatis, . . . gr. xxiv. 

Atropinae Sulphatis, . . . . gr. j. 

01. Amygdalae Amar., . . gtt. j. 

Aquae Destillat., !|ij. 

Solve. Sig. — n\x contain gr. % of 
Morphine Sulphate, and gr. -^ of Atropine 
Sulphate. (Didama's Solution.) 



Physostigmine (Eserine). 

R. Physostigminae Sulph., . . gr. j. 
Aquae Destillatae, . . . . j|j. 
Solve. Sig. — TTLviij contain gr. -^. 



Pilocarpine. 

R. Pilocarpinae Hydrochlor., . gr. xvj. 

Aquae Destillat., ^j. 

M. Sig. — Tl\v contain gr. y^. 



Potassium Iodide. * 

R. Potassii Iodidi, ..... ^j. 

Aquae Fontanae, 3 iv. 

Solve. Sig. — Dose, rr^vj-xx. 



Quinine. 



R. 



Quininae Disulph., . . . . gr.l(5o). 
Ac. Sulphurici Dil., . . . rtlj:(ioo). 

Ac. Carbolici, TT^v (5). 

Aquae Fontanae, 3jj. 

Solve. Sig. — gj contains gr. vj. (Lente.) 
Is irritant. (B.) 



R. Quininae Hydrobrom., . . . gr. xlviij. 

Aquae Destillat., 5jiv. 

Solve. Sig. — ir^xx contain gr. iv. 



R . Quininae Bimur. Carbamidat., 

Aquae Destillatae, . . . aa ^iv. 
Solve. Sig. — Xr\x contain gr. v. 



R. 



Strychnine. 

Strychninae Sulphat., . . . gr. j. 
Aquae Destillatae, .... ^j. 
Solve sine alcohol. Sig. — TT^x contain 



gr- 



48' 



R . Strychninae Nitratis, . . . gr. iij. 

Aquae Fervid., gx. 

Solve. Sig. — Y(\x contain gr. ¥ V 

(Portugalojf.) 



Solutions for hypodermic use should be neutral in reaction, neither acid nor alkaline ; 
and freshly prepared, especially solutions of the alkaloids, which soon develop a peni- 
cillium, which grows at the expense of the alkaloid. Aqua Fontana, if filtered, is a 
better menstruum than Aqua Destillata which has been kept for a week, and frequently 
exposed to the atmosphere. To run the least risk of producing a sore at the point of 



CHLORODYNE. 



743 



injection, use very fine needles, and deliver the injection into the areolar tissue beneath 
the skin, instead of into the skin, as lay parties generally do for themselves. The writer 
has given injections of Morphine and Atropine to a dying girl 3 or 4 times daily for two 
months, and never produced a sore. Always force out all liquid, and wipe the needle- 
point dry between the fingers, before returning it to the case ; the sebaceous matter on the 
fingers will keep it free from rust. There is an area of several inches square, on the upper 
and exterior aspect of the thigh, just below the great trochanter of the femur, which is 
remarkably insensible, being sparingly supplied with cutaneous nerves. (See Fig. 307, 
Gray's Anatotny, loth English edition.) An injection delivered in this area will not be 
felt by the patient. Avoid puncturing a vein ; if you do so, watch the patient and pre- 
pare an injection containing gr. -^ of Atropine Sulphate, to administer if dangerous 
symptoms arise. Never, except under special circumstances, administer the salts of Mor- 
phine or Atropine hypodermically to children less than 15 years of age. 

Acetanilid, in minute proportion, added to aqueous solutions for hypodermic use, is 
said to preserve them from decomposition more efficiently than any other agent hitherto 
employed for that purpose. 



CHLO.RODYNE. 

A Comparison of its Ingredients, according to Ten Formula therefor, the 

Quantities Being Calculated for Each Formula to a 

Four -Ounce Mixture, or Tr^ 1920. 



Articles. 


Quantity of each article in a giv mixture 


, as per the formula of 


* 

Ah' 
V 

■3 
a* 

co 


■4- 

i 

w 
a 

CO 


a 

u 


5 

CO 


s 


* 

V 

Q 
Ph" 




pq 




V 

a 



U 


Morphine Hydrochlorate, 

Chloroform, 

Ether, 


gr. 

m 
m 
m 

gr. 

m 

m 
m 
m 
m 
m 
m 

gr. 
gr- 
ill 

m 
m 
m 
m 

m 


236 

59 

1x8 

2 

236 

147 

236 

io33 


16 

192 

96 

'•% 

290 

384 

760 
760 


16 

240 

32 
'16 

4 
810 

818 


32 
372 

248 

50 

10 

4 
994 
126 

126 


33^ 
375 

250 

50 

8 

37 

IOIO 

62 
128 


14 

207 

207 

42 
7 

7 

690 

760 


16 
240 
120 

20 

90 
7 

120 

30 
20 

9°3 
150 

240 


247 

62 

123 
2 

247 

154 

247 
992 


4 
240 
60 

120 
2 

240 

240 

240 
q. s. 


24 
240 

24 
48 

1632 


Cannabis Indica,Tincture, 
Cannabis Indica, Extract, 
Hydrocyanic Acid, 2 p. c, 
Ol. Menthae Piperitse, . . 
Capsicum, Fluid Extract, . 
Capsicum, Tincture, . . 
Capsicum, Oleo-resin, . . 
Alcohol, 


Hydrochloric Acid, . . . 

Sugar, Burnt 

Glycyrrhizse, Extract, . . 
Acacia, Mixture, .... 
Tragacanth, Mucilage, . . 
Theriaca, or Syr. Fusci, . 


Glycerin, 

Water, 


Total No. of Minims, . . 




1920 


1920 


1920 


1920 


1920 


1920 


1920 


1920 


1920 


1920 


Adult Dose, 


m 


5-io 


5-3° 




3-10 


5-15 


5-3o 


5-30 


5-15 


5-10 


10-30 


Morphine Hydroch. in 
TT]xv, 


gr- 


iks 


% 


% 


a 


VAr 


iff 


Vs 


123 


3J 


I 





Note. — See ante, page 185, for remarks on this preparation, and the number of formulae representing it. 

* Author of "A Companion to the Br. Pharmacopoeia." 

f See Hartshorne's " Essentials," 5th ed., p. 625. ** Parke, Davis & Co., Detroit. 

I Made by Eli Lilly & Co., Indianapolis. ffTinct. Chloroformi et Morphinae, B P. 

f 2d ed., page 430. §As given by Stokes and Blyth in " Hygiene." 



744 



PATENT MEDICINES. 



PATENT MEDICINES. 

These formulae have been published from time to time in various journals and formu- 
laries, and are supposed to represent the preparations designated. The name of the 
author is appended in each case when known. 



Alcoholic Strength of Quack Bitters. 

Hostetter, 43- 2 ° 

Drake Plantation, 30.24 

Rush, 34.20 

Peruvian, 22.40 

Hoofland, 20.85 

Oxygenated, l 9- 2 3 

California Wine Bitters, . . . . . 18.20 
Walker's Vinegar Bitters, 7.20 



Amick's Consumption Cure. 

The Amick advertisements appeared 
shortly after the publication of Dr. N. B. 
Shade's paper in this and other journals. 
Amick copied Shade's language, speaking 
of the " chemical " cure, etc., and, I believe, 
adopted Shade's methods of treatment. 
These were fully described by Shade, and 
consist in the use of Calomel, Iodoform, 
Guaiacol, etc. 

(Dr. Waugh, in Times and Register?) 



Ayer's Ague Cure. 

This, according to Churchill's analysis, is 
alleged to consist of a syrupy tincture of 
Peruvian Bark with Aromatics, each bottle 
holding six fluid ounces, and each fluid 
ounce containing 3.2 grains of amorphous 
Cinchona alkaloids, 3 grains Cinchonine, 
0.7 grain Cinchonidine, 0.8 grain Quinine, 
and I grain of Quinidine. 



Ayer's Cherry Pectoral. 

Morphinae Acetat., . . . . gr. iij. 
Vini Antim. et Potass. Tartrat., 
Vini Ipecacuanhas, . , . aagiij. 
Tinct. Sanguinariae, . . . ^ij. 
Syr. Pruni Virginian., . . . ^iij. 



Ayer's Pills. 

Consist of Colocynth, Gamboge and 
Aloes, coated with Starch and Sugar. 



Ayer's Sarsaparilla. 

Alcohol, fl. oz. 3. 

Fluid Extr. of Sarsaparilla, fl. oz. 3. 
Fluid Extr. of Stillingia, . fl. oz. 3. 
Fluid Extr. of Yellow Dock, fk oz. 2. 
Fluid Extr. of Podophyllum, fl. oz. 2. 

Sugar, oz. I. 

Iodide of Potassium, . . . grs. 90. 

Iodide of Iron, grs. 10. 

Mix. 



Brandreth's Pills. 



Podophylli Radicis, . . 


• gr- x. 


Extracti Podophylli, . . 


. gr. x. 


Extr. Phytolacca; Baccae, 


. gr. xxx. 


Pulv. Caryophylli, . . . 


• gr. x. 


Cambogiae, 


• gr. U-v. 


01. Menthae Piperitae, . . 


. rn,iij. 


Croci, 


. gr. 11. 



Misce, fiat masse, et div. in pil. xxiv. 

(Hager.) 



Castoria. 

Senna, av. oz. 2. 

Pumpkin seed, dr. 6. 

Rochelle salts, dr. 4. 

Wormseed, Levant, . . .dr. 3. 

Sodium Bicarbonate, . . . dr. 2. 

Anise Seed, dr. I. 

Oil of Gaultheria, . . . . dr. ^. 

Oil of Peppermint, . . . . dr. y%. 

Sugar, av. oz. 8. 

Water, enough to make . . fl. oz. 16. 

Exhaust the vegetable drugs by boiling 

with water, evaporate to the proper volume, 

and dissolve the sugar and other ingredients. 

( Western Druggist. ,) 



Chlorodyne, Collis Browne's. 

Morphinae Hydrochlor., . . gr. 6. 

Chloroform, dr. 6. 

Cannabis Indica, gr. 6. 

Prussic Acid (Scheele's), . rr\, 6. 

Treacle, to make oz. I. 

Dose. — 10 to 30 minims. (Hygiene.) 



PATENT MEDICINES. 



745 



Clarke's Blood Mixture. 

Potassium Iodide, . . . . gr. 48. 

Chloric Ether, dr. 4. 

Liquor Potassse, ... . rr\, 30. 
Water, colored with Burnt 

Sugar, oz. 7^. 

Dose. — One tablespoonful four times 



day. 



[Hygiene.) 



Ely's Cream Balm. 

consists of Vaseline, I ounce; Thymol, 3 
grains; Carb. Bismuth, 15 grains ; Oil Win- 
tergreen, 2 minims. The directions are to 
dip the little finger into the balm and insert 
up the nostrils, giving two or three full 
inhalations. {Medical Record.) 



Garfield Tea. 



consists chiefly of Senna leaves and Couch- 
grass (Triticum), with aromatics. 

[Prof. Leng field.) 



Hamburg Tea. 

Sennse Foliorum, . . . . pt. viij. 

Mannse, pt. iv. 

Coriandri, . , pt. j. 



Hamlin's Wizard Oil. 

Spt. Camphorse, ^j. 

Spt. Ammoniae, 

Olei Sassafras, aa ^ ss. 

Olei Caryophylli, . . . . % ij. 

Chloroformi, 

Olei Terebinthinae, . . . aa^ss. 

Alcoholis, . . . . q. s. ad £ v. 



Helmbold's Buchu. 

Said to resemble the genuine. 

Short Buchu, oz. 9. 

Uva Ursi, oz. 4^. 

Licorice root, dr. 10. 

Macerate in 9 pints of boiling water, 
strain and add — 

Caramel, oz. 2. 

Molasses, oz. 8. 

Mix well and add — 

Cubeb (fluid extract), . . . oz. 5. 

Alcohol, pints 2. 

Peppermint Oil, oz. 1. 

Water, sufficient to make . pints 12. 
(Lillard's Prac. Hints and Formula.) 



Holloway's Ointment. 

Has in 159 parts — 

Olive Oil, 62! parts. 

Lard, 50 " 

Resin, 25 " 

White Wax, ...... 12I " 

Yellow Wax, 3 " 

Turpentine, 3 " 

Spermaceti, 3 " 



Holloway's Pills. 



Have in 144 Pills- 
Aloes, . . . . 
Rhubarb, . . . 
Saffron, . . . 
Glauber's Salt, 
Pepper, . . . 



. gr. 62. 
■ gr. 27. 

• gr. 3- 

• g r - 3- 

• gr- 7. 

(jDorvall.) 



Hostetter's Bitters. 
Sacchari Albi, 
Aurantii Corticis, 
Calami, 
Cinchonse, 

Gentianse, aa lb j. 

Rhei Pulv., £iv. 

Cinnamomi, ^ij. 

Caryophylli, Jj. 

Alcoholis Diluti, Cij". 

(Med. Bulletin, 1884.) 



Keeley's Chloride of Gold Cure. 
For drunkenness and the opium-habit. 
The composition is said to be as follows : — 
Chloride of Ammonium, . gr. j. 

Aloin, gr. ij. 

Compound Tincture of Cin- 
chona, fl. J| iij. 

Water, sufficient to make fl. ^ iv. 
The hypodermic injection, administered 
4 times daily for 5 weeks, contains Strych- 
nine and Atropine (or Hyoscine) with Co- 
deine and Cocaine for the opium cases. 
The whiskey supplied to the victims con- 
tains about gr. -gL of Apomorphine to each 
average drink. (JV. Y. Med. Record.) 



Laville's Gout Mixture. 
Calcium Chloride, Chinoi- 

din, each . . . 
Extract Colocynth, 

Water, 

Alcohol, .... 
Spanish Wine, . . 
Made into a solution. A pill of very 
complicated composition is used in connec- 
tion with the gout remedy. (Hager.) 
[See also page 206, ante."] 



. . grm. 


5- 


. . grm. 


2-5 


. . grm. 


85. 


. . grm. 


100. 


. . grm. 


800. 



746 



PATENT MEDICINES. 



Morrison's Pills. 

Powdered Colocynth, . . . gr. 3. 

Powdered Gamboge, . . . gr. 6. 

Powdered Aloes, gr. 9. 

Cream of Tartar, gr. 12. 

Syrup enough for 12 pills. Serious re- 
sults are often produced by large doses of 
these pills. 

Orange Blossom. 

Zinc Sulphate, gr. 60. 

Alum, , gr. 15. 

Expr. Oil of Almond, . . gr. 90. 

Extract of Hyoscyamus, . gr. I. 

White Wax, gr. 30. 

Oil of Theobroma, . . . . gr. 180. 
Made into oblong suppositories, one inch 
long, one and a half wide and half an inch 
thick, weighing 32 grains each. 



Perry Davis's Pain Killer. 

Tinct. Capsici, ^j. 

Spt. Camphorae, %\]. 

Guaiaci Resinae, Jss. 

Alcoholis, 1 . giij. 

Tinct. Myrrhae, q. s. to color. 



Pierce's Favorite Prescription. 

Sabinae, Cinchona, 

Agarici Albi, aa gij. 

Cinnamomi, gr. xv. 

Coq. in aq. suff., ut ft. decoct. ^ viij. 
Deinde cola, et adde — 

Sacchari Albi, ^ ss. 

Acacise, 5[j. 

Solve, et addantur — 

Tinct. Opii Deodorat., 

Tinct. Digitalis, . . . . aa ^ss. 

01. Anisi, gtt viij, in Alco- 
holis, ^j ss - 

Misce. {Hager.) 

Pierce's Golden Discovery. 

Ext. Lactuci, gj. 

Mellis, *|j. 

Tinct. Opii Deodorat, . . . 5 ss. 
Alcoholis Diluti, 

Aquae, aa t ^iij. 

\Hager.) 

Radam's "Microbe-Killer." 

Oil of Vitriol (impure), . . dr. 4. 
Muriatic Acid (impure), . . dr. I. 

Red Wine, oz. 1. 

Water, gall. I. 

{Eckels.) 



Radway's Ready Relief. 
Tinct. Capsici, 
A quae Ammonia?, 

Alcoholis, aa. %]. 

Linimenti Saponis, . . . . t ^iij. 

{Hager.) 

Radway's Resolvent. 
Vini Zingiberis, 
Vini Cardamomi, . . . aa ifiij. 

Sacchari Albi, q. s. 

{Hager.) 

Recamier Balm. 

Zinc Oxide, Hbs. 5. 

Glycerin, dr. 2. 

Alcohol, oz. 2. 

Mercuric Chloride, . . . . oz. 4. 

Distilled Water, qts. 64. 

{Boston Herald?) 



Recamier Cream. 

Rice Flour, oz. 

Zinc Oxide, ....... 07. 


48. 
60. 


Glycerin, .... 
Cacao Butter, . . 

Lard, 

Mercuric Chloride, 
ake 32 pints. 


. . . . oz. 640. 
. . . . oz. 48. 
. . . . oz. 48. 
. . . . oz. 4. 
{Boston Herald?) 



Revalenta Arabica Food. 
Consists solely of Lentils ground up into 
a fine powder. {Stokes in " Hygiene") 



Sage's Catarrh Remedy. 
Salis Culinaris (Sodii Chlor.), partes xx. 
Pulv. Camphorae, .... part. j. 

Acidi Carbolici, part. j. 

M. — To be dissolved in water and either 
injected or sniffed up the nose. 

Pulv. Hydrastis Canadensis, partes v. 

Pulv. Indigo, part. y 2 . 

Pulv. Camphorae, 

Acidi Carbolici, . . . . aa partes ij. 

Sodii Chloridi, partes 1. 

{New Remedies.) 

Sanford's Catarrh Cure. 
According to an analysis made by Prof. 
A. B. Lyons for the New Idea, this prepa- 
ration is composed of distilled extract of 
Witch-hazel, containing a little Alcohol and 
Glycerin and some Morphine. The pro- 
portions of the constituents were not de- 
termined. {Nat. Druggist.) 



Seigel's (Mother) Syrup. 
Contains Aloes, gr. 30 to the oz. Also 
Borax, Capsicum, Liquorice, and Treacle. 
{Stokes in " Hygiene") 



PATENT MEDICINES. 



747 



Sequah's Oil. 
A mixture of ^ Turpentine and y£ Fish 
Oil, scented with a few drops of Oil of 
Camphor. [Stokes in "Hygiene.") 



Sequah's Prairie Flower. 
Has to the ounce — 

Aloes, gr. 52^. 

Carbonate of Soda, . . . gr. 17 }4- 

Water, gr.362^. 

and a few drops of the Tinctures of Capsi- 
cum and Myrrh. (Stokes in "Hygiene.'''') 



St. Jacob's Oil. 

Gum Camphor, 

Chloral Hydrate, 

Chloroform, 

Sulphuric Ether, . of each, oz. 1. 

Tinct. of Opium, 

Oil of Origanum, 

Oil of Sassafras, . of each, oz. y^. 

Alcohol, . gal. y^. 

Dissolve the Gum Camphor in the Oils 

and Alcohol, then add the other ingredients. 

Squibb says that it is a weak Aconite 

Liniment, also containing Ether, Alcohol, 

Turpentines, red coloring matter, and water. 

(Ephemeris, p. 114.) 



Swift's Specific, " S. S. S." 

Fluid Extr. of Smilax Sarsaparilla, 16 parts. 
Fluid Extr. of Stillingia Sylvatica, 16 parts. 
Fluid Extr. of Lappa Minor, . . 16 parts. 
Fluid Extr. of Phytolacca, . . .16 parts. 
Tinct. of Xanthoxylum, .... 8 parts. 
(Registered Pharmacist.) 
Stearns' New Idea gives the following : 
Stillingia, Pokeroot, and Sarsaparilla, with 
Nitrate of Potash and a small quantity of 
Iron, and enough Alcohol to preserve it. 



Tamar Indien. 



According to the Report de Pharmacie, 
the formula for this preparation is as fol- 
lows : — 

Tamarind (pulp), 450, powd. Sugar, 
40; powd. Sugar-of-milk, 60; pure Gly- 
cerin, 50 (all parts). Mix and evaporate 
to the consistence of a soft extract, then 
add powd. Anise, 10 ; Ess. Lemon, 3 ; Tar- 
taric Acid, 3 (all parts). Mix and divide 
into 100 boluses. Roll in the following 
mixture : Cream of Tartar, 5 ; White Su- 
gar, 35 ; Sugar-of-milk, 35 ; Tragacanth, 2 ; 
Tartaric Acid, 2; powd. Red Sandal, 25 
(all parts). Dry and put up in tin foil. 

(American Druggist.) 



Thompson's Eye-Water. 



Sulphate of Copper, . 
Sulphate of Zinc, . . 

Rose-water, 

Tincture of Saffron, . 
Tmcture of Camphor, 
Mix and filter. 



gr. 10. 
gr. 40. 
pints 2. 
drchm. 4. 
drchm. 4. 



Van Buskirk's Sozodont. 

Saponis Albi, 3 ss. 

Alcoholis, ^j. 

Aquae, gvj. 

Glycerini, gij. 

Olei Gaultheriae, 
Olei Caryophylli, 
Olei Menthae Piperita?, 

aa q. s. ad saporem grat. 
Cocci Cacti, q. s. ad color et. 



Calcis Praecipitat, 
Magnesia Carbonatis, 
Iridis Florent. Radicis, 

aa p. aeq. 
M. et trit. (Hoffmann.) 

Vita Nuova. 

Cocaine, gr. 8. 

Pepsin (golden scale), . . gr. 48. 

Port Wine, gall. I. 

(Boston Herald.) 

Walker's Vegetable Vinegar Bitters. 

Aloes Socotrin., gij. 

Guaiaci Resinae, % iv. 

Sassafras Mucil., £]. 

Aceti, gij. 

Aquae, q. s. 

Coque, et ft. decoctum, ad ^xix, 
deinde cola, et addantur — 

Sodii Sulphatis, |jj. 

Acaciae, £ij. 

Spt. Anisi, 10 p. c, . . . gij. 

Alcoholis, Jj. 

M. Dose, ^ij. (Eberbach.) 



Warner's Safe Kidney and Liver Cure. 
In Germany each maker of patent medi- 
cines must furnish the government with 
the formula for the patent he makes. This 
is the one furnished by Warner for " Safe 
Kidney and Liver Cure." Each bottle 
contains : — 

Extr. Lycopus Virginiana 



(herb), 


• ^. 


308. 


Extr. Hepatica (herb), . 


• S r - 


322. 


Ext. Gaultheria, . . . . 


• £^. 


v/?. 


Potassium Nitrate, . . . 


• £?• 


39- 


Alcohol (90 ), 


. oz 


2^. 


Glycerin, 


. dr. 


10. 


Water sufficient to make 


one pint. 


(Formulary and Druggists 


Magazine.) 



( 



; 4 8 



FORMS OF BRIGHT S DISEASE. 



TABLES OF DIFFERENTIAL DIAGNOSIS. 



Forms of Bright's Disease. 

Compared with Acute Nephritis and with each other. 







a 

V 
V 

< 


(i) Acute 

Bright's 

Disease. 

Acute 

Parenchy. 

Nephritis. 


Chronic Bright's Disease. 


Clinical Phenomena. 


(2) Chron. 
Parenchy. 
Nephritis. 
{Large 
White 
Kidney) . 


J 3) 
Fatty 

Kidney. 


(4) 
Amyloid 
or Waxy. 
Kidney. 


(5) Chron. 

Interstitial 
Nephritis. 
( Cirrhotic 
Kidney.) 


a 

3 ' 


Quantity, 


Normal 
or — 


- 


— or + 


Normal 
or — 


Normal 
or + 


Normal 
or + 


Reaction, 


Acid. 


Acid. 


Acid. 


Acid. 


Acid. 


Acid. 




Wine 
yellow. 


Dark 

smoky. 


Brown 
yellow. 


Pale. 


Pale. 


Clear. 




Sp. Gr., 


Normal 
or — 


High. 


- 


1.015-1.030 


— , above 
1. 010 


— 1. 010 


Urea, 


Normal. 


- 


- 


- 


Normal 
or — 


Normal. 




Chlorides, . 


Normal. 


- 


- 


- 


- 


Normal. 


Albinnen{per cent.), . . . 


tV to i 


i to 6 


y 2 to 2 


1 to 6 


T l fftO^ 

of 
globulin. 


h to % 


Casts, 


Hyaline 
and 

Epithel. 


Blood 
Epithel. 
Hyaline. 


Granular 
Hyaline. 
No blood. 


Fatty. 


Few and 
Hyaline. 


Very few. 


Sediment {macroscopical), 


Mucus. 
Blood. 


Brown 

cells. 

Urates. 


Kidney 
epithel'm 

Blood 
Lymph. 


Free oil. 


Seldom 
any. 


Seldom 
any. 


T> 




Seldom. 


Great, 

especially 

of face. 


Never 
absent. 


Great. 


Trifling. 


In last 
stages. 






TT, 






Often 
great. 


Not 
marked. 


Rare. 


'Rare. 


Great. 








Other Symptoms, 


Stiff 

joints. 

Sacral 

pain. 

Lassitude. 


Fever. 


Tempera- 
ture low. 
No fever. 
Inflam. of 

serous 
membr's. 
Cardiac 

hyper. 


Face pale, 
puffy. 
Cardiac 
hyper. 


Emacia- 
tion, sal- 
low face, 

enlarged 
liver and 

spleen, 

thirst, 

diarrhcea. 


Retinitis. 
Tense, 
quick 
pulse. 

Hyper, of 
heart. 


Pf 




Favorable 


Recovery 
or No. 2. 


Recovery 
(?)orNo.3. 


Always 
fatal. 


Depends 
on con- 
stitutional 
disease 
present. 


Unfavor- 
able, but 
course 
perhaps 
long. 







Note. — The signs -f- and — respectively denote a specific gravity greater than 1.024, or less than 1. 018, 
in the line entitled Sp. Gr. 



DIFFERENTIAL DIAGNOSIS. 



749 



Cancer. 



Cancerous {Malignant) Tumors. 

Are of constitutional origin. 

Have no cyst, but invade and convert the 

surrounding tissues. 
Cancer material is short-lived from rapid 

deterioration, but is rapidly reproduced. 
Severe increasing pain. 
Extend to remote parts, reappearing chiefly 

in lymphatic glands. 
Cancerous cachexia of general health. 
Recur after extirpation, fatal in end. 



Non-malignant Tumors. 

Origin, some local error of growth. 
Limited by a cyst ; may compress, but do 

not invade adjacent tissues. 
Have uncertain period of increase, after 

which may remain stationary. 
Usually no pain. 
Are local, have no disposition to spread. 

Impair functions of parts pressed on. 
Do not recur. 



Scirrhus. 

Is hard. 

Appears mostly on female breast. 

Hard kernel, movable under skin. 

Becomes fixed to adjoining structures, which 

it puckers. 
Single and grows slowly. 
Course slow — 2-4 years. 
Never in the young. 



Encephaloma. 

Is soft and brain-like. 

Most frequently on the limbs. 

At first deeply seated, hard to recognize. 

Spreads through loose textures, which 

pushes aside and distends. 
Has numerous tumors, grows rapidly. 
Generally fatal in 1-2 years. 
Often in the young, even at birth. 



Endocarditis. 



Carditis. 



Blowing sound. Excited heart action. 
Slight if any increase of percussion dulness. 
Impulse strong. 

Sounds normal, or more distinct, except at 
site where murmur is heard. 



Pericarditis. 



Friction sound. Excited heart action. 
Marked increase in effusion stage. 
Wavy and feeble. 
Feeble and muffled; no blowing sounds. 



Cerebral. 



Concussion. 



Patient can be roused ; pupils act. 

Breathing seldom stertorous. 

Urinary action normal. 

Symptoms appear closely after accident. 



Compression. 



Complete insensibility ; motionless pupils. 
Breathing usually stertorous. 
May be either retention or incontinence. 
Frequently do not. 



Chancre and Chancroid. 



Chancre. 



Commences about 3d week after coitus. 
First as a papule, abrasion, or crack. 

Generally indurated (rarely not). 

Develops slowly. 

Discharge slight, unless irritated. 

Is soon limited and seldom phagedenic. 

Edges sloping, not undermined. 

Scanty serous secretion. 

Sore remains solitary, and cannot be multi- 
plied. 

Followed by numerous buboes, rarely sup- 
purating, never furnish inoculable pus. 



Chancroid. 



In 24 hours to 3 days. 

First as a red spot, then a pustule, then a 
suppurating sore. 

Not on an indurated base. 

Develops rapidly. 

Suppurates profusely. 

Tends to invade surrounding tissues, or be- 
come phagedenic. 

Edges undermined. 

Discharge is pus and copious. 

May be transplanted at will, and is seldom 
single. 

A single bubo may appear and suppurate. 



750 



DIFFERENTIAL DIAGNOSIS. 



Cholera. 



Asiatic. 



Preceded by painless diarrhoea. 
Not directly from error in diet. 
First pain shooting down thighs. 
Prostration rapid and overwhelming, and 

out of ratio to evacuations. 
Rapid reduction of surface temperature ; 

high temperature in cavities. 
Evacuations like rice-water from first. 

Cramps commence in extremities. 
Veins congested ; tongue, lips, and extremi- 
ties livid purple. 
Urine albuminous. 



Simple. 



Seizure sudden. 

Generally is from error in diet. 

First pain is abdominal (colic). 

Prostration gradual, less marked than the 

vomiting and purging. 
Gradual reduction of surface temperature • 

internal temperature normal. 
Discharges bilious, causing burning and 

smarting pain ; colorless only at very last. 
Cramps commence in abdomen. 
Not so. 

Not so. 



Croup and Diphtheria. 



Croup. 



Premonitory hoarse, metallic cough, with- 
out illness. 

A child's disease. 

Tenacious mucus covering the swollen 
membrane. 

A local disease. 



Diphtheria. 

Premonitory illness, marked by shivers, 

fever, and sore throat, without cough. 
Attacks adults as well. 
Distinguished by a false membrane. 

A blood poison ; great general depression. 



Epilepsy and Hysteria. 



Epilepsy. 



Loss of consciousness is sudden, complete. 

Livid face, frothy saliva escapes, eyelids 
half open, eyeballs rolling, teeth grind- 
ing, tongue biting; more or less insensi- 
bility of pupils to light. 

Countenance is distorted. 

Patient shows no feeling. 

Aura epileptica. 

Short paroxysm, followed by heavy coma- 
tose sleep and dull intellect. 

Frequently occurs at night. 

Not necessarily of uterine connection, 
though a paroxysm often occurs at the 
menstrual period. 



Hysteria. 



Gradual and partial or apparent. 

Face flushed, or complexion unaltered, no 
froth on lips, eyelids closed, eyeballs 
fixed, no grinding of teeth, or biting of 
tongue; pupils react readily. 

Is not. 

Sighs, Or laughs, or sobs. 

Globus hystericus. 

Longer paroxysm ; patient not sleepy, usu- 
ally wakeful and depressed in spirits. 

Rarely occurs at night. 

Often connected with uterine or menstrual 
disorders. 



Scarlet Fever. 
Incubation, I day to weeks. 

Fever, great heat of skin, 
and frequent pulse, un- 
abated during eruption. 

Brilliant stare. 



Exanthemata. 

Measles. 
Incubation, 7 to 14 days. 

Same fever rather increased 
by eruption. 

Liquid, watery eye. 



Smallpox. 

Incubation, 6 to 20 days, 
average, 10. 

Fever often violent, bound- 
ing pulse, pain in loins ; 
all are greatly relieved 
by eruption. 



DIFFERENTIAL DIAGNOSIS. 



75i 



Scarlet Fever. 

Eruption on second day, not 
rough, first on neck and 
chest, spreads rapidly, 
white streak on pressure 
with nail. 

Eruption uniform, or in 
large patches, inter- 
spersed raised spots and 
some vesicles; rash scar- 
let, on its seventh day 
very complete desquama- 
tion in large patches. 

Sore throat, rarely coryza 
or bronchitis. 

" Raspberry " tongue, red. 

Cerebral symptoms are fre- 
quent and grave. 

Temperature may be 105 - 
106 to 10th day, subsides 
gradually, falls on 5th, 
loth, and 15th days. 

No secondary fever. 

Pneumonia rare, pleurisy 
more frequent. 

Sequelae : Eright's disease, 
dropsy, deafness, conjunc- 
tivitis, phthisis, chronic 
diarrhoea; glandular en- 
largements. 



Measles. 

Eruption on fourth day, on 
face, rough, spreads grad- 
ually, the streak lasts only 
a short time. 

Eruption in crescentic 
patches, lasts about 5 
days, then partial des- 
quamation, scales very 
fine. 



Coryza and bronchitis very 
constant, sore throat 
rarely. 

Tongue coated, may be red 
at edges. 

Not so. 

io3°-io6° before eruption, 
remains high for 1-2 days 
thereafter, then falls sud- 
denly. 

No secondary fever. 

Pneumonia a frequent com- 
plication. 

Sequelae : chronic bronchi- 
tis, phthisis, conjunctivitis. 



Smallpox. 

Eruption usually on third 
day, at first on Jips and 
forehead, spreads rap- 
idly. 

Eruption is first papular, 
then vesicular, finally 
pustular ; pustules matur- 
ate on 8th day of eruption. 



Sore throat often, also a dry 
cough. 

Tongue coated, and swollen, 
may be red at edges. 

Cerebral symptoms are fre- 
quently seen. 

Before eruption often 106 , 
then rapidly sinks to ioo° 
in 36 hours; rises during 
the secondary fever. 

Secondary fever always. 

Pneumonia not a very fre- 
quent complication. 

Sequelae : chronic diarrhoea, 
glandular enlargements, 
various eye diseases. 



Gout and Rheumatism. 



Gout. 



Affects chiefly the small joints, especially 

the metatarsal joint of the great toe. 
Occurs from 35-50 years of age ; rarely 

before puberty. 
Most frequent in men, and result of idle, 

intemperate and luxurious life. 
Is strongly hereditary. 
Chalk-stones (sodium urate) in external ear, 

on tops of fingers, or elsewhere. 
Uric Acid in the blood, absent from urine. 
A fit often affords temporary relief. 
Is confined to the temperate zone. 



Rheumatism. 
Large joints chiefly implicated. 

Occurs generally in young adults. 

Affects both sexes equally, and equally the 

poor and the rich. 
But slightly so. 
Not so. 

Lactic Acid in the blood. 

Quite the contrary. 

Is ubiquitous — prevails in all climates. 



Hematemesis and Hemoptysis. 



Hematemesis. 
Blood is of a dark color, and is vomited. 

Often mixed with food, not froth. 
Preceded by nausea and stomachal dis- 
tress, and blood is passed with the stools. 



Hemoptysis. 

Blood is bright red, and generally coughed 

up. 
Generally frothy and mixed with sputa. 
Preceded by pain in the chest and dyspnoea. 
No blood in the stools. 



{ 



752 



DIFFERENTIAL DIAGNOSIS. 



Pleurisy and 

Pleurisy. 

Sharp pain, friction sound, dry cough, im- 
paired chest motion. 

In stage of effusion, obliteration of inter- 
costal spaces, enlargement of the side, 
viscera displaced. 

Dullness, with enfeebled or absent respira- 
tion, voice, and fremitus. 

Sputa frothy, rarely any rales. 
Febrile symptoms slight usually. 
Temperature irregular, rarely high. 



Pneumonia. 

Pneumonia. 
Dull pain, crepitant rale, cough followed 

by expectoration. 
In stage of hepatization none of these 

signs are present. 

Dullness, with marked bronchial respira- 
tion, distinct thoracic voice, increased 
vocal fremitus. 

Sputa rusty color, rales common. 

Febrile symptoms severe. 

Sudden elevations and falls, high tempera- 
ture not uncommon. 



Phthisis, 



Tubercular. 
First symptom, a dry, short cough. 

No exciting cause apparent. 

Hereditary cases are of this class. 

Frequently preceded by enlarged or suppu- 
rating glands, or other evidence of the 
scrofulous diathesis. 

Voice changes, from tubercular deposit. 



Non- Tubercular. 
First stage follows catarrh, bronchitis, or 

some other acute disease. 
Is referable to some exciting cause, as cold, 

inflammation, or inhaling heavy dust. 
Not hereditary. 
No evidence of scrofula. 



No change of voice. 



Typhus and Typhoid. 



. 



Typhus Fever. 
Attacks quickly, incubation 9 days. 

Occurs at any age. 

Rare among the higher classes, except 

those exposed. 
Mulberry Eruption on 4th or 5th day, on 

extremities, lasts till close. 



Brain chiefly affected ; bowels often but 
little so; abdomen natural, evacuations 
dark, but never bloody (these are occa- 
sionally reversed). 

Contracted pupils, dusky face. 

Pulse and temperature rise to 120 and I05 
till 3d day, high for 6 days, then fall. 

Lasts 2-3 weeks. 
Relapses rare. 

Death from coma, or congestion of the 
lungs, in 1st or 2d week. 

Arises from destitution, over-crowding, bad 
ventilation, is highly contagious, and gen- 
erally epidemic. No microbe determined. 

Post-mortem : not constant, most frequent 
are dark blood and enlarged spleen, soft 
heart. 



Typhoid {Enteric) Fever. 
Commences slowly, incubation about 13 s , 

days. 
Most common in youth and childhood,. 

rarely after 40. 
As common among the rich as the poor. 

Rose Eruption on 7th to 10th day, isolated,, 
flattened papules, few, on abdomen and 
back, in successive crops, which fade and 
disappear. 

Bowels chiefly affected, evacuations ochre- 
color and watery, sometimes hemorrhage,. 
or even ulceration, abdomen tumid. 

Dilated pupils, cheeks flushed. 

Pulse and temperature rise and fall inde- 
pendently, and without uniformity, but. 
both are usually high to 15th day. 

Last 4-6 or more weeks. 

Relapses frequent. 

Death from asthenia, pneumonia, hemor- 
rhage, or perforation of intestine, in or 
after 3d week. 

From poisoned drinking water, putrid ani- 
mal matter, bad drainage ; is not conta- 
gious, often sporadic. Eberth's bacillus 
present in the lesions. 

Post-mortem : morbid Peyer's patches, en- 
larged mesenteric glands, ulcerated mu- 
cous coat of intestines; enlarged and 
soft spleen, ulcerated pharynx. 



TEMPERATURE IN DISEASE. 



753 



Yellow and Bilious Fevers. 



Yellow Fever. 

Duration short, ends in 3-7 days. 

Incubation 5-9 days. 

A disease of one paroxysm, terminating in 

recovery or collapse. 
Very severe nausea and vomiting, early 

epigastric tenderness. 
Black vomit, due to gastric hemorrhage. 
Hemorrhages from various parts. 
Tongue clean, or slightly coated. 
Pulse variable, slow at end. 
Eye injected and humid. 
Supra-orbital pain, pain in back and in 

calves of leg. 
Rarely delirious, mind clear generally. 
Urine albuminous, usually suppressed. 
Convalescence rapid, no sequelae. 
Muscular prostration slight. 
Mortality high, disease epidemic. 
Treatment unsatisfactory. 
Autopsy : inflamed or congested stomach, 

enlarged yellow liver, filled with oil 

globules, muscular fibres of heart are 

often disintegrated. 



Bilious Remittent. 

Lasts 9 days or more. 

Incubation may extend to months. 

A disease of several paroxysms, with inter- 
vening remissions. 

These symptoms are not so severe nor do 
they occur so early. 

Bilious vomiting. 

No hemorrhagic tendency. 

Tongue heavily coated. 

Pulse quick until convalescence. 

Eye natural. 

Headache, sense of fullness in head, often 
no loin or leg pains. 

Delirium frequent, mind dull. 

Not so. 

Convalescence slow, tedious sequelae. 

Muscular prostration greater. 

Mortality slight, disease endemic. 

Very amenable to treatment. 

Autopsy: stomach congested, rarely in- 
flamed, liver olive or bronze hue, not 
fatty. 



Vomiting. 



Cerebral. 



Little or no nausea, vomiting continues after 

stomach is emptied. 
No tenderness or pressure over the liver or 

stomach. 
Pulse infrequent and hard. 
Tongue clean, breath sweet, conjunctivae 

normal or injected, and headache primary. 

Constipation generally obstinate. 
No salivation. 



Gastric or Hepatic. 



Nausea relieved by discharge, returns when 
food is taken. 

Liver and stomach are tender, pressure pro- 
duces inclination to vomit. 

Pulse frequent and weak. 

Tongue furred, breath offensive, conjunc- 
tivae often yellowish, and headache sec- 
ondary as to time. 

Griping abdominal pain, diarrhoea and 
clay-colored stools. 

Increased salivation. 



TEMPERATURE IN DISEASE. 

Average Normal Temperature, of adults, 98. 6° F. ; of children, 99 ; of the 
aged, 98. 8°. Diurnal variation i° to 1.5 F., highest from 9 a. m. to 2 p. m. 
Above 108 F. is a fatal sign, which issue may be averted by cold baths, reduced 
by ice from 96 to about 6o° F. (A). The clinical thermometer placed in the 
mouth, axilla or rectum, and retained in situ for five minutes, should go hand 
in hand with Aconite in the treatment of inflammations (R). [For Antipyretics 
see the articles Fever, Inflammation, in part III, also the list of these agents 
on page 43.] 

Clinical Thermometry is one of the principal means of positive diagnosis. 

The thermometer should be self-registering, certified, and accurately marked 

according to the Fahrenheit scale. The most reliable temperature is that in 

the rectum or vagina ; less so in the axilla and folds of skin, and still less're- 

48 



I 



754 TEMPERATURE IN DISEASE. 

liable in the mouth. A correct reading of the thermometer cannot be obtained 
in less time than five to seven minutes (Da Costa). 

The Average Normal Temperature of the body is 98. 6° ; which, like the pulse, 
will vary somewhat in individual cases ; as a general practical result, it is agreed 
that in temperate regions the normal temperature at completely sheltered parts 
of the surface of the human body amounts to 98.4 Fahr., or a few tenths more 
or less ; and a rising above 99. 5 , or a depression below 97. 3 F., are sure in- 
dications of some kind of disease, if the increase or depression is persistent. 
The temperature is increased at the prime of life, is raised and depressed 
temporarily by the influence of diet, stimulants, exercise, etc. The minimum 
diurnal temperature is observed at 2 A. m., the maximum at 4 to 6 P. m. The 
greatest recorded range of temperature in disease is 50.4 ; the minimum is 
71.6 in a case of sclerema neonatorum (Ouain's Diet.), the maximum 122 . 
In severe and fatal cases it rarely exceeds 107 , and rarely falls below 92 , even 
in fatal collapse. It may rise 3°-4° after death, as observed in a case of typhoid 
fever in which death occurred with a temperature of 107 , which increased 
shortly afterward to 110.5 . A temperature of 107 indicates malignancy, and 
when met with for two consecutive days in typhus, scarlatina, measles, pneu- 
monia, pyaemia, meningitis or rheumatism, death may be expected shortly. 
In relapsing, remittent and intermittent fevers, and in the initial chill of an 
abortion, the temperature may reach 107 without indicating great danger. 
During the last hours of life, in many diseases, the temperature rises to 109 - 
111 ; for example, in tetanus, sunstroke, typhus, etc. With a temperature 
of 96° collapse is imminent. 

Abnormally High Temperatures reported in the British Medical Jour., by Dr. 
Donkin, include those of eight cases, all but one in females, and none proved 
fatal. Pain was a prominent symptom in all. (1) 111.6 ; convalescing from 
enteric fever. (2) 108 ; no organic lesions; ovarian pain. (3) 115.8°; great 
abdominal pain and excitement. (4) in°; convalescing from enteric fever. 
(5) 1 13°; enteric fever and double pneumonia. (6) 112°; synovitis; this 
was the only male. (7) 112°; painful stump, with necrosis. (8) 117°; pyo- 
nephrosis. 

High Average Temperature (above 104°), is found in severe pneumonia, 
scarlatina, remittent, typhus, typhoid and relapsing fevers, pyaemia, etc. Mod- 
erate High Temperature (102° and above), is seen in peritonitis, acute rheuma- 
tism, pericarditis, pleurisy, dysentery, cerebro-spinal-meningitis, catarrhs, etc. 
A temperature of ioo° and above is found in chronic affections, incipient inflam- 
mations, and mild fevers. When, in effervescence, the heat increases rapidly, 
it will, in defervescence, decline proportionately fast, and vice versa. Beware 
of a grave affection when the temperature is of a continuous type. A distinct 
interval between morning and evening temperature is a favorable sign. A slow 
and gradual increase indicates typhoid fever ; in rheumatism and anomalous 
fevers the increase is more rapid, and still more so in acute inflammatory dis- 
ease, as pneumonia, angina, pleurisy, typhus, scarlatina, rubeola, etc. The 
rise is usually very rapid in intermittent fever, febricula, and ephemeral fevers. 
A rapid effervescence and slow defervescence indicates some complication of 
disease ; the reverse order indicates great danger. When the temperature 
begins to fall from the evening to the morning, it is an indication of im- 
provement ; while a rise of temperature from the evening to the morning 
is a sure indication that the patient is worse. Stability of temperature from 
morning to evening is a good sign, but from evening to the morning is un- 
favorable. 

Decrease of Temperature below the normal point is rare. It occurs sometimes 
transitorily, announcing thereby a favorable crisis, by preceding return to the 
normal temperature. It is also met with occasionally during the morning re- 
mission of remittent fever ; also during the apyrexia of intermittents ; in acute 
collapse, preceded or not by fever ; in chronic wasting diseases ; and some- 
times, also, on the approach of death, especially in typhus fever. 



CLINICAL EXAMINATION OF THE URINE. 755 

In Phthisis, the temperature is higher in the evening than in the morning; 
later, higher at early bedtime than at noon, and high again at dusk. This is a 
valuable and delicate test of the progress of tuberculization. 

In Typhoid Fever, the accession is by a rise of one degree each day, with the 
diurnal variation. If the evening temperature does not exceed 103. 5 , the dis- 
ease will probably be mild ; but a temperature of 105 in the evening indicates 
a severe type and much danger. A sudden reduction to 95 in the third week 
denotes intestinal hemorrhage; a lingering temperature of ioi°-io2° in the 
fourth and fifth weeks indicates non-cicatrization of the intestinal ulceration. 

In Scarlatina, the rise of temperature is rapid, 104. 7 may be reached in a few 
hours. It seldom rises above 105 and almost never above 106 ; is continuous 
until the eruption begins to fade, when remissions take place, unless complica- 
tions arise. 

In Measles, 103 is the usual temperature, with daily variations, increasing 
with the eruption and catarrhal symptoms. A high temperature lasting beyond 
the tenth day denotes complications. 

In Diphtheria, the temperature by the end of the third day will, in uncom- 
plicated cases, not exceed io3°-io4°. It falls temporarily with the exudation. 
Defervescence in the severe, favorable cases, is from the twelfth to the four- 
teenth day ; in the milder cases not before the sixth. In some fatal cases it 
occurs early, from the third to the fourth day. In asthenic cases the tempera- 
ture of the surface falls, while that of the interior remains high, ioo° in the 
axilla, and 103 in the rectum. During convalescence, the temperature is low, 
and readily depressed, but may be raised by intercurrent maladies. Any in- 
crease after the. first five days, or a continuous high temperature after the first 
ten days is unfavorable. A sudden rise may indicate complications. 

Co-Relation of Pulse and Temperature. — As a general rule the co-relation 
of pulse and temperature may be stated as follows, namely : — an increase of 
temperature of one degree above 98 F. corresponds with an increase of ten 
beats of the pulse per minute, as in the following table : — 

corresponds with a pulse of 60. 

" " 70. 

" " 80. 

" " 90. 

" " 100. 

" " no. 

" " 120. 

130. 

" " 140. 



•era 


iture of 98 


« 


99° 

IOO° 


it 


IOI° 


a 


102° 


(< 

it 


I0 3 ° 
I0 4 ° 
105° 

106 



CLINICAL EXAMINATION OF THE URINE. 

Urine for Examination should be that passed in the morning, or a sample of 
all passed during the 24 hours. 

Quantity. Normal quantity is about 50 fl. oz. in 24 hours, from which there 
may be considerable variation either way according to the quantity of sweat, 
the fluidity of food used, etc. 

Specific Gravity. If possible, take the mixed urine. Normal sp. gr. is about 
1.018, 1. e., 18 grains of solids in each fl. oz. If sp. gr. is high, suspect sugar; 
if low, suspect albumen. 

Color and Specific Gravity. Urine pale and copious, of sp. gr. 1.030 and 
above, indicates the presence of sugar. Pale and copious, sp. gr. below 1.018, 
is seen in hysteria, convulsions, nervous diseases. Color high, urine scanty, 
sp. gr. above normal, — in fevers and the uric acid diathesis. Color high, urine 






75^ CLINICAL EXAMINATION OF THE URINE. 

scanty, sp. gr. below normal, — in Bright's disease. Urine is colored very yel- 
low or greenish-yellow, by Bile and by Rhubarb : dark, with odor of violets, 
by Turpentine : dark, muddy, smoky, by blood and strong coffee : black, by 
disintegrated blood, putridity of the urine, Tar, Creosote : olive-green or smoky, 
by Carbolic Acid : brown, by Arbutin : green by Salicylic Acid : dark-green, 
by Thymol: dark-blue, by Methylene Blue: bluish-violet, by Resorcin : violet, 
by Juniper : greenish-yellow, reaction acid, by Santonin : reddish-purple, reac- 
tion alkaline, by Santonin : blood-red, hy Hasmatoxylon : magenta, by 
Fuchsin : reddish-brown, by Sulphonal. 

Smell, — fragrant, indicates Cystine or Sugar : fetid, alkalinity : of violets, 
Turpentine. 

Reaction, — in health of 24-hours' urine, is always acid ; but may be alkaline 
shortly after a meal. It is often alkaline from medicine or disease. If exces- 
sively acid, examine for crystals of uric acid. If alkaline, let the test-paper 
dry, so as to ascertain whether the alkali be fixed or volatile. 

Albumen by Heat and Nitric Acid. With Acetic Acid, or dilute Ammonia, 
make the urine slightly acid, if alkaline or neutral. If a precipitate appear on 
boiling, it may be Albumen or Phosphates. Add a drop or two of Nitric Acid ; 
if the precipitate dissolve, it is Phosphates; if not, it is Albumen. If a deposit 
or turbidity disappears on heating, it consists of Urates ; if not, add a drop of 
Nitric Acid ; if now dissolved, we have Phosphates ; if not, Cystine. Other 
Tests are the Potassio-Mercuric Iodide, the Sodium Tungstate, Potassium 
Ferro-cyanide, and Picric Acid Tests ; but the above described one, if carefully 
done, will give as good results as any. 

Bile Pigment and Acids, if necessary. Vogel's color-table. Marechal's 
Test, as follows : Put Z) of urine in a test-tube, and pour one or two drops of 
Tinct. Iodi to trickle down along the side of the tube, held horizontally nearly, 
so that the two fluids may touch, but not mix. If bile pigment be present, a 
fine green color will at once be developed below the red Iodine layer. Noel's 
Test, Pettenkofer's Test, Nitric Acid Test, Oxide of Silver Test. 

Sugar, if necessary. Urine containing sugar is usually light-colored, froths 
readily when poured from one vessel to another, and has a high specific gravity. 
Fehling's Test, as follows: Add to the boiling urine a few drops of freshly- 
prepared Alkaline Cupric Tartrate Volumetric Solution (Fehling's Solution). 
If sugar be present, a yellow, orange or red precipitate of Cuprous Oxide will 
form, 10 Cc. of the solution being reduced by gramme 0.05 of diabetic sugar 
(anhydrous glucose). For the preparation of Fehling's solution, see ante, page 
215. Much more convenient is Dr. Piffard's Cupro-Potassic Paste, or Dr. 
Pavy's Cupric Test Pellets, (See Tyson on Urine, page 57), or Wyeth's Com- 
pressed Tablets for preparing Fehling's Solution ; a box of the latter costing 
only 50 cents, and obtainable in any good drug>store. The writer has used 
these tablets for several years with great satisfaction. 

Pavy's Solution is a modification of Fehling's ; is equally good for qualitative 
and volumetric testing, and is intended for those who prefer the apothecaries' 
weights and measures to the metric system. It is made in the same manner 
as Fehling's, 100 minims corresponding to ]/ 2 grain of diabetic sugar, and con- 
sists of — Copper Sulphate, gr. 320; Potassium Tartrate (neutral), gr. 640; 
Caustic Potash, gr. 1280 ; and Distilled Water, f^ 20. 

Other Tests for sugar are Bottcher's Bismuth Test, the Fermentation Test, 
Moore's, Trommer's, the Picric Acid and the Indigo-Carmine. They are all 
useful, but will not be detailed here, as one good method is all that the average 
practitioner wants. 

Chlorides. Add a drop of Nitric Acid, and then Silver Nitrate until a pre- 
cipitate ceases to form. Thus estimate the amount of Chlorides. 

Urea. Place a drop of urine on platinum-foil, and to it add a drop of Nitric 
Acid, and leave undisturbed in a cool place for a minute or two. If the urea 
is in excess, crystals of Uric Nitrate form immediately. 

» 



CLINICAL EXAMINATION OF THE URINE. 



757 



To ascertain the percentage of urea present, use Parke, Davis & Co.'s 
Ureometer, employing the Solution of Sodium Hypobromite, instead of the 
solution of Chlorinated Soda, the former giving much the best results. This 
apparatus is simple, reliable, and quite accurate enough for clinical purposes. 

Mucus and Pus resemble each other so closely under the microscope, that it 
is almost impossible for any one, except an expert, to distinguish between them 
thereby. Mucus is more cloudy and flocculent to the naked eye than Pus, 
which latter is generally of a stringy consistence and thickish yellow appear- 
ance at the bottom of the vessel. The supernatant liquid being poured off, 
and an equal bulk of Liquor Potassae added, the deposit, if containing much 
pus, becomes gelatinized, and so tough that it cannot be poured out. If Mucus, 
Acetic Acid added coagulates it, forming delicate molecular fibres. 

Other Deposits are best examined with the microscope, and compared with 
good plates, rather than with printed descriptions. The plates in Hoffmann 
and Ultzmann on Analysis of the Urine, will answer the wants of most general 
practitioners, but the text follows the metric system. The urinary deposits 
may be classified thus : — 



In Alkaline Urine 
only. 


In Alkaline or Acid 
Urine. 


Organized Deposits. 


Calcium Phosphates 
Ammonium Urates 
Ammoniaco- 
magnesian, or 
Triple Phosphates. 


Uric Acid 

Urates 

Phosphates 

Oxalates 

Cystine. 


Mucus Torulae 
Pus Sarcinae 
Blood Vibriones 
Tube-casts Bacteria 
Spermatozoids, etc. 



Necessary Apparatus. A dozen Test-tubes. Alcohol lamp. A small porce- 
lain dish. 2 watch-glasses. A sheet of platinum foil, }i inch square. 3 pipettes 
of different sizes, to be used only for urine. A 2-oz. graduate. Urinometer. 
Blue and red litmus-paper. The reagents mentioned above. A little Grape- 
sugar, for use in testing the Fehling's solution. Ureometer (Parke, Davis & 
Co.'s). 

The foregoing directions comprise all that the average practitioner will usu- 
ally perform in the matter of urinary analysis. For fuller directions, the 
reader is referred to one of the numerous manuals on the subject, among 
which may be mentioned Da Costa on Medical Diagnosis, Chapter vn, — 
Tyson on the Practical Examination of Urine, — and Sir Henry Thompson's 
Clinical Lectures on Diseases of the Urinary Organs, Lecture xxiv. 

A " Physician's Pocket Reagent Case," intended for urinalysis at the bed- 
side, is put up by Parke, Davis & Co., and sold at the low price of $1.50. It 
contains a set of Dr. Oliver's Test Papers or Pellets (the latter preferable), a 
color scale, specific gravity beads, two test tubes, a pipette, and full directions 
for the use of the reagents. 



758 TREATMENT OF POISONING. 



THE TREATMENT OF POISONING. 

The most energetic poisons are Hydrocyanic Acid, some reptile poisons, 
Strychnine and Nicotine. (See pages 74, 306, 407.) Those usually selected for 
criminal purposes are Arsenic, Colchicum, and Tartarized Antimony, the 
symptoms of which resemble those of natural disease. 

General Principles of Treatment. In the treatment of poisoning, whether 
by mineral or vegetable substances, if the poison is known, the first indication 
is to administer the proper chemical Antidote, so as to render it harmless or 
comparatively so. Next, the stomach should be emptied and washed out, lest 
the newly-formed compound be absorbed after a time, and also in order to 
remove any of the poison which may have escaped the action of the antidote. 
Next, the appropriate Antagonist should be administered, to counteract the 
effects of such portion of the poison as may have been absorbed. Lastly, such 
Antagonistic Measures should be employed as may sustain the action of any 
organic function showing signs of failure. In most cases of alkaloidal poison- 
ing absorption has proceeded so far before professional assistance is obtained, 
that antidotes are of no value, and reliance can only be placed upon the 
physiological antagonist and such supporting measures as will tend to main- 
tain vitality until the poison can be eliminated by the natural channels. 

Antidotes and Antidotal Measures. 

Antidotes affect a poison, either physically or chemically or both, so as to 
remove it from the body or alter its character before absorption, and thereby 
prevent its toxic action upon the organism. They do their work in the ali- 
mentary canal or in the respiratory passages, and are applicable to vegetable 
as well as mineral poisons, but are not available against poisons administered 
hypodermically. Among them are Emetics, Cathartics, Washes, Injections, 
Ligatures, Poultices, the use of the Stomach-pump, of tourniquets, etc., which 
are termed Mechanical Antidotes ; and the Chemical or True Aiitidoles, which 
include Albumen, Milk, Charcoal, Soap, Starch, Oils, Tannin, Turpentine, 
Acids, Alkalies, Potassium Permanganate, Carbonates, Hydrates, Sulphates, 
Sodium Chloride, Iodine, Iron preparations, etc. 

Albumen is an ideal antidote, being harmless, easily procured, and forming 
compounds, which are more or less insoluble, with most of the metallic salts, 
corrosive alkalies and mineral acids, as also with Iodine, Bromine, Chlorine, 
Creosote, Anilin, and alcoholic solutions of most of the Alkaloids. It is 
especially suitable against inorganic poisons, and was recommended by Orfila 
for invariable use, even on mere suspicion of poisoning. It should be well 
diluted, the whites of four eggs to a quart of lukewarm water ; and should be 
followed by emetics and cathartics, as many of its compounds are soluble in 
an excess of itself. 

Milk is a good substitute for Albumen, its range of action being nearly the 
same. It is contraindicated, however, when fatty antidotes are to be avoided, 
by reason of its richness in fat. 

Oils and Fats are efficient against the corrosive acids and alkalies, metallic 
oxides and salts ; but are contraindicated in poisoning by Phosphorus, Canth- 
aris, or Copper salts, the absorption of which they promote. 

Soap, as Castile Soap, dissolved in 4 times its bulk of hot water, to make 
" suds," and given by the cupful, is one of the most efficient antidotes against 
corrosive acids and metallic salts, especially Corrosive Sublimate, Potassium 
Bichromate, and salts of Tin and Zinc. It should not be used against alkalies. 

Starch, in paste (1 part to 15 of water), is the antidote for Iodine and Bro- 
mine, and has some value against Corrosive Acids, Corrosive Sublimate, and 
Zinc and Copper Sulphates. 



TREATMENT OF POISONING. 759 

Tannin (Tannic Acid), precipitates the Alkaloids and their salts, with which 
it forms compounds (tannates), which, though comparatively insoluble, are not 
entirely inactive, and should be removed at once from the alimentary canal 
by emetics and drastic purgatives. It acts well against many metallic salts, 
though inferior to Albumen for these, except against Tartar Emetic, which 
albumen does not affect, but Tannin renders harmless. It is given in doses of 
gr. xv to xlv, in a 2 per cent, solution, every % hour ; and if not itself obtain- 
able, decoctions or infusions of substances containing it may be used, as tea 
and coffee, nut-galls, kino, rhatany, catechu, and the barks of oak, willow and 
cinchona. 

Magnesia (Magnesium Hydrate and Carbonate), when calcined, and gelatin- 
ized by mixing with 25 times its weight of warm water, is the most efficient 
antidote against Acids and their salts ; also against Oxalic Acid and the acid 
Oxalates, in the absence of the calcium antidotes therefor. It is also valuable 
against Arsenic, Phosphorus, Corrosive Sublimate and other metallic salts, 
forming with Arsenic a compound which is almost insoluble. It is given in 
doses of 3Jss to ij at short intervals for a few doses, then at longer intervals. 
An excess does no harm, but rather benefits by its cathartic action. 

Carbonates of Sodium and Potassium, also their Bicarbonates, are antidotal 
to most of the poisonous metallic salts, especially those of Zinc, which they 
immediately decompose, forming therewith insoluble basic compounds ; also 
against Iodine, Bromine and Potassium Bichromate. They are contraindicated 
for Oxalic Acid, with which they form dangerous compounds. , 

Calcium Carbonate and Hydrate, as Lime-water, Chalk, Egg-shells, or 
Oyster-shells powdered, are employed against Acids, especially Oxalic Acid 
and the acid Oxalates, which they neutralize and convert into the insoluble 
calcium oxalate. 

Sulphates, as Epsom and Glauber's Salts (Magnesium and Sodium Sul- 
phates), are particularly efficient as antidotes against Carbolic Acid and salts 
of Lead and Barium. 

Potassium Permanganate destroys organic poisons rapidly by oxidation, and 
is an efficient antidote therefor, if used promptly, before absorption has taken 
place. It has been employed successfully against Morphine and Strychnine 
salts in the stomach, and against snake-venom, locally. 

Iron Oxide in the Hydrated form, freshly prepared, is the official and best 
antidote against Arsenic, in the proportion of 10 parts to 1 of the latter. 
Dialyzed Iron, Saccharated Iron, and the basic Ferric Acetate, have also been 
used successfully in Arsenic poisoning. 

Emetics are often rendered needless by the vomiting brought on by the 
poison itself; and are contraindicated when there is severe corrosion of the 
alimentary canal, or when abdominal inflammation is present. Zinc Sulphate, 
gr. xx-xxx in water, is the best emetic for stomachal administration, being 
non-nauseating. For children, gr. v, or Tartar Emetic, gr. ss, in a little sweet- 
ened water. Apomorphine, gr. T V"1"> hypodermically, when narcosis prevents 
the use of emetics by the mouth. Apomorphine should always be administered 
hypodermically, as it is very uncertain in action when given otherwise. 
Mustard may be used, two teaspoonsful in a cup of warm water ; or the fauces 
may be tickled with a feather or the finger, until emesis occurs. 

Cathartics are useful after the chemical antidote, to remove its new com- 
pounds from the intestinal tract. The best are Castor and Croton Oils, Senna, 
and Epsom salt (Magn. Sulph.), but the Oils must be avoided in poisoning by 
Phosphorus, Cantharis or Copper salts. 

Antidote Bag, designed by Martindale, of London, contains the following- 
named articles, labeled with directions for use, viz. — 
Dialyzed Iron. Spt. Ammoniae Aromat. Amyl Nitrite. 

Syrup of Chloral. Oil of Turpentine. Zinc Sulphate. 

Chloroform. Acetic Acid. Ipecacuanha. 

Spt. Chloroformi. Tinct. Digitalis. Potassium Bromide. 

Calcined Magnesia. Tannic Acid. Potassium Permanganate. 



760 TREATMENT OF POISONING. 

Also a Hypodermic Syringe and Solutions or Pellets therefor of — 
Morphine Sulphate. Apomorphine Hydro- Pilocarpine Nitrate. 

Atropine Sulphate. chlorate. Strychnine Nitrate. 

General Antidotes have been devised for use when the nature of a poison is 
unknown, with the object of a " shot-gun prescription," intended to hit some- 
thing. One of the best is Jeaunel's, composed as follows, — Liquor Ferri 
Sulphatis (sp. gr. 1.45) ^ijss, Magnesia Calcinat. gij, Carbo Animalis ^j, Aqua 
^xx. These ingredients should be kept separate — the solution of the sulphate 
in one vessel, the others together. When needed, the former should be added 
to the latter and violently agitated. Dose, ^jss to Hjiij. This is a perfect anti- 
dote to Arsenic, Zinc, Digitalin, etc. It delays the action of salts of Copper, 
Morphine and Strychnine, and slightly influences compounds of Mercury. It 
is valueless for Cyanide of Mercury, Tartar Emetic, Hydrocyanic Acid, Phos- 
phorus, or the caustic Alkalies. 

Bellini, of Florence, considers the Iodide of Starch a valuable antidote to 
alkaline Sulphides, earthy Sulphides, vegetable and caustic Alkalies, and 
Ammonia. In the first two cases he considers it superior to all other antidotes. 

A fresh mixture of the Sulphides of Iron and Sodium with Magnesia, is said 
to be a perfect antidote for Copper salts, Corrosive Sublimate and Mercuric 
Cyanide. If the nature of the poison is entirely unknown, a harmless yet 
effectual antidote in most cases is one composed of equal parts of Magnesia, 
Wood Charcoal, and the Hydrated Ferric Oxide, given freely in plenty of 
water. 

Bouchardat's Antidote for vegetable poisons consists of Iodine, gr. iij, Potas- 
sium Iodide, gr. xxx, Aqua Destillata ^xj ; the dose of which is ^jss-iij fre- 
quently repeated. 

Antagonists and Antagonistic Measures. 

Antagonists in toxicology are agents which oppose each other in their 
physiological action, and may be employed against each other as counter- 
poisons, to neutralize their effects upon the organism. They do their work in 
the blood and tissues, after absorption, and are especially available against 
poisons administered hypodermically, in both which cases antidotes are use- 
less. Substances so employed are generally the active principles of plants, a 
few being chemicals, as Oxygen and Chloral. Antagonistic Measures include 
such proceedings as tend to neutralize the remote effects of poisons, as arti- 
ficial respiration, faradism of the respiratory muscles, hot and cold applica- 
tions, douching, constant motion or absolute repose, etc. 

Poisons, their Antidotes and Antagonists. 

Acids. Antidotes. — Alkalies for the least irritant acids, Magnesia, Mag- 
nesium Oxide, Lime, slaked, Chalk ; plaster from wall with water, milk, oil, 
white of eg?;, bland mucilaginous drinks and poultices (R). Antagonists. — 
See Acids, Mineral, below. 

Acid, Acetic. Antidotes. — Magnesia or Magnesium Carbonate, freely ; Soap 
and water, Lime-water, Chalk, White-wash ; also milk, oils and thick gruel 
may be given. Antagonists. — Morphine, gr. % hypodermically, to ward off 
shock. 

Acid, Carbolic. Antidotes. — Any soluble Sulphate is the best, to form a 
sulpho-carbolate, as Magnesium or Sodium Sulphate, (Epsom or Glauber's 
salts). In a case where l /z oz. of 95 per cent, acid had been taken, nearly 
3 ozs. of Magnesium Sulphate were used, resulting in full recovery from an 
apparently hopeless condition. Liquor Calcis Saccharatus, or the official 
Syrupus Calcis, given freely. Soap, in strong watery mixture (suds), is said to 
be almost a perfect antidote. Cider Vinegar may prove antidotal, as it removes 



TREATMENT OF POISONING. 76 1 

the effects of the strong carbolic acid applied locally. Vegetable Demulcents, 
(but no oils or glycerin), to protect the mucous surface. Sodium Carbonate, in 
strong solution locally, for the effects of its local use in excess : this also as a 
wash for the mouth, if necessary. Antagonists. — Atropine is a very complete 
antagonist to the systemic symptoms, maintaining the heart and respiration 
until elimination occurs: gr. -^ hypodermically. Amyl Nitrite, by inhalation. 
Alcoholic stimulants freely. Heat to the extremities, also Faradism and fric- 
tion thereof. Venesection in desperate cases (Murrell). 

Acid, Hydrocyanic (Prussic). Forty minims of the official diluted acid has 
proved a fatal dose. Antidotes, — if time to do anything. Per- and Proto-salts 
of Iron with Magnesia. Ammonia, diluted, by inhalation, or Chlorine-water as 
spray, for the vapors. Calcium or Sodium Chloride, gr. xxx-xl, in water. 
Emetics or stomach-pump. Antagonists. — Stimulants, as Brandy, Chloric 
Ether, Ammonia, ad libitum. Alternate hot and cold Douche, from a height. 
Artificial Respiration. Faradic current (mild) to chest walls and over cardiac 
region. Atropine has antagonistic action, but is too slowly diffused to be of 
any value. Ammonia by inhalation, by the stomach, and by intra-venous 
injection, with cold affusion to the spine, and artificial respiration, are the 
measures most likely to avail in cases where there is time to do anything. 

Acids, Mineral. Antidotes. — Alkalies, as Sodium Carbonate, or Bicarbonate, 
Magnesia, or Chalk, Soap, Whiting, Wall-plaster, in water. Albumen, Flour, 
Milk, Starch, Olive Oil, to protect the mucous membrane. Avoid water in 
Sulphuric Acid cases. Antagonists. — Opium, Ammonia (intra-venously), Al- 
cohol, as stimulants, to combat the depression of the vital powers. 

Acid, Oxalic, also the Acid Oxalates, as Potassium Oxalate, known as " Salts 
of Lemon " or of " Sorrel," used for removing ink-stains. Antidotes. — Calcium 
Carbonate or Hydrate (as lime-water, chalk, whiting, wall-plaster, in water), or 
Magnesia. Avoid Potassium and Sodium Carbonates and Bicarbonates. 
Bland mucilaginous drinks and poultices to the abdomen. 

Aconite. Antidotes. — Tannic Acid, or Animal Charcoal, powdered, in water. 
Emetics or the stomach-pump. Castor Oil, or other purgatives. Bland fluids, 
and poultices for abdominal irritation. Antagonists. — Atropine, Caffeine, 
Morphine, Ether, Ammonia, Amyl Nitrite, antagonize its effects on the heart 
and respiration. Digitalis antagonizes its action on the heart and its relax- 
ation of cardiac inhibition (Fothergill). In Aconite-poisoning the stomach 
should be evacuated, warmth applied to the extremities, stimulants adminis- 
tered, artificial respiration if necessary, and the recumbent posture strictly 
maintained. Caffeine may be administered hypodermically, and strong Coffee 
by the mouth. 

Alcohol. Antidotes. — Emetics or the stomach-pump, if much alcohol re- 
cently swallowed. Antagonists. — Ammonia by inhalation cautiously. Cold 
affusion to the head. Warmth to the extremities. Faradism of the muscles of 
respiration. Artificial Respiration. Chloral, gr. xx-xxx every 4 hours to 
secure sleep. Bromides for the same purpose, or Capsicum in doses of 
gr. xx-xxx. Ammonium Chloride, about gss in half a pint of water at one 
draught, has a marvellous effect in generally straightening up the victim, 
antagonizing stupor and restoring faculties. Hyoscine, as hypnotic, gr. tpo-^o 
hypodermically. [Compare Alcoholism and Delirium Tremens in Part III, 
also page 101, ante.] 

Alkalies. Antidotes. — Acids, diluted, especially the vegetable acids, as Vine- 
gar, Lemon-juice, etc. Albumen. Milk. Gelatin. Oils to protect the mucous 
surfaces. [Compare Ammonia below.] Antagonists. — Opium for the shock 
and vital depression, also Caffeine, Alcohol, and other stimulants. 

Alkaloids. Antidotes. — Tannin holds high rank, forming tannates, which 
are comparatively insoluble. Potassium Permanganate (see ante, page 316) 
Albumen. Iodine. Charcoal. Emetics and cathartics afterwards. Antago- 
nists, — differ for each. [See their several titles below.] 



762 TREATMENT OF POISONING. 

Alum. Antidotes. — Carbonates of Ammonium, Potassium, etc. Other treat- 
ment as for corrosive salts. [See Metallic Salts below.] 

Ammonia. Sources of Danger are the use of Smelling Salts or Spirit of 
Hartshorn in excess, and the strong solution of Ammonia kept by house- 
keepers for laundry purposes. Antidotes. — Vinegar, Lemon- or Orange-juice, 
any Vegetable Acid, followed by demulcents to protect the mucous surfaces. 
When inhaled, give vapor of Acetic or Hydrochloric Acids or Chlorine-water 
by inhalation, the two latter forming the chloride. Antagonists. — Aconite, 
Veratrum, Digitalis, as cardiac sedatives. 

Amyl Nitrite. Antagonists. — Ergot, Belladonna, Strychnine, Brucine, Digi- 
talis, Picrotoxin, and all other agents which increase the functional activity of 
the spinal cord and sympathetic, are antagonistic, though not always available 
by reason of their slower rate of diffusion. Stimulants, artificial respiration, 
the alternate cold and hot douche, with cold to the head, and Ergotin or Atro- 
pine hypodermically, are the best measures to be used in cases of poisoning by 
the Nitrites. 

Anaesthetics, (Ether, Chloroform, etc., by inhalation). Antagonists. — Atro- 
pine, hypodermically, is of great value in combating the cardiac and respira- 
tory failure of Ether (Amidon in N. Y. Med. Record, May 2d, 1885)-, and is 
equally efficient in Chloroform poisoning, as I have found by experience 
(Potter). Amyl Nitrite by inhalation. Ammonia, the solution, rt^x in n\,xl 
aquae, intravenously, — Bartholow says unsuccessfully. Heat to body and 
limbs, Ice in the rectum. Artificial Respiration. Faradism of respiratory 
muscles. Invert patient, draw tongue well forward with forceps, compress and 
relax chest, maintaining position until pulse and respiration are good (Nelaton). 
Oxygen by inhalation, fresh air, coffee. 

Antimony, (as Tartar Emetic, etc.). Antidotes. — Tannin, or any substance 
containing it, is the antidote, forming the insoluble tannate. Carbonates of 
Magnesium and Sodium. Magnesia, in milk, especially for the Chloride of 
Antimony. Alkalies and Salts of Lead decompose Tartar Emetic. Emesis by 
tickling the fauces. Demulcent drinks freely, to protect the mucous membranes. 
Water, warm, in large draughts ; or lavage of stomach with water first, then 
with solution of Tannin. Albumen, or Milk. Antagonists. — Opium, Alcohol, 
Ether, and other antispasmodics. 

Arsenic (Arsenous Acid). Gr. ij have been fatal. Antidotes. — Hydrated 
Ferric Oxide, freshly precipitated, by precipitating a solution of Ferric Chloride 
with Sodium Carbonate or Ammonia, — or as the official Ferri Oxidum Hydra- 
turn cum Magnesia, (See ante, page 236), in the proportion of gr. viij for each 
grain of the poison ingested. Dialyzed Iron, is quite efficient as an antidote, 
is more easily obtained than the hydrated oxide, and has rendered good service 
in many cases of poisoning from inhaling arsenical fumes. Ferri Subcarbonas 
is equally good, §ij followed by Castor Oil (Leale) ; or Hydrated Magnesia, or 
Magnesia and Sugar (Carl). Magnesium Bicarbonate or other alkalies (R). 
Charcoal, ^ss or more (R). Saccharated Ferric Oxide. Basic Ferric Acetate. 
Apomorphine, hypodermically, or Zinc Sulphate, as emetic, (avoid Tartar 
Emetic). Emesis by feather-tickling. Oil and Lime-water mixed, before and 
after emesis (Taylor). Milk or other bland fluids to wash stomach. Castor 
Oil after emesis. Magnesia and Linseed tea. Poultices and fomentations over 
abdomen. Potassium Iodide afterwards to promote elimination. Antagon- 
ists. — None. 

Com?non Sources of Danger, — are arsenical wall-papers, Arsenic mistaken 
for "salts" or for "magnesia," adulterated confectionery, also Paris Green 
(Cupric Aceto-Arsenite) taken with suicidal intent. 

Barium Salts. Antidotes. — Sulphate of Magnesium, Sodium (Epsom and 
Glauber's salts), Calcium, or Potassium. Diluted Sulphuric Acid. 

Bee and Insect Venom. Antidotes. — Aqua Ammonias, Sodium Bicarbonate 
or Chloride, or Carbolic Acid, applied to the wound ; or n\,xv of a 2 per cent. 



TREATMENT OF POISONING. 763 

solution of the first hypodermically, with Liquor Ammonii Acetatis internally. 
[Compare the article Stings in part III.] 

Belladonna and Atropine. Caustic alkalies decompose Atropine and are there- 
fore incompatible with the preparations of Belladonna. Antidotes. — Tannin. 
Zinc Sulphate or Apomorphine, as emetics, or the Stomach-pump. Purgation. 
Magnesium Bicarbonate, and other alkalies (R). Charcoal, ^ss or more is 
necessary (R). Antagonists. — Morphine is the physiological antagonist to the 
effects of Atropine on the cerebrum, pupils, heart, respiration, arterial tension 
and kidneys. Aconite, Physostigmine, Pilocarpine and Quinine are each 
antagonistic to some of its effects, Muscarine to most of them. Brandy or 
strong Coffee. Capsicum. Faradism of respiratory muscles. Flagellation. 
Cold to the head. Ammonia, breathed into air-passages (R). 

Bromides. Antidotes. — Nitrous Ether is incompatible with Ammonium 
Bromide, Acids and Metallic Salts are so with all the Bromides. Poisoning 
thereby is always chronic, never acute, hence no antidotes can be employed. 
Antagonists. — Morphine is the most efficient, especially for the mental symp- 
toms. Digitalis, Ergot, Belladonna, and other vaso-motor stimulants, antag- 
onize many of the effects of the bromides. Cocaine is useful in chronic 
depressant poisoning thereby, and Alcohol with Opium as a nervous stimulant. 

Bromine. Antidotes. — Albumen. Starch. Gelatin. Sodium and Potassium 
Carbonates and Bicarbonates. Against the irritant vapor, Ammonia vapor by 
inhalation, or steam inhalations. Antagonists. — Opium and Alcohol as stimu- 
lants, if much depression ensues. 

Camphor. Antidotes. — Water to precipitate it from the alcoholic solution. 
Alkalies and earthy salts precipitate even the small quantity which is soluble 
in water. Emetics to remove as much as possible. Antagonists. — Aconite and 
other arterial sedatives. Coffee. Cold. Alcoholic stimulants. Opium and 
Bromides for the convulsions. 

Cannabis Indica. Antidotes. — Emetics to remove as much as possible. 
Caustic Alkalies are incompatible. Antagonists. — Alcohol, as stimulant. 
Strychnine as respiratory stimulant. Faradism of muscles of respiration. 
Lemon-juice is said to antagonize its effects, which last over 24 hours from a 
large dose. 

Cantharis. Avoid Oils, also fats and milk, which promote its absorption. 
Antidotes. — Emetics. Demulcents (as linseed tea, gruel, barley-water), freely. 
Water in large quantity, to flush the kidneys. Oleaginous injections into the 
bladder to allay irritation. There is no chemical antidote. Antagonists. — 
None, but Opium may be given for the gastro-enteritis. 

Chloral Hydrate. All Alkalies are incompatible. Antidotes. — Emetics or 
the stomach-pump, if patient is seen shortly after ingestion of a toxic dose. 
Reliance must be placed on the antagonism of the following. Antagonists. — 
Strychnine, but only to a limited extent ; though Chloral is the most perfect 
antagonist to strychnine, opposing its spinal action. Heat to the body and 
limbs, by hot blankets, hot water bottles, etc., is the most efficient antagonist. 
Atropine antagonizes its cardiac, respiratory and spinal depression, and should 
be used hypodermically, in small doses (gr. ^jo), frequently repeated, until its 
effects are apparent. Morphine administered with Chloral antagonizes its 
tendency to produce cardiac failure, while synergistic to the hypnotic action of 
the drug. Cocaine is of value for the cardiac and respiratory depression. 
Alcoholic stimulation. Amyl Nitrite by inhalation. Frictions. Coffee, black, 
a pint injected into rectum, as for narcotic poisoning. Artificial Respiration. 

Chlorine. Antidotes. — Albumen for Chlorine preparations in the stomach, 
also Aqua Ammoniae in small quantity, well diluted. Ammonia vapor inhaled 
against Chlorine inhalations, forming Ammonium Chloride. Ammonium Sul- 
phide has similar reaction, but should be used in great moderation. Fresh air. 
Steam inhalations. Emesis with warm water, then white of egg or milk, flour, 
or lime-water. Antagonists. — Chloroform by inhalation to ease the cough. 



764 TREATMENT OF POISONING. 

Chloroform (swallowed). Antidotes. — Sodium Carbonate in plenty of water. 
Emetics. Treatment as for irritant poisoning. Antagonists. — Atropine, hypo- 
dermically. Amyl Nitrite ; by inhalation. Coffee, black, a pint into the rectum. 
Heat to the body and especially to the cardiac region. Rouse by slapping with 
wet towel. Mustard to calves of legs and over the heart. Relapse may occur, 
hence the patient should not be left for some time after apparent restoration. 

Coal-gas. Antidotes. — Chlorine-water as spray, inhaled. Antagonists. — 
Oxygen by inhalation, 4 or 5 quarts. Ammonia vapor inhaled. Galvanism, 
by interrupted current to extremities. Artificial Respiration, to be maintained 
steadily for hours. Fresh air, in plenty ; open all doors and windows. Coffee, 
black, a pint as enema. Venesection may be of service. Douche, alternately 
cold and warm, to head and chest. Horizontal position, clothing removed. 
Alcohol moderately by mouth or rectum. Catheter may be required in pro- 
longed cases. Subsequently, a warm bed, open windows ; Condy's fluid 
about the room, stimulants sparingly, cold acid drinks freely. 

Cocaine. Antidotes. — See Alkaloids, above. Antagonists. — Chloral is the 
most direct antagonist, so also are Chloroform and Ether. Morphine is directly 
antagonistic at almost all points of action. Amyl Nitrite combats the earliest 
symptoms of cardiac depression, then Alcohol and Opium as cardiac stimulants. 
Artificial Respiration may be required. 

Colchicum. Antidotes. — Tannic or Gallic Acid, followed by emetics and 
cathartics. Demulcent drinks, warm. Antagonists. — Alcoholic stimulants. 
Morphine, hypodermically for the cardiac depression. Treatment is the same 
as that for Aconite poisoning. 

Conium. Antidotes. — Tannic or Gallic Acid, followed by emetics and 
cathartics. Antagonists. — Nux Vomica and its alkaloids, also Picrotoxin and 
other tetanizers. Alcohol. Muscular Movement. Heat applied externally, as 
soon as the stomach has been evacuated. 

Copper Salts. Antidotes. — Albumen. Soap. Gluten. Milk. Sugar. Mag- 
nesia. Potassium Ferrocyanide. The latter is the most efficient chemical anti- 
dote, but Magnesia or Albumen may be used. In the absence of eggs, give a 
thin paste of flour and water. Any antidote should be followed by prompt 
evacuation of the stomach, and Potassium Iodide to saturation of the system. 
Antagonists. — Opium and Demulcents for the gastro-enteritis. 

Corrosive Sublimate (Corrosive Mercuric Chloride). Antidotes. — Albumen. 
Gluten. Magnesia. Milk. Lime-water, Albumen, in some form, is the most 
efficient ; the white of one egg to each 4 grains of the poison, forms the albu- 
minate, which must be at once evacuated by emesis or the stomach-pump, it 
being soluble in an excess of albumen, also in the alkaline contents of the in- 
testines. Potassium Iodide for after-treatment, converts the poison into solu- 
ble combinations and promotes their elimination. Charcoal, ^ss or more neces- 
sary (R). Hydrated Protosulphide of Iron, if given within 20 minutes, is said 
to be an efficient antidote. Antagonists. — See under Mercury, below. Fatal 
Dose. — gr. iij have proved fatal. 

Creosote. Antidotes. — Mucilage, Oils, are the most easily obtained. Antag- 
onists. — Ammonia, for depression. Treatment is the same as for Carbolic 
Acid, which see. 

Curare. Antidotes. — Ligate above wound, if any ; incise the part freely and 
suck it strongly. Evacuation of the bladder repeatedly, to prevent reabsorp- 
tion. Caustic Alkalies destroy the poison. Antagonists. — Artificial Respira- 
tion is the most efficient antagonist, maintaining life until elimination occurs. 
Strychnine, though from a member of the same family of plants, is antagonis- 
tic as to the action upon the heart and respiration. So also is Atropine. 

Cyanide of Potassium. Antidote. — Ferrous Sulphate to form Prussian Blue 
(Ferric Ferrocyanide), followed by evacuation of the stomach. Antagonists. — 
Ammonia, intravenously. Alcohol. Artificial respiration. [Compare Acidum 
Hydrocyanicum, above]. 



TREATMENT OF POISONING. 765 

Digitalis. Antidote. — Tannic Acid, to form the tannate, which, however, is 
not inert, so that the stomach should be immediately evacuated. Antagonists. 
— Aconite for the effects of large doses, Opium for those due to its continued 
use. Saponin and Senegin are its most complete physiological antagonists. 
Alcohol. Galvanism. Horizontal posture. The treatment is similar to that 
for Aconite. 

Ergot. Antidote. — Tannic Acid, followed by an emetic. Antagonists. — Amyl 
Nitrite, Aconite, Veratrum Viride, Tobacco and Lobelia, antagonize its action 
on the circulation. 

Fish-poison. Antidotes. — Emetics and Cathartics. Antagonists. — Potassium 
Chlorate freely. Liquor Ammonii Acetatis. Opium. Capsicum. Chloroform. 

Gamboge. Antidotes. — Potassium or Sodium Carbonates. Magnesia in 
milk. Emetics. Mucilaginous drinks. Antagonists. — Opium for the depres- 
sion. Alcoholic stimulants. 

Gases and Vapors. See under Acid Carbonic, Acid Hydrocyanic, Am- 
monia, Chlorine, Coal-gas, Sulphuretted Hydrogen. 

Gelsemium. Antidote. — Tannic Acid, followed by an emetic or the stomach- 
pump, if recent. Antagonists. — Morphine is the most complete. Digitalis, 
Ammonia, Alcohol, Atropine, and to some extent the tincture of Xanthoxylum, 
are also antagonistic. Heat externally, Faradization of the respiratory muscles, 
and Artificial Respiration are measures of prime importance. Brandy and 
Capsicum are useful. 

Glass (coarse or powdered). Antidotes. — Bread-crumbs freely to envelope 
it, then emetics. 

Gold Salts. Antidotes. — Ferrous Sulphate. Albumen, as eggs or flour. 
Mucilage. Emetics. Treatment as for Corrosive Sublimate. 

Hyoscyamus. See Belladonna, above. 

Hypochlorites. See Javelle Water, below. 

Ignatia. See Nux Vomica, below. 

Iodine. Antidotes. — Starch. Albumen. Flour. Gelatin. Sodium and 
Potassium Carbonates and Bicarbonates. Starch is the antidote to free Iodine, 
but the stomach must be evacuated, as the Iodide of Starch is not inactive. 
In chronic poisoning by the Iodides, a free salivary flow induced by chewing 
Pyre thrum-root will hasten elimination of the drug. Antagonists. — Quinine, 
Digitalis, and other restorative agents and vaso- motor tonics. Amyl Nitrite. 
Morphine, for pain. 

Ipecacuanha. Antidotes. — Vegetable Acids and Astringents are incom- 
patible with Ipecac, and may be used as antidotes. Antagonists. — Bismuth, 
Carbolic and Hydrocyanic Acids, also Narcotics, antagonize the emetic action. 

Iron. Antidotes. — Ammonium and Sodium Carbonates. Magnesia. Mucil- 
aginous drinks. 

Javelle Water (Potassium Hypochlorite), Labarraque's Solution (Sodium 
Hypochlorite), and Bleaching Powder (Calcium Hypochlorite). Antidote. — 
Sodium Hyposulphite, in dose of gr. xv, well diluted and frequently repeated, 
reducing them to chlorides, itself undergoing oxidation to the sulphate. 

Lead Salts. Antidotes. — Sodium or Magnesium Sulphate. Sodium Phos- 
phate. Diluted Sulphuric Acid. Magnesium Bicarbonate. Ferrous Sulphate, 
freshly precipitated. Albumen. Milk. Emetics or the stomach-pump. Potas- 
sium Iodide, gr. xv-xxx, 3 or 4 times daily, in cases of chronic poisoning, as 
eliminative (R). The cachexia is much relieved by a combination of Quinine 
Sulphate, Ferrous Sulphate and Diluted Sulphuric Acid (B). Baths of Potassa 
Sulphurata (^j or more in the necessary water), are also very useful in chronic 
poisoning by Lead (R). Antagonists. — Opium, to allay irritation. Belladonna, 
the extract, gr. yi, with Pulv. Rhei, gr. ij, in pill twice daily, for the great pain 
at defecation (Da C). Alum, is the most efficient remedy for the colic ; to a 
pint of boiling milk add 90 grains of powdered Alum, separate the curd and 



766 TREATMENT OF POISONING. 

sweeten with sugar; give a wineglassful every hour or two (B). Strychnine, 
for the paralysis, gives good results; also Atropine, gr. t 1q, with Potassium 
Iodide, gr. v. Electricity, a slowly interrupted current until it causes reaction, 
for the paralysis of extensors (dropped wrist) ; cure to be completed by the 
faradic current (B). Marked Diagnostic Signs of chronic poisoning by Lead 
are — the dropped wrist, due to paralysis of extensor muscles ; dark, blue line 
around margin of gums. 

Lime. Antidotes. — Calcium Chloride, Albumen. Mucilaginous drinks, or 
Oils. Milk. Flour and water. Avoid acids. Antagonists. — Opium, Alcohol, 
for vital depression. 

Lobelia. Antidotes. — Tannic Acid, to form the insoluble tannate. Char- 
coal, powdered in water. [See Aconite, above.] Antagonists. — Alcohol, 
Digitalis, Belladonna, Ergot, the vaso-motor excitants, antagonize its effects on 
the circulation ; Strychnine, Picrotoxin, and Thebaine, those on the nervous 
system. 

Mercury. [See Corrosive Sublimate above, also Metallic Salts below.] 
Antidotes. — Albumen. Gluten. Flour. Milk. Vegetable astringents. Hy- 
drated Protosulphide of Iron. Charcoal. Alkalies, especially Magnesium Bi- 
carbonate (R). Potassium Iodide, to saturation of the system, as after-treat- 
ment; converts the metal into soluble combinations (B). Baths, simple or 
sulphurous (R). Antagonists. — Bismuth, Tannin, Sodium Sulphite, Diluted 
Nitric Acid in water, as gargles and mouth-washes for salivation. Belladonna, 
Tt\,v-x of tincture every 4 to 6 hours, to lessen secretion in ptyalism (B). Hyos- 
cyamine, for the tremor, gr. -^ gradually increased to gr. -^ w (Oulmont). 

Metallic Salts. Antidotes. — Albumen. Milk. Magnesia. Starch. Soap. 
Oils and other demulcents. Sodium or Potassium Carbonate and Bicarbonate. 
Lavage of stomach. Emetics and cathartics. Antagonists. — Opium, Alcohol, 
Cocaine, and other stimulants, when shock and vital depression. 

Mezereum. Antidotes. — Albumen. Milk. Oils and fats. Mucilaginous 
drinks. Antagonists. — Opium, as stimulant against shock and depression. 
Poultices, cool, to abdomen. 

Morphine. See Opium, below. 

Muscarine. Antidotes. — See Alkaloids, above. Antagonists. — Atropine 
exactly opposes Muscarine, and vice versa. Digitalis is antagonistic to some 
extent, so also is Physostigmine. There is no example of physiological antag- 
onism so complete in all particulars as that between Atropine and Muscarine. 
[See ante, page 92.] 

Mushrooms. Antidotes. — Emetics, if poisoning very recent ; Cathartics, 
especially Castor Oil, if some time has elapsed. Tannic Acid, has been recom- 
mended. Antagonists. — Atropine. Alcoholic stimulants. Poultices, warm, 
to abdomen. [Compare Muscarine, above.] 

Nitrobenzol. Antidotes. — Ammonia, diluted, by inhalation. Emetics. An- 
tagonists. — Alcohol, Liq. Ammoniae (3ss in water), or Chloric Ether (3j in 
water), frequently repeated, as stimulants, given internally, by enema or hypo- 
dermically (brandy). Atropine. Artificial Respiration. Galvanic current, in- 
terrupted, to chest-walls, and over cardiac region. Fatal Dose. — Death has 
resulted from merely tasting it. 

Nitroglycerin. See Amyl Nitrite, above. 

Nitrous Oxide Gas. Antagonists. — Artificial Respiration, to be commenced 
at once and kept up for two hours if necessary, not faster than 18 per minute. 
Fresh air, open all doors and windows, and fan the patient. Oxygen by in- 
halation, 3 or 4 pints. Douche to chest, alternately hot and cold. The tongue 
should be pulled well forward, and the mouth cleared of any obstruction to 
respiration, as artificial teeth. In apparently hopeless cases, two or three violent 
blows on the chest, delivered in quick succession, may restore the cardiac action 
(Murrell). 



TREATMENT OF POISONING. j6j 

Narcotics. See Alkaloids, also Opium, Belladonna, etc. Vegetable 
Acids antagonize the after effects to some extent. 

Nux Vomica and Strychnine. Antidotes. — Tannic Acid, forms the very 
insoluble tannate. Iodine in dilute solution, or a soluble salt thereof. Animal 
Charcoal, largely. Potassium Permanganate has been taken in large dose by 
Dr. Fahr, of Milford, N. J., after having ingested gr. % of Strychnine, resulting 
in the entire absence of any symptoms of strychnine poisoning. Emetics or 
the stomach-pump should follow the administration of any antidote. The 
bladder must be frequently evacuated to prevent reabsorption. Antagonists. — 
Quiet, as perfect as possible, is very important. Chloral is the antagonist, gr. 
xxx as soon as possible, repeated in 20-grain doses at hourly intervals, as long 
as reflex exaltation continues. Potassium Bromide, is almost too slow of action 
to be of much practical service. Tobacco, by enema. Chloroform or Ether 
inhalation, to procure muscular relaxation. Physostigma is antagonistic (R). 
Chamomile Oil, remarkably subdues reflex excitability in frogs after poisoning 
by Strychnine or Brucine (P). Amyl Nitrite, by inhalation (R). Veratrum 
Viride, cured a bad case ; Z] was given at once, then gtt. ij every ten minutes 
(R). Urethan. Methyl and Ethyl compounds of Strychnine, Brucine, and 
Thebaine. Monobromated Camphor. Ice to spine. Valerian mitigates the 
spasms (P). Curare, gr. % hypodermically; is warmly recommended, but its 
claims are doubtful (P). Nicotine, many cases prove its curative power (P). 
Hydrastinine Hydrochlorate, in doses of gr. j hypodermically, has been suc- 
cessfully employed. Artificial Respiration, if possible. Fatal Dose of Strych- 
nine, — gr. ^ for an adult, gr. -^ for a child. 

Opium and Morphine. Antidotes. — Tannic Acid, or vegetable astringents, 
followed by evacuation of the stomach, if the poison has been taken by the 
mouth. Charcoal, ^ss or more (R). Compound Tincture of Iodine. Apo- 
morphine, as emetic, gr. -^ to -^ hypodermically ; must be administered before 
narcosis sets in (B). Stomach-pump better than emetics, which by the mouth 
are generally useless in these cases. Potassium Permanganate, an efficient 
antidote if given soon after ingestion of the poison, — (See ante, page 316) ; and 
as Morphine in part re-enters the stomach after making the round of the circu- 
lation, this antidote will probably act continuously if taken from time to time 
(Waugh). Antagonists. — Atropine, hypodermically, gr. t ^q every 1 5 minutes 
for three doses (B) ; antagonizes the cerebral action, also that on the respira- 
tion, heart, and arterial tension ; but, if given too freely, will endanger the case 
by deepening the narcosis. No one is warranted in omitting it (P). Caffeine, 
is also antagonistic, and may be given hypodermically, though generally used 
in the form of strong coffee, frequently administered by mouth or rectum. 
Cocaine, is of especial value against the cardiac and respiratory depression. 
Strychnine, efficiently antagonizes the respiratory paralysis, and may be used 
in lieu of Atropine, or in conjunction therewith. Amyl Nitrite, by inhalation, 
or Ammonia by intravenous injection, when the heart shows signs of failure ; 
the former proved eminently successful in a case wherein Atropine proved 
useless to restore the patient. Capsicum, the tincture, ^ss-j by rectal injec- 
tion, is said to antagonize the stupor almost instantaneously. Vegetable Acids, 
as Vinegar and water, Lemon-juice, Cream of Tartar in water, etc., every 10 
minutes (R); to antagonize the narcotism. Douche, alternately cold and hot, 
or hot water and ice alternately to nape of neck, for the narcosis. Artificial 
Respiration, should be kept up for at least two hours (Murrell). Potassium 
Bromide removes some of the cerebral effects of Opium, as the vertigo and 
mental confusion ; others are antagonized by Quinine, and the general intra- 
cranial effects of the drug are to some extent opposed by Digitalis and Tartar 
Emetic. 

The Chief Indications in Opium-poisoning are — to evacuate the stomach, 
maintain respiration, and keep up the circulation. Faradization of the chest 
muscles, cold affusion and artificial respiration are of great value, and evacua- 
tion of the bladder frequently is important, to prevent reabsorption. Flagella- 
tion is a very dangerous procedure, from the exhaustion which may be thereby 



768 TREATMENT OF POISONING. 

induced, — strong faradic currents are much more efficient. The anode should 
be placed over the lowest conjoined root of the phrenic nerve, the cathode 
three inches below the ensiform cartilage and a little to the left of the median 
line. 

Common Sources of Danger. — Overdosing with cough mixtures, or Paregoric, 
or the Soothing Syrups so much used for quieting children, all of which contain 
Opium. The American Journal of Pharmacy estimates the loss of life from 
the latter cause at 150,000 yearly. 

Fatal Doses. — See page 316, ante. 

Phosphorus. Antidotes. — Cupric Sulphate as emetic and chemical antidote, 
forming a phosphide of copper, which is comparatively insoluble ; doses of 
gr. iij in dilute solution every 5 minutes until emesis occurs. Turpentine, old 
and acid (French Turpentine) containing oxygen, is the best antidote ; it may 
be given rapidly in a gum emulsion. Lime-water or Charcoal, to prevent 
action on the tissues. Hydrated Magnesia, as a quickly acting purgative; 
may be given in Linseed tea. Copper Carbonate, with sugar and water. 
Avoid Oils, Fats and Milk, as they dissolve the poison and promote its absorp- 
tion. Antagonists. — Opium, to counteract the cardiac and systemic depres- 
sion. Transfusion, to repair the blood. 

Physostigma. Antidotes. Emetics or the stomach-pump. Tannic Acid or 
vegetable astringents. Antagonists. — Atropine, as to the effects on the respira- 
tion, heart and pupil; gr. -^ to -^ hypodermically, repeated until effects are 
evident. The one nine-thousandth of a grain of Atropine, injected 5 minutes 
before giving a minimum fatal dose of Physostigma, prevents its fatal result 
(R). Chloral, is also antagonistic, and over a greater field of action, but to be 
effective must be administered very early in the case (R); gr. x by mouth or 
rectum every }4 hour. Strychnine, gr. g 1 ^ of the sulphate or gr. y 1 ^ of the 
nitrate, hypodermically; or the Tincture of Nux Vomica, rr\,xx by mouth or 
rectum, in very bad cases (Murrell). Stimulants, freely. Artificial Respira- 
tion. Fatal Dose, — gr. i T 2 ^ is given as the minimum fatal dose. 

Picrotoxin. Antidotes. — Emetics or stomach pump. Acetic Acid gives relief 
in overdosing, and may have some antidotal power. Antagonists. — Chloral, is 
antagonistic to its cerebral and spinal action, but synergistic to its depressant 
power over the heart and respiration. Anaesthetics, against its spasm-produc- 
ing action. Potassium Bromide, in addition to Chloral, if tetanus (Murrell). 

Pilocarpine (Jaborandi). Antidotes. — Persalts of Iron and salts of the metals 
generally, are chemically incompatible. Antagonists. — Atropine, gr. y^y for 
gr. £ of the poison, is a complete antagonist, the most so known to physio- 
logical experimentation. Conversely, Pilocarpine is exactly antagonistic to 
Atropine, but Jaborine acts similarly to the latter. Morphine controls the 
nausea and vomiting. 

Potash. See Alkalies, above. 

Potassium Bichromate. Antidotes. — Sodium and Potassium Carbonates and 
Bicarbonates. Soap. Antagonists. — Opium or Alcohol, for the nervous and 
muscular depression. 

Potassium Nitrate (Saltpetre). Antidotes. — No chemical antidote. Emetics 
or stomach pump. Demulcent drinks and emollient enemata. Milk. An- 
tagonists. — Opium, for the subsequent depression. Aromatics. Brandy. 

Pulsatilla. Antidotes. — Tannic Acid, followed by Emetics. Antagonists. — 
Alcohol, Opium, Digitalis. 

Quinine. Antidotes. — Emetics and cathartics, also diuretics and sudorifics 
to promote elimination. Antagonists. — Alcohol. Opium. Coffee. Morphine 
antagonizes its cerebral action, Atropine that on the nervous system and heart, 
also its antipyretic power. 

Rat-pastes, — contain Phosphorus or Arsenic. Ratsbane is Arsenous Acid 
(Arsenic). Rough-on-Rats contains Arsenic. 

Reptile-venom. Antidotes. — Potassium Permanganate, hypodermically into 



VI 



TREATMENT OF POISONING. 769 

cinity, after ligating the part above the wound. Carbolic Acid, strong, or a 
Mineral Acid, as caustic, after forcible sucking of wound by a person with per- 
fect mucous surface of lips and mouth, and thorough cleansing. Ammonia, 
n\,xij of Liq. Ammonias, diluted with 3 volumes of water, hypodermically into 
the radial vein, for snake-poison (Halford) ; is shown to be unavailing by 
Brunton and Fayrer (B). Antagonists. — Alcohol, as Brandy or Whiskey, 
freely. Agave Americana. Arsenic, internally for the rapid prostration (R). 
R. Potassii Iodidi, gr. iv; Hydrarg. Chlor. Corr., gr. ij ; Bromi, 3v ; Aquae, Z] ; 
of which gtt. x in gij of Brandy, repeated if necessary (Hammond). Viola 
Cucullata, the common Violet, is used in Pennsylvania against rattlesnake 
venom. [See ante, page 424.] 

Resorcin. Antidotes. — Albumen. Soda or Saccharated Lime, in plenty of 
tepid water, as wash for stomach. Emetics or the stomach-pump. Antago- 
nists. — Stimulants freely. Heat to the extremities. Amyl Nitrite, inhaled. 
Atropine and other cardiac and respiratory stimulants, cerebral excitants, and 
agents which raise the arterial tension, are physiologically antagonistic. Fric- 
tion with warm hand. Galvanism, the interrupted current. Fatal Dose. — gij 
nearly proved fatal (Murrell). 

Rhus (Poison Oak or Ivy). Antagonists. — Cocaine, a 5 per cent, aqueous 
solution, or a 10 per cent, oleate, locally, is by far the most efficient applica- 
tion, promptly relieving the burning and itching. Grindelia Robusta, the fluid 
extract, 1 to 10 of water, or undiluted, is a very serviceable lotion. Other 
applications found useful are — Carbolic Acid, 5 per cent, solution; Lobelia, as 
infusion, Sjj to the pint; solutions of Corrosive Sublimate, Lead Acetate, Chlo- 
rinated Soda, Lime-water with Linseed Oil, Alum-curd. R. Plumbi Acetatis, 
Z'\) ; Ammonii Chloridi (crude), ^ss; Aquae, ^viij ; as lotion on cloths con- 
stantly wetted therewith, is used with uniform success (Burns). Soap-suds and 
Hot Water, frequent washing therewith the surest, speediest and best treat- 
ment (Couch). Aristol, freely dusted over the part, gives magical relief (Le- 
vick). Opium or Coffee, to relieve the nervous irritability. Rest, low diet, 
and laxatives are appropriate measures. 

Sanguinaria. Antidotes. — Tannin, Alkalies, and most of the metallic salts 
are incompatible. Antagonists. — Opium, Atropine, Amyl Nitrite, etc., to an- 
tagonize the depression of the circulation and the local irritant action of the 
poison. 

Savine. Antidotes. — Epsom salt. Demulcents. Emetics and purgatives, 
especially Castor Oil. Antagonists. — Morphine, gr. X hypodermically. Poul- 
tices of linseed meal to abdomen. 

Silver Salts. Antidotes. — Sodium Chloride (common salt), dissolved in 
water, largely diluted and freely used ; precipitates the silver as the insoluble 
and harmless chloride, and acts as an emetic (R). Alkalies, especially Mag- 
nesium Bicarbonate (R). Albumen. Antagonists. — Milk, to allay the result- 
ing irritation ; it may serve as food until the stomach is restored. Opium, 
against results of irritation. [See also Metallic Salts, above. For treat- 
ment of chronic poisoning, and regulation of a course of silver medication, see 
page 128, ante.~] 

Snake-bite. See Reptile-venom, above. 

Soda and Sodium Salts. See Alkalies and Potassium Nitrate, also 
Metallic Salts, above. 

Stramonium. See Belladonna, above. 

Strychnine. See Nux Vomica, above. 

Sulphur and Sulphides. Antidotes. — Chlorine-water. Sodium Chloride (com- 
mon salt). Potassium Chloride. Ferrous Sulphate. Chlorine Gas, for Sul- 
phuretted Hydrogen ; it should be well diluted with common air. Antagonists. 
— Artificial Respiration is the best treatment for poisoning by Sulphuretted Hy- 
drogen. 

Tartar Emetic. See Antimony, above. 
49 



77° 



TABLE OF SPECIFIC GRAVITIES AND VOLUMES. 



Tin. Antidotes. — Albumen. Ammonium and Sodium Carbonates. Milk. 
[See also Metallic Salts, above.] 

Tobacco. Antidotes. — Tannin, followed by Emetics, or the stomach-pump. 
Iodides. Antagonists. — Strychnine is the true physiological antagonist to 
Nicotine (or Tobacco) and vice versa. Alcohol, Ammonia, Ergot, Digitalis, 
Belladonna, antagonize its action on the circulation. Brandy is efficient, also 
strong coffee. Warmth applied to the surface, also friction. Artificial Respi- 
ration. Recumbent position should be strictly maintained. 

Turpentine. Antidotes. — Magnesium Sulphate (Epsom salt), ^j in water. 
Emetics or the stomach-pump. Demulcent drinks, as milk, barley-water, etc. 
Antagonists. — Opium or Morphine, if much pain, and for shock. 

Veratrum and Veratrine. Antidotes. — Emetics or the stomach-pump. An- 
tagonists. — Alcohol, Opium, Ammonia, Digitalis, and Belladonna counteract 
the cardiac depression. Morphine with Atropine hypodermically, or Lauda- 
num internally, with alcoholic stimulants. Heat, dry, applied to the body. 
Recumbent posture strictly maintained. Coffee, strong, as enema. [See also 
Aconite, above.] 

Wounds, Poisoned. — Antidotes. — Ammonium Carbonate, gr. v hypodermi- 
cally in the vicinity of wounds caused by poisoned arrows, was repeatedly used 
with entire success by Dr. Parke, surgeon to Stanley's last African expedition. 
[See ante, page no; also Reptile-venom above, and the article Wounds, in 
Part in.] 

Zinc Salts. Antidotes. — Sodium or Potassium Carbonates dissolved in warm 
water, largely diluted, used freely. Albumen, as eggs and milk, with tepid 
water, freely. Tannic Acid, or vegetable astringents, or strong tea. Lime- 
water. Soap-suds, freely. Mucilaginous drinks. Antagonists. — Opium, or 
Morphine hypodermically. Linseed-meal as poultices to abdomen. Enemata 
of gruel or starch-and- water, if much abdominal pain. 



TABLE OF SPECIFIC GRAVITIES AND SPECIFIC VOLUMES. 

(Temperature at 59 F., except when otherwise stated. Where the sp. gr. is variable, 
the mean specific gravity is stated.) 



Liquid. 


Specific 
Gravity. 


Specific 
Volume. 


Liquid. 


Specific 
Gravity. 


Specific 
Volume. 


Acid, Acetic, 

Acid, Acetic Dil., . . . 
Acid, Hydrobromic, 

(34 per cent.) 

Ac. Hydrobrom. Dil., . 
Ac. Hydrochloric, . . 
Ac. Hydrochlor. Dil., . 

Acid, Lactic, 

Acid, Nitric, 

Acid, Nitric. Dil., . . . 

Acid, Oleic, 

Acid, Phosphoric, . . 
Ac. Phosphoric, Dil., . 
Acid, Sulphuric, . . . 
Ac. Sulphuric. Dil., . 
^Ether, . . . • 


1.048 
1.008 

i-3°3 
1.077 
1. 163 

1.059 
1.213 

1. 414 

1-057 

.900 

1.710 

1.057 

1.835 

1.070 

.725 

.820 

.812 

•937 

•93° 

1. 000 

.960 

.901 

.670 

1.268 

1.490 

1.470 

1 250 

1. 160 

1-387 


•954 
.992 

.767 

.928 

.860 

.952 

.824 

.709 

.946 

1. in 

.584 

.946 

•545 

•934 

J -379 

1.219 

1.231 

1.066 

1 075 

1. 000 

1.042 

1.109 

1.493 

.788 

.671 

.680 

.800 

.862 

.721 


Liq. Ferri Tersulph., . 

Liq. Potassse, 

Liq. Sodse, 

Mel (Honey), 

Ol Adipis, ...... 

Ol. Amyg. Expres., . . 
01. Aurant. Cort., . . . 
01. Bergamottae, 
Ol. Caryophylli, . . . 

Ol. Copaibae, 

Ol. Cubebae 

01. Eucalypti, .... 
Ol. Gaultheriae, . . 
Ol. Gossyp. Sem., . . 
Ol. Lavandulae, .... 


1.320 
1.036 

1.059 
1-375 
•9*5 

HI 

.883 

1.065 

.900 

.920 

.920 

1. 180 

•9 2 5 

- .886 

.858 


■757 

•9 6 5 

•944 

.727 

1.092 

1. 091 

1. 1 76 

1.132 

•939 

1. in 

1.086 

1.086 

.838 

1.081 

1. 128 

1.165 

1.068 

1.098 

1.083 

1.092 

1.042 

1. 104 

.925- 

I-I94 

1.160 

1. 191 

1.086 

1. 071 

•759 
1. 000 


Alcohol, at 6o° F., . . 
Alcohol, at 77 F., . . 
Alcohol, Dil.,at6o° V., 
Alcohol, Dil., at 77 F., 
Aqua Destil., at 59 F.. 
Aq. Ammonise. . . 
Aq. Ammon., Fort., . . 

Benzin, 

Carbon Disulphide, . . 

Chloroform, 

Chloroform) Venale, . . 

Glycerin, 

Liq. Ferri Acet 

Liq. Ferri Chlor., . . . 


01. Lini, 

Ol. Menthae Pip., . . . 

01. Morrhua;, 

Ol. Olivse, 

01. Ricini, 

Ol. Rosmarini, .... 

Ol. Sassafras, 

Ol. Sesami, 

Ol. Terebinthinae, . . . 
Spt. iEtheris Nitrosi, . 
Spt. Frumenti, .... 
Spt. Vini Gallici, . . . 

Syrupus, 

Vinum Album, .... 


•936 

.910 

•9 2 3 

.916 

.960 

■9°5 

1.080 

.921 

.862 

.839 

.920 

•933 

1-3*7 

1. 000 



DROPS IN A FLUIDRACHM. 



771 



TABLE SHOWING THE 
NUMBER OF DROPS IN A FLUIDRACHM 

OF VARIOUS LIQUIDS, ALSO THE WEIGHT OF ONE FLUIDRACHM IN GRAINS. 

(Compare page 438.) 



Liquid. 



Acetum Opii, 

Acetum Scillae, 

Acid, Acetic, 

Ac. Acetic. Dil., . . . . 

Acid, Carbolic, 

Ac. Hydrochloric, . . . 
Ac. Hydrocyanic, . . . . 

Acid, Lactic, 

Acid, Nitric, 

Ac. Nitro-hydrochloric, . 
Ac. Phosphoric Dil , . . 
Ac. Sulphuric, . . . . . 
Ac. Sulph. Aromat., . . . 

Ac. Sulph. Dil., 

Ac. Sulphurosum, . . . . 

^Ether, 

Alcohol, 

Aqua, 

Aqua Destillata, .... 
Balsam Peruvian, .... 

Bromine, 

Chloroform, 

Copaiba, 

Creosote, 

Ext. Belladon, Fl., . . . 

Ext. Buchu FL, 

Ext. Digitalis Fl., . . . . 
Ext. Ergotse FL, ... . 
Ext. Ipecac. FL, .... 

Ext. Rhei FL, 

Ext. Senegae FL, .... 
Ext. Valerianae Fl , . . . 
Ext. Zingib. FL, .... 

Glycerin, 

Hydrargyrum, 

Liq. Acidi Arsenosi, . . . 
Liq. Ferri Chloridi, . . . 



Drops 
in f5j. 

(mix.) 



9° 
68 

108 



76 

59 

128 

146 

60 

59 
176 
146 
60 
60 
101 
250 
250 
no 
122 
156 
150 
134 
133 
120 
158 
137 
150 
142 
67 
150 
57 
7 l 



Weight 
of f5j in 
grains. 



53 

58^ 
55 
39 
44 
55 

53% 
60 
165 
80 
5i 
56^ 

57 !/ 

47% 

62 

60 

60 

61 

62 

49 



760 

55 
72 



Liquid. 



Liq. Iodi Compos,, . 
Liq. Potassae, .... 
Liq. Zinci Chloridi, . 
Oleores. Aspidii, . . 
Oleores. Capsici, . . 
Oleores. Cubebae, . . 
Oleum Anisi, .... 
Oleum Bergamottae, . 
Oleum Cari, .... 
Oleum Juniperi, . . 
Oleum Limonis, . . 
Oleum Ricini, . . . 
Oleum Rosse, .... 
Oleum Terebinthinae, 
Oleum Tiglii, .... 
Spt. ^Etheris Comp , 
Spt. iEtheris Nitrosi, 
Spt Camphorae, . . 

Syrupus, 

Syrupus Acaciae, . . 
Syrupus Ferri Iodidi, 
Syrupus Scillae, . . . 
Syr. Scillae Comp, . . 
Syrupus Senegae, . . 
Tinctura Aconiti, . . 
Tinctura Belladonnas, 
Tinct. Benzoini Comp. 
Tinct. Cantharidis, . 
Tinct. Digitalis, . . 
Tinct. Ferri Chlor., . 

Tinct. Iodi, 

Tinct. Opii, 

Tinct. Opii Camph., . 
Tinct. Opii Deodor., 
Vin. Colchici Rad., . 
Vin. Colchici Sem., . 
Vinum Opii, .... 



Drops 
in f3j 

(mix.) 



120 
123 
119 
130 
132 
148 
129 

77 

132 

136 

104 

148 

146 

143 

65 

44 

65 

75 

102 

106 

146 

137 



131 
128 
150 
148 



130 

no 

107 
111 



Weight 
off5j in 
grains. 



WEIGHTS AND MEASURES. 



Pound. 
ft) 



APOTHECARIES OR TROY WEIGHT. 

Ounces. Drachms. Scruples. 
$ 5 3 



96 



METRIC WEIGHTS. 

i Milligramme, o.ooi 

1 Centigramme, o.oi 

1 Decigramme, o.i 

1 Gramme, i. 

Kilogramme, iooo. 



Grains. 

gr. 
5760 
480 
60 



gr-i 
gr- ij 
gr- 15-432 
ft) 2.7 



Gallon 
C. 



apothecaries' or wine measure. 

Pints. Fl' ounces. Fl' dr'ms. Minims. 

O. f§ f5 m 

8 = 128 = 1024 = 61440 

1 = 16 = 128 = 7680 

1 = 8 = 480 

1 = 60 



APPROXIMATE EQUIVALENTS. 

TTlJorgr. j, = .06 gramme. 

f 5j or 5j, = 4. grammes. 

fSj, =30. 

§j, • • =3i- 

foj of Glycerin, =37- 

fSj of Syrups, =40. 



772 



METRIC CONVERSIONS. 



TABLE FOR CONVERTING 
APOTHECARIES' WEIGHTS AND MEASURES INTO METRIC. 

(Adapted from Maisch.) 

[Multiply all grains, or fractions of a grain, by 6479 (or 648) for the metric equivalent 

in milligrammes. — Potter.] 



Troy Weight. 


Metric. 




Fluid Grammes or Cubic Centimeters. 






Apothecaries' 












Measure. 


Liquids 


Liquids of 
Specific 

Gravity of 
Water.f 


Liquids 


Grains. 


Grammes. 




Lighter than 
Water.* 


Heavier than 
Water.J 




Milligramme. 


HI I 


•055 


.06 


.08 


l 

64 


.OOI 


2 


.IO 


.12 


•15 


1 
¥0 


.OOI5 


3 


.16 


.18 


.24 


A 


.002 


4 


.22 


•24 


•32 


A 


.003 


5 


.28 


•30 


.40 


1 
T6" 


.OO4 


6 


•32 


.36 


.48 


tV , 


.005 


7 


•38 


.42 


•55 


tV 

1 

8 


.006 

.008 


8 
9 


•45 
•5° 


•50 

•55 


-.65 

•73 


1 


Centigramme. 


10 


•55 


.60 


.80 


"6 
1 


.OIO 
.Ol6 
.02 
.03 
•05 
.065 
Decigramme. 


12 


.65 


•72 


.96 


4 

* 

1 


15 

16 


.80 
.90 


.90 
1. 00 


1.20 

1.32 


2 
8 

4 
I 


20 
25 
30 


1. 12 

1.40 
1.70 


1.25 

i-55 
1.90 


1.60 

2-00 
2.5O 


2 


• T 3 


35 


2.00 


2.20 


2.9O 


3 


.20 


40 


2.25 


2.50 


3-30 


4 


.26 


48 


2.70 


300 


4.OO 


5 


•3 2 


50 


2.80 


3,12 


4.15 


6 


•39 


60 (fsj) 


3-4o 


3-75 


5.00 


7 


•45 


65 


3.60 


4.00 


5-3° 


8 


•52 
•59 


72 


4.00 


4-5o 


6.00 


9 


80 


4-5o 


5.00 


6.65 


10 


•65 


90 (fsjss) 


5.10 


5.60 


7-5o 




Gramme. 


96 


5 -4o 


6.00 


8.00 


15 


I. OO 


100 


5.60 


6.25 


8.30 


20 Oj) 


I.30 


I20(fgij) 


6-75 


7-5o 


10.00 


24 


I.50 


150(1 3 ijss) 


8.50 


9-5o 


12.50 


26 


I.62 


160 


9.00 


10.00 


i3-3o 


3 o(3ss) 


i-95 


i8o(f 3 iij) 


10.10 


11.25 


15.00 


40 


2.60 


210 (f giijss) 


11.80 


13.00 


i7-5o 


5o 


3.20 


240(fgiv) 


i3-5o 


15.00 


20.00 


60 (3J) 


3-90 


300 (fgv) 


16.90 


18.75 


25.00 


100 


6.48 


330 (f^vss) 


18.60 


20.75 


27.50 


120 (31J) 


7.80 


3 6o(f3vj) 


20.25 


22.50 


30.00 


180 


11.65 


420 (fgvij) 


23.60 


26.25 


35-00 


240 ( I ss) 


i5-5o 


480 (f^j) 


27.00 


30.00 


40.00 


300 


19.40 


540 (f Six) 


30.40 


33-75 


45.00 


360 


2350 


600 (f.^x) 


33-75 


37-5o 


50.00 


i 420 


27.20 


720 (f.^xij) 


40.50 


45.00 


60.00 


480 (3j) 


31.10 


840 (f'^xiv) 


47-25 


52.50 


70 00 


960 (gij) 


62.20 


9 6o(f^ij) 


54.oo 


60.00 


80.00 


1000 


64.79 


1000 


56.00 


62.50 


83.00 



* Lighter than water are tinctures, spirits, compound spirit of ether, sweet spirit of nitre, fixed and 
volatile oils. ./Ether, f 5j = grammes 2.80. 

f Same as water are waters, liquids, decoctions, infusions, most fluijd extracts, and tinctures made 
with dilute alcohol. 

X Heavier than water are syrups, glycerin, a few fluid extracts, and chloroform. Of the latter f 5j = 
grammes 5.50. 



PRESCRIPTION DOSES AND QUANTITIES. 



772- 



A TABLE OF PRESCRIPTION DOSES AND QUANTITIES. 
Designed and Calculated by Dr. Sam'l O. L. Potter, M.R.C.P. Lond. 



Grains 
in Entire 
Mixture 



A 



IJSS 



"J 



IIJSS 



IV 



VI 



VIJ 



VIIJ 



xij 



XIIJ 



XVIJ 
XVIIJ 



XXI 



XXIJ 



XXVI 



XXVIIJ 



XXIX 



xxx(3ss) 



Grains in each 5 dose in a mixture of 



^i ^ij ^nj ^iv ^vi ^vnj ^xij £ 



i ■ 

i tt 



"k 



96 



A 



I A 



A 



A 



H 



i-. 5 . 



if 



if 



il 



U 



A 



A 



A 



TT 



TT 



tV 



^o 



A 



A 



Grains 
in Entire 
Mixture 



XXXI 



XXXIJ 



XXXI1J 



XXXIV 



XXXV 
XXXVI 



XXXVIIJ 



XXXIX 



XLIJ 



XLIIJ 



XLIV 



XLV 



XLVIJ 



XLIX 
L 



LIJ 



LVIIJ 



L *(3J) 



IJSS 



I1J 



IIJSS 



VIJ 

v"J(gi) 



VIIJSS 



IX 



XI 



xij(giss) 



xvi(gij) 



Grains in each 5 dose in a mixture of 



3* 



4t 



4s 



4i 



*i 



51 



5i 



5f 



5i 



61 



7i 



71 



15 



18! 



3<? 



37* 



45 



52i 



60 



63: 



67^ 



75 



5... 



23 



3i 



31 



3 J 



3i 



3f 



51 



7i 



9f 



ni 



'3* 



1 8' 



26I 



30 



33t 



37* 



4i| 



60 



3 "j 



1 J 



H 



1 4 

1 77 



T -5 
■I v 



2 I 



2^ 



3f 



61 



7* 



15 



74 



25 



271 



40 



»A 



1* 



1 5 

• T .7 



l4 



lV 



31 



5^ 



7i 



91 



'3* 



15 



16 



1 64 



m 



30 



A 



>A 



i4 



3 k 



3f 



4| 



61 



7* 



lot 



1 3| 



'5 



7* 



(VIIJ 



2i 



3i 



C 5 

5s 



65- 



1\ 



13* 



»5 



A 



TT 



T 5 



3t 



31 



4^ 



5} 



51 



61 



1\ 



Explanation.— In Writing a Prescription look for the dose of the ingredient (say gr. £ s ) in the 
column headed by the size of your mixture (Svi) ; then on that line in the left marginal column is the 
quantity you must put into the entire mixture (gr. ijss) to get your dose in each drachm thereof. In 
Reading a Pkescription find the quantity of any ingredient called for, in the left marginal column (say 
gr. y ir ) i and on the same line in the column headed by the number of ounces in the mixture (Snj) you 
will find the quantity in each drachm dose (gr -£?). Of course when the dose is more or less than 51 the 
result must be proportionately multiplied or divided accordingly. 

Copyrighted, 1894, by P. Blakiston, Son & Co. 

This Table May be Cut from the Book, and Pasted on a Card, for Office Reference 



\ 



INDEX. 



Abbreviations, their use, 443 

Table of, 444, 751 
Abdominal Plethora, 503 
Abies, 338 
Abies balsamea, 409 

canadensis, 338 

excelsa, 338 
Abietic Anhydride, 354 
Abortion, 503 
Abrus, 57 
Abscess, 504 

of the Liver, 620 

Mammary, 504 
Absinthe, 58 
Absinthium, 58 
Acacia, 58 

Catechu, 175 
Aceta, — See also Vinegars, 465 
Acetanilid, 58 

Acetates, — See their basic components 
Acetone, 400 

Acetous Preparations, 464 
Acetphenetidin, 196 
Acetum, 61 
Acid Abietic, 354 

Abric, 57 

Acetic, 61 

Aconitic, 82 

Agaricic, 90 

Aloetic, 104 

Anemonic, 351 

Angelic, 406 

Arabic, 58 

Arsenous, 131 

Artanthic, 295 

Benzoic, 145, 195 

Boracic, 62 

Boric, 62 

Brassic, 389 

Butyric, 302 

Calumbic, 163 

Camphoric, 164, 166 

Camphretic, 164 

Capronic, 129 

Caprylic, 129 

Carbazotic, 79 

Carbolic, 63, 195 
Solution of, 64 
Gauze, 64 

Carminic, 204 



Acid Caryophyllic, 173 
Caryophyllinic, 173 
Catechuic, 175 
Catechu-tannic, 175 
Cathartic, 357, 386 
Cathartogenic, 386 
Cerotic, 176 
Cetraric, 177 
Cevadic, 421 
Chelidonic, 178, 375 
Chromic, 69 
Chrysammic, 104 
Chrysophanic, 190, 357, 366 
Cinnamic, 140, 145, 400 
Citric, 285 
Coca-tannic, 200 
Copaibic, 210 
Cresylic, 63, 212 
Cubebic, 214 
Digallic, 81 
Ergotic, 228 
Ergotinic, 228 
Erucic, 389 
Eugenic, 302 
Euonic, 233 
Euphrastic, 234 
Filicic, 136 
Fluoric, 70 
Gallic, 70 
Gallo-tannic, 81 
Gambogic, 163 
Gelsemic, 242 
Gentesic, 244 
Gentianic, 244 
Glycyrrhizic, 246 
Guaiac, 250 
Guaiaconic, 250 
Guaiarec, 250 
Gurjunic, 252 
Gynocardic, 177 
Hydriodic, 271 
Hydrobromic, 72 
Hydrochloric, 72 
Hydrocyanic, 74 
Hypophosphorous, 327 
Hypopicrotoxic, 332 
Igasuric, 305 
Ipecacuanhic, 275 
Juglandic, 279 
Kinic, 193 



773 



I 



774 



INDEX. 



Acid Kinotannic, 193, 281 
Kinovic, 193 
Kinovo-tannic, 1 93 
Lactic, 76, 311 
Lactucic, 283 
Laricic, 90 
Linoleic, 286 
Lobelic, 2S8 
Lupulinic, 255 
Maizenic, 426 
Malic, 141 
Mastichic, 295 
Meconic, 311 
Melassic, 369 
Methyl- salicylic, 242 
Mezereinic, 299 
Mineral, 72 
Muriatic, 72 
Myristic, 302 
Nitric, 76 

Nitro- hydrochloric, 72, 77 
Nitro-muriatic, 72, 77 
Oleic, 77, 302, 310 
Ophelic, 179 
Oxalic, 48, 510, 761 
Palmaric, 354 
Palmitic, 310 
Phenic, 63 
Phosphoric, 78 
Phytolaccic, 331 
Picric, 79 
Picrotoxic, 332 
Pinic, 354 
Piperonylic, 211 
Podophyllinic, 343 
Polygonic, 344 
Protocatechuic, 343 
Prussic, 74 
Punico-tannic, 249 
Pyrogallic, 71, 195 
Pyroligneous, 338 
Quercitannic, 81, 353 
Rhatania tannic, 81, 281 
Rheotannic, 357 
Rheumic, 357 
Ricinoleic, 361 
Rosolic, 64 
Sabadillic, 421 
Salicylic, 195, 370 
Salicylous, 371 
Salicyluric, 371 
Sanguinarinic, 375 
Scheele's, 74 
Sclerotic, 228 
Sclerotinic, 228 
Silvic, 354 
Sphacelinic, 229 
Stearic, 85 
Strychnic, 306 
Sulphuric, 79 
Sulphuric, Aromatic, 79 
Sulphurous, 80 
Succinic, 92 



Acid Tannic, 81 

Tartaric, 82 

Thebolactic, 31 1 

Tiglinic, 415 

Toxicodendric, 360 

Tropic, 141, 266 

Valerianic, 406, 418 

Vanillic, 420 

Vegetable, 61 

Veratric, 421 

Viburnic, 423 

Xylic, 63 
Acids, — their action, 36, 72 
Acidity, 504 
Acipenser Huso, 268 
Acne, 505 

Acocanthera Ouabaio, 399 
Aconine, 83 
Aconite, 82 
Aconitine, 8^ 
Aconitum, 82 

Cammarum, 8^ 

Chinense, 83 

ferox, 83 

Japonicum, 83 

Napellus, 82 
Acorin, 160 
Acorus Calamus, 160 
Acrinyl, Sulpho-cyanate, 389 
Acrolein, 245 
Adeps, 85 

Benzoinatus, 85, 145 

Lanae Hydrosus, 85 
Addison's Disease, 506 
Adenitis,— See Glandular Enlargements. 
Administration of Medicines, 20 
Adynamia, 506 
/Ether, 86 

Acetic, 86 
After-pains, 507 
Agalactia, 507 
Agaricin, 90 
Agaricus albus, 90 

chirurgorum, 91 

muscarius, 91 
Agave Americana, 104 
Agropyrum repens, 417 
Ague, — See Intermittent Fever, 631 
Ailanthus, 92 
Alabastrine, 304 
Albau, 227 

Albumen in Urine, Test for, 756 
Albumin, 424 
Albuminuria, 508 
Alcohol, 92 

Amyl, 94 

Caustic, 391 

Ethyl, 92 

Methyl, 93 

Phenyl, 63 
Alcoholic Preparations, 464 

strength of Bitters, 744 
Alcoholism, 98, 508 



INDEX. 



775 



Aldehyde, 93, 319 

Proto-catechuic, 420 
Alder Bark, 71, 104 

Black, 349 

Buckthorn, 241 
Ale, 95 

Alkalies, their action, 36 
Alkaline Mineral Waters, 123 
Alkaloids, 433 

Liquid, 407, 433 
Allium cepa, 103 

porrum, 103 

sativum, 103 
Allspice, 336 
Allyl Sulphide, 103, 134 

Sulpho- cyanide, 389 
Almond, 74, III 
Alnus, 71, 104 
Aloe socotrina, 104 
Aloes, 104 
Aloin, 104 
Alopecia, 509 

Areata, 712 
Alstonia scholaris, 225 
Alteratives, 42 

Uterine, 49 
Althaea, 105 
Alum, 106 

Ammonio-ferric, 237 
Alum-root, 71 
Alumen, 106 

Exsiccatum, 106 
Aluminum, 107 
Amanita Muscaria, 91 
Amaurosis, 510 
Amber, 400 
Amblyopia, 30, 510 
Amenorrhcea, 510 
Amick's Consumption-cure, 744 
Amido-benzene, 195 
Ammonia, 107 
Ammonia-alum, 106 
Ammoniated Copper, 216 

Glycyrrhizin, 247 

Mercury, 256 
Ammoniacum, 107 
Ammonio-ferric Alum, 237 

Tartrate, 237 
Ammonium, 107 
Amorphous Bodies, 456 
Amygdala, in 

Amara, 74, III 

Dulcis, in 
Amygdalin, 74, in, 350 
Amyl Chloride, 89 

Hydrate, 94 

Hydride, 89 

Nitrite, 112 
Amylene, 89 

Hydrate, 180 
Amylic Alcohol, 94 
Amylum, 1 14, 369 

Iodatum, 760 



Anaemia, 511 

cerebral, 539 
Anaesthesia, 88, 187, 512 

Local, 25, 201 
Anaesthetics, 25, 27, 88, 187 

Local, 25, 201 

Mixtures, 87 

Modes of using, 187 
Anacyclus Pyrethrum, 352 
Analgesics, 27 
Anamirta paniculata, 332 
Anaphrodisiacs, 48 
Anaphrodisiac Pills, 490 
Anasarca, see Dropsy, 568 
Andira Araroba, 190 
Anemone, Meadow, 350 

patens, 351 

pratensis, 350 

Pulsatilla, 350 
Anemonin, 351 
Aneurism, 512 
Angelate of Butyl, 115 
Angina, — See Croup, Laryngitis, Pharyn- 
gitis, Throat, Tonsillitis, etc. 
Angina Pectoris, 513 
Anhidrotics, 47 
Anilin, 195 

Red, 241 
Anise, 115 

Star, 269 
Anodynes, 25, 27 

Local, 25 
Ant-acids, 36 
Antagonists, 53, 760 

List of, 54, 450 
Anthelmintics, 40 
Anthemis, 115 

Anthrax, — see Carbuncle, Pustule, Malig- 
nant. 
Antibilious Pills, 490 
Antidote, Arsenic, 236 

Jeaunel's, 760 
Antidote-bag, 759 
Antidotes, 53, 758 

General, 760 
Anti-emetics, 37 

-fat, 241, 332, 661 
Antifebrin, 58 
Antigalactagogues, 49 
Antikamnia, 58 
Antilithics, 46 
Antimonial Powder, 116 
Antimony, 116 

Sulphurated, 116 
Antinervin, 58, 60 
Antiperiodics, 43 
Antiphlogistics, 43 
Antipyretics, 42 
Antipyrin, 118 

Salicylate, 1 19, 371 
Antiseptic Fluid, 414 

Solution, 262 
Antiseptics, 52, 414 



77 6 



INDEX. 



Antisialics, 35 
Antispasmodics, 28 
Antizymotics, 52 
Antrum, Disease of, 513 
Anus, Fissured, 514 

Prolapse of, 683 
Aperients, ^8, 490 
Aphonia, 513 
Aphrodisiacs, 48 
Aphthae, 514 
Apiin, 121 
Apiol, 121 

Apis mellifica, 176, 296 
Apnoea, 517 
Apocynin, 121 
Apocynum, 121 
Apomorphine, 122 
Apoplexy, 515 
Apotheme, 472 

Apparatus for testing urine, 757 
Appetite, 515 
Approximate Measures, 438, 77: 

Weights, 771 
Aqua, 122 

Bulliens, 123 

Carbonata, 123 

Communis, 123 

Destillata, 123 

Fervens, 123 

Fluvialis, 123 

Fontana, 123 

Marina, 123 

Pluvialis, 123 

Regia, 77 
Aquae (see also Water of), 465 
Aqueous Preparations, 465 
Arabin, 58, 416 
Arbor Vitae, 413 
Arbutin, 178, 196, 242, 417 
Arctium Lappa, 283 
Arctostaphylos glauca, 417 

Uva-ursi, 417 
Argentum, 127 
Argol, 344 
Argyria, 128 
Aristol, 274 
Aristolochia, 387 
Aristolochine, 387 
Arnica, 129 
Arnicin, 129 
Aromatic Fluid Extract, 199 

Powder, 199 

Sulphuric Acid, 79 
Arsenate, Iron, 237 

Sodium, 131 
Arsenauro, 132 
Arsenic, 131 

Antidote, 236 
Arsenite, Copper, 131 

Potassium, 131 
Arsenum, 131 
Artemisia Absinthium, 58 

paucifiora, 377 



Arterial Transfusion, 21 
Arthritis, 515 
Asafcetida, 134 
Asagraea officinalis, 420 
Ascarides, — See Worms, 728 
Ascites, 516 
Asclepias, 135 
Ash, Flowering, 294 

Prickly, 425 
Asparagin, 105, 106, 233, 246 
Asphyxia, 517 
Aspidium, 136 
Aspidosperma, 136 
Aspidospermine, 136 
Assay, 462 
Asthenia, — See Adynamia, Convalescence, 

Atrophy. 
Asthenopia, 519 
Asthma, 519 
Astigmatism, 520 
Astragalus gummifer, 416 
Astringents, 42, 50, 71, 490 

Intestinal, 39 

Powder, 492 

Urinary, 45 

Vegetable, 71, 81 
Atheroma, 521 
Atropa Belladonna, 141 
Atrophy, 521 
Atropine, 141, 142 

and Morphine, 319, 742 
Atrosin, 141 
Aurantiin, 137 
Aurantium, 137 
Aurin, 64 
Aurum, 138 
Authorities, List of, 502 
Ava-kava, 280 
Avena Sativa, 139 
Ayer's Ague Cure, 744 

Cherry Pectoral, 744 

Pills, 744 

Recamier Balm, 746 
Cream, 746 

Sarsaparilla, 744 

Vita Nuova, 747 
Azedarach, 139 

Azoturia, — See Urinary Disorders, 719 
Azulen, 296 



Balanitis, 521 

Baldness, — See Alopecia, 509, 712 

Balm, 296 

Cream, 745 

of Gilead, 409 
Balnea, 465 
Balneum Maris, 123 

Vaporis, 123 
Balsam of Copaiba, 210 

of Fir, 409 

Friar's, 145, 400 



INDEX. 



777 



Balsam, Gurjun, 252 

of Peru, 140 

of Tolu, 140 
Balsamum Dipterocarpi, 252 

Peruvianum, 140 

Tolutanum, 140 
Bandoline, 219 
Baptisia, 140 
Baptisin, 141 
Barbaloin, 104 
Barberry, 146 
Bark, Casca, 174 

Chittem, 357 

Cuprea, 192 

Honduras, 174 

Huxham's Tincture of, 193 

Oak, 353 

Ordeal, 174 

Peruvian, 192 

Sacred, 357 

Sassy, 174 

Soap, 354 
Barley, 292 
Barium Dioxide, 141 
Barosma, 154 
Barosmin, 154 
Basham's Mixture, 236, 569 
Basilicon Ointment, 354 
Bassorin, 416 
Baths, Formulae, 465 
Bay, Sweet, 291 
Bay-berry, 302 
Bay Rum, 302 
Bear-berry, 417 
Bed-sores, 521 
Beer, 95 
Belladonna, 141 
Belladonnine, 141 
Benne Oil, 387 
Benzene, 89, 145 
Benzin, 144 
Benzoate, Ammonium, 108, 145 

Lithium, 145 

Sodium, 145 
Benzoin, 145 

Benzoinated Lard, 85, 145 
Benzol, 89, 145, 195 
Benzosol, 212, 214 
Benzoyl Guaiacol, 212 

Sulphonic-imide, 368 
Benzyl Cinnamate, 140 
Berberine, 147, 163, 263, 320, 343, 425 

Muriate, 147, 263 
Berberis, 146 
Bergamot, Oil of, 147 
Bergaptene, 147 
Beta-naphtol, 304 
Beta Vulgaris, 368 
Betula lenta, 370 
Bhang, 167 

Bibliography and References, 502 
Bichlorinated Chloride of Methyl, 184 
Bichromate of Potassium, 69, 70 



Bile, Agents affecting the, 40 

Bile Pigment in Urine, Test, 756 

Biliary Solvents, 46 

Biliousness, 521 

Bilious Remittent Fever, 753 

Bind-weed, 254 

Birch, Sweet, 370 

Bird lime, 424 

Bismuth, 147 

Bismuth Mixture for Children, 482 

Bites and Stings, 705 

Bitters, Action of, 163 

Alcoholic Strength of, 744 

Hostetter's, 745 

Vinegar, 747 
Bittersweet, 226 
Black-berry, 71, 365 

Bark, 365 
Black Draught, 386 

Drop, 321 

Paste, 601 
Bladder, Inflammation of, 556 

Irritable, 522 

Paralysis of, 523 
Bladder-wrack, 241 
Blancard's Pills, 235 
Blaud's Pills, 235 
Blende, 427 
Blepharitis, 523 
Blistering Cerate, 168 

Collodion, 248 
Blisters, 50, 469 
Blood-root, 375 
Blood- stains, 704 
Blue Flag, 277 

Mass, 256 

Methylene, 299 

Ointment, 256 

Pill, 256 
Boiling, 464 
Boils, 523 
Boldine, 149 
Boldo, 149 
Boldus, 149 
Bolus, 484 
Bone Diseases, 524 
Boneset, 233 
Borax, 62 
Borneol, 410 
Boro-glyceride, 62 
Bos-taurus, 234 
Bots, 140 
Bougies, 494, 495 
Boxwood, 320 

Brain Disorders, — See Cerebral Anaemia, 
Cerebral Concussion, etc. 

Fever, — SeeMeningitis,Cerebro-spinal 
Meningitis, Typhoid Fever, Typhus 
Fever. 
Brandreth's Pills, 744 
Brandy, 94 
Brassica, 2,^ 
Bray era, 218 



778 



INDEX. 



Breasts, — See Abscess, Lactation, Mastitis, 

Nipples. 
Breath, Fetid, 524 
Bright's Disease, Acute, 524 

Chronic, 525 

Diagnosis, 748 
Bromides, 149 

Formulae for, 583, 664 
Bromidrosis, — See Feet, 589 
Bromine and Bromides, 149 
Bromism, 150 
Bromoform, 150 
Bronchiectasis, 526 
Bronchitis, Acute, 526 

Capillary, 527 

Chronic, 528 
Bronchocele, — See Goitre, 599 
Bronchorrhcea, 529 
Broom, 382 
Brown Mixture, 247 
Brucine, 254, 269, 306 
Bruises, 530 
Bryonia, 152 
Bryonin, 153 
Bubo, 530 
Buchu, 154 

Helmbold's, 745 
Buckthorn, 241, 357 
Bulimia, 515 
Bunion, 530 
Burdock, 283 

Burnett's Disinfectant, 52, 427 
Burns, 530 
Bursitis, 531 
Butternut, 279 
Butyl Angelate, 115 

Chloral Hydrate, 183 

Chloride, 89 

Hydride, 89 

Valerianate, 1 15 
Buxine, 320 
Buxus sempervirens, 320 



Cacao-butter, 413 
Cachets, 491 
Cachexia, 531 
Cadmium, 154 
Caffea, 154 
Caffeine, 155, 251 

Citrated, 155 
Caffeol, 155 
Caffeone, 155 
Cajuput, Oil of, 160 
Cajuputene Bihydrate, 
Cajuputol, 1 60 
Calabar Bean, 330 
Calabarine, 330 
Calamine, 427 

Ointment, 429 
Calamus, 160 
Calcination, 458 
Calcium, 160 



[60 



Calculi, Biliary, 532 

Renal, 532 

Solvents of, 46 

Vesical, 532 
Calendula, 162 < 
Calomel, 256 
Calumba, 163 
Calx, 160 

Chlorata, 189 

Sulphurata, 403 
Cambogia, 163 

Camp Fever, — See Typhus, 717 
Camphene, 410 
Camphor, 164 

Baldrian, 418 

Bergamot, 147 

Carbolated, 165 

-Chloral, 165 

-Cymol, 164 

Monobromated, 164 

Naphtol, 304 

Peppermint, — See Menthol, 297 

Salicylated, 165 
Camphylene, 304 
Canadian Hemp, 121 

Moonseed, 297 
Cancer, 533 

Diagnosis of, 749 

of Uterus, 720 
Cancrum Oris, 534 
Cannabene, 166 
Cannabin, 166, 180 
Cannabis, 166 

Americana, 166 

Indica, 166 

sativa, 166 
Cantharides, 168 
Cantharidin, 168 
Cantharis, 168 
Caoutchouc, 227 
Capsicin, 170 
Capsicum, 170 
Capsules, 466 
Caraway, 173 
Carbinol, 93 
Carbo, 171 

Animalis, 171 
Purified, 171 

Ligni, 171 
Carbon 171 

Disulphide, 171 

Dioxide, 89 

Monoxide, 89 

Tetrachloride, 89, 186 
Carbonei Disulphidum, 89, 171 
Carbonated Mineral Waters, 123, 
Carbonization, 455 
Carbuncle, 534 
Carcinoma, — See Cancer, 533 
Cardamom, 172 
Cardiac Disorders, — See Heart. 

Sedatives, 33 

Stimulants, 33 






INDEX. 



779 



Cardiac Tonics, 33 
Cardialgia, — See Pyrosis, 690 
Carditis, Diagnosis of, 749 
Carduus, 173 
Carica Papaya, 322 
Caries, 535 
Carminatives, 38 

Dewees', 135, 290 
Carmine, 204 
Caroval, 217 
Carragheen, 190 
Carron Oil, 161, 286 
Carthamus tinctorius, 214 
Caruen, 173 
Carum, 173 
Caruol, 173 
Caryophyllin, 1 73 
Caryophyllus, 173 
Casca Bark, 174 
Cascara Amarga, 174 

Sagrada, 357 
Cascarilla, 175, 192 
Cascarillin, 175 
Cassia, Cinnamon, 199 

Fistula, 175 

Purging, 175 
Castanea, 71, 175 
Castor Oil, 361 

Emulsion; Formula, 551 
Castoria, 744 
Catalepsy, 535 
Cataplasmata, 466 
Cataract, 535 
Catarrh, Acute Nasal, 536 

Broncho-pulmonary, — See Bronchitis, 
Bronchorrhoea. 

Chronic Nasal, 537 

Duodenal, 569 

Epidemic,— See Influenza, 628 

Gastric, — See Gastritis, Chronic, 595 

Genito-urinary, — See Bladder, Catarrh 
of, Cystitis, Endometritis, Gonor- 
rhoea, Leucorrhoea, etc. 

Intestinal, — See Dysentery, Jaundice. 

Summer, — See Hay Fever, 604 
Catechol, 196 
Catechu, 71, 175 
Cathartics, 38 
Catharto-mannite, 386 
Caulophyllin, 176 
Caulophyllum, 176 
Caustic, Lunar, 127 

Mitigated, 127 

Potash, 344 

Soda, 390 
Caustics, 50 
Cedar, Oil of, 377 

Red, 367 

White, 413 
Celandine, 177 
Cellulose, 247, 369 
Centaurea benedicta, 173 
Century-plant, 104 



Cephaelis Ipecacuanhas, 275 
Cephalalgia, 605 
Cera, 176 

Alba, 176 

Flava, 176 
Cerata, 466 
Cerate, 176 

Cantharides, 168 

Cetaceum, 177 

Goulard's, 341 

Lead, Subacetate, 341 

Resin, 354 

Savine, 367 

Theobroma, 413 
Cerates, 466 

Compounding of, 500 
Ceratum, 176 

Cerebellum, Agents affecting, 28 
Cerebral Anaemia, 539 

Compression, Diagnosis, 749 

Concussion, 539 
Diagnosis, 749 

Congestion, 539 

Depressants, 26 

Excitants, 26 

Softening, 539 

Vomiting, — Diagnosis, 753 
Cerebro-spinal Fever, 647 
Cerium Oxalate, 176 
Cerolein, 176 
Cetaceum, 177 
Cetin, 177 
Cetraria, 177 
Cetyl Palmitate, 177 
Cevadilla, 420 
Cevadilline,42i 
Cevadine, 420 
Chalk, Prepared, 161 
Chalybeate Waters, 124 
Chamomile, 115 

German, 296 
I Chamomilla, 296 
I Chancre, 539 

Diagnosis of, 749 
; Chancroid, 540 

Diagnosis of, 749 
Change of Life, — See Climacteric, 545 
i Chapped Hands and Lips, 540 
Charcoal, 171 

Chartse (see also Papers), 467 
Chartulae, 491 
Chaulmoogra Oil, 177 
Chelerythrine, 177, 375 
Chelidonine, 177 
Chelidonium, 177 
Chelidoxanthin, 177 
Chelsea Pensioner, 467 
Chemical Incompatibility, 446 
Chenopodium, 178 
Cherry- laurel, 74, 76 
Cherry, Wild, 350 
Chestnut, 175 
Chestnut-leaves, 71 



780 



INDEX. 



Chest-pains, 540 

Chian Turpentine, 410 

Chicken-pox, 541, 724 

Chilblains, 541 

Children, Dosage for, 55 

Chimaphila, 178 

Chimaphilin, 178 

China, Pride of, 139 

Chinicin, 195 

Chininum Amorphum Boricum, 194 

Chinoidin, 194 

Chinolin, 178, 195 

Chirata, 179 

Chiratin, 179 

Chiretta, 179 

Chittem Bark, 357 

Chloral, 179 

Analogues of, 180 

Butylic, 183 

Formidate, 183 

Hydrate, 179 
Chloralamid, 183 
Chloral-habit, 181 
Chlorates, — See their basic titles. 
Chlorides, — See their basic titles. 

in Urine, Test, 756 
Chlorinated Waters, 124 
Chlorine, 188 

Chlorine-water, 188 • 

Chlorodyne, 185, 313 

Collis Browne's, 744 

Formulae for, compared, 743 
Chloroform, 88, 184 

Commercial, 185 

Methylic, 185 
Chlorosis, 541 
Chlorum, 188 
Chocolate, 157, 413 
Choking, 542 
Cholagogues, 39 

Pills, 490 

Purgatives, 38 
Cholera Asiatica, 542 

Infantum, 543 

Simplex, 543 

Diagnosis of, 750 

Mixture (Squibb), 312, 542 
Cholesterin, 424 

Chondodendron tomentosum, 320 
Chondrus, 190 
Chordee, 544 
Chorea, 544 
Choroiditis, 545 
Chrysarobin, 190 
Chrysophan, 357 
Churrus, 167 

Cigarettes, Formulae for, 520 
Ciliary Excitants, 33 
Cimicifuga, 191 
Cimicifugin, 191 
Cinchona, 192 

Flava, 193 

Rubra, 193 



Cinchona Red, 193 
Cinchonamine, I92 
Cinchonidine, 193 
Cinchonine, 193 
Cinchonism, 197 
Cinnamein, 140 
Cinnamomum, 199 

Camphora, 164 
Cinnamon, 199 
Cinquefoil, 672 

Circulation, Agents affecting, ^^ 
Circumcision, 675 
Cissampeline, 320 
Cissampelos Pareira, 320 
Citrates, — See their basic titles, also 285 
Citrine Ointment, 257 
Citron, 285 

Citrullus Colocynthis, 206 
Citrus acris, 285 

Aurantium, 137, 285 

Bergamia, 147 

Limonum, 285 

medica, 285 

vulgaris, 137, 285 
Clarification, 455 
Clarke's Blood Mixture, 745 
Classification of Medicines, 23 
Claviceps purpurea, 228 
Clavus, — See Headache, 605 
Clemens' Solution, 132 
Climacteric Disorders, 545 
Cloves, 173 
Club-moss, 289 
Clysters, 476 
Cnicin, 173 
Cnicus benedictus, 173 
Coca, 157, 199 
Cocaine, 200 
Cocaine-habit, 202 
Cocculus Indicus, 332 
Coccus, 204 
Coccyodynia, 545 
Cochineal, 204 
Cocoa, 157 
Codamine, 311 
Codfish, 299 
Codeine, 31 1, 313 
Cod-liver Oil, 299 

Emulsion, 300, 471 
Coffee, 154 
Cohosh, Black, 191 

Blue, 176 
Colation, 455 
Colchiceine, 205 
Colchicine, 205 
Colchicum, 205 
Coldness, 546 
Colic, Hepatic, 547 

Intestinal, 546 

Lead, 546 

Renal, 547 
Colic-root, 225 
Collodia, 467 



INDEX. 



781 



Collodion, 248, 467 

Cantharidal, 168, 248 

Flexible, 248 

Styptic, 81, 248 
Colloids, 457 
Colloxylin, 248 
Collunarium, 476 
Collyrium, 478 

Formulae for, 478 

of Four Sulphates, 478 
Colocynth, 206 
Colocynthein, 206 
Colocynthin, 206 
Colocynthis, 206 
Colocynthitin, 206 
Cologne-water, 94 
Colophony, 354, 410 
Columbo, 163 
Coma, 100, 547 

Combination, Principles of, 441 
Combustibles, 448 
Comminution, 455 
Commiphora Myrrha, 303 
Compounding Medicines, 452 

a Mixture, 481 
Condylomata, 547 
Condy's Fluid, 52, 293 
Confectio Damocratis, 467 
Confection of Rose, 364 

of Senna, 386 
Confectiones, 467 

Formulas for, 467 
Conhydrine, 207 
Conrine, 207 
Conium, 207 
Conjunctivitis, Catarrhal, 548 

Diphtheritic, 548 

Gonorrhceal, 549 

Granular, 549 

Phlyctenular, 549 

Purulent, 550 
Conspergatives, 486 
Constipation, 550 

Constituents of Vegetable Drugs, 432 
Contractions, List of, 444, 731 
Convalescence, 551 
Convallamarin, 209 
Convallaria, 209 
Convallarin, 209 
Convolvulin, 278, 381 
Convolvulus Scammonia, 381 
Convulsions, 552 

Infantile, 552 

Puerperal, 687 
Copaiba, 210 

Emulsion, 471 
Copaifera Langsdorffii, 210 
Copper, 215 
Cordial, Cascara, 357 
Coriander, 211 
Coriandrum, 21 1 
Corneal Opacities, 552 
Corneitis,— See Keratitis, 635 



Corn, Indian, 114, 426 

Silk, 426 

Smut, 426 
Cornin, 211 
Corns, 553 
Cornus, 211 
Cornutin, 229 

Corpulence, — See Obesity, 660 
Corrosive Sublimate, 256 
Coryza, — See Catarrh, Acute, 536 
Coto Bark, 211 
Cotoin, 211 
Cosmoline, 324 
Cotton, 247 

Iodized, Formulae for, 61 1 
Cotton-seed Oil, 248 
Couch-grass, 417 
Cough, 318, 553 

Mixtures, Formulae for, 555, 629, 674 
Counter irritants, 49 
Court Plaster, 268 
Coxalgia, 555 

Coxe's Hive Mixture, 116, 382 
Crab Lice, — See Pediculi, 670 
Cramp Bark, 423 

Cramps, See Trismus, Spasmodic Affec'ns. 
Cranesbill, 71, 245 
Cream, Cold, 177, 363 

of Tartar, 345 
Creosote, 64, 212, 407 
Creolin, 68 
Cresol, 63, 212 
Creta Pr?eparata, 161 
Crocus, 214 
Croton-chloral, 183 
Croton Eleuteria, 175 

Oil, 415 

Tiglium, 415 
Croup, Catarrhal, 555 

Membranous, 556 

Diagnosis, 750 
Cryptopine, 31 1 
Crystallization, 455 
Cubeba, 214 
Cubeben, 214 
Cubebene, 214 
Cubebin, 214 
Cuca, 157, 199 
Cucumber, Squirting, 227 
Cucumber Tree, 291 
Cucurbita Pepo, 321 
Cucurbitine, 321 
Culver's Root, 284 
Cuprea Bark, 192 
Cuprum, 215 

Ammoniatum, 216 
Curare, 217 
Curarine, 217 
Cusso, 218 

Cutaneous Irritants, 49 
Cyanides, — See their metallic titles. 
Cyanosis, 556 
Cydonin, 218 



782 



INDEX. 



Cydonium, 218 
Cymene, 410, 414 
Cynips Gallae tinctoriae, 242 
Cypripedin, 219 
Cypripedium, 219 
Cystitis, Acute, 556 

Chronic, 557 
Cysts, 558 
Cytisus Scoparius, 382 



Damiana, 219 

Dandelion, 409 

Dandruff, — See Pityriasis, 679 

Daphne Mezereum, 299 

Daphnin, 299 

Datura Stramonium, 396 

Tatula, 219 
Daturine, 219, 396 
Deafness, 559 

Death, Signs of, — See Asphyxia, 518 
Debility, — See Adynamia, Anaemia, Con- 

valescence. 
Decantation, 456 
Decocta, 468 
Decoctions, 468 
Decoloration, 456 
Deer, Musk, 301 
Deflagration, 456 
Deliquescence, 456 
Deliquescent Salts, List of, 488 
Deliriants, 26 
Delirium, 559 

Tremens, 98, 101, 559 
Delphinine, 394 
Delphinium Staphisagria, 394 
Dementia, 629 

Paralytica, 560 
Demulcents, 51 
Dengue, 561 
Dentition, 561 
Dentifrices, 34 
Deodorants, 52 
Deposits in Urine, 757 
Depressants, Cerebral, 26 

Hepatic, 40 

Renal, 44 

Respiratory, 31 

Uterine, 49 
Dermatol, 148, 275 
Desiccation, 457 
Destructive Metamorphosis, 42 
Dew-berry, 365 

Dewees' Carminative, 135, 290 
Dextrin, 369 
Dextrose, 368 
Diabetes Insipidus, 561 

Mellitus, 562 
Diabetin, 369 
Diachylon Ointment, 341 

Plaster, 341 
Diagnosis, Differential, 748 
Dialysis, 457 



Dialysed Iron, 237 
Diaphoretics, 46 
Diarrhoea, 563 
Diastase, 292 

Pancreatic, 322 
Dichlor-methyl Chloride, 184 
Dichloro-methane, 186 
Diethylsulphon-diethylmethane, 402 
Diethylsulphon-dimethyl methane, 400 
Diethylsulphon-methylethylmethane, 402 
Diffusate, 457 

Digestive System, Agents affecting, 34 
Digitalein, 220 
Digitalin, 220 
Digitalis, 219 
Digitin, 220 
Digitonin, 220 
Digitoxin, 220 
Diluents, 46, 481 
Dimethyl-ethylcarhinol, 180 
Dimethyl-phenylpyrazolon, 1 18 
Dioscorea, 225 
Dioscore'in, 225 
Diospyros, 71 
Dioxide, Barium, 141 

Carbon, 89 

Hydrogen, 264 

Manganese, 280, 292 
Dipentene, 410 
Diphtheria, 565 

Diagnosis of, 750 

Temperature in, 755 
Dipsomania, — See Alcoholism, Delirium 

Tremens. 
Discutients, 42 
Disinfectants, 52 

Burnett's, 52, 427 

Condy's, 52, 293 

Labarraque's, 52, 189 
Disinfecting Fluid, 411 

Oil, 69 
Dislocations, 593 
Dispensatories, 432 
Dispensing, 452 

by Physicians, 452 
Displacement, 459 
Distillation, 457 

Dry, 457 

Fractional, 457 
Dita Bark, 225 
Ditaine, 225 
Ditamine, 225 
Dithymol-Iodide, 274 
Diuretics, 44 

Formulas for, 568, 720 
Diuretin, 159 

Dizziness, — See Vertigo, 725 
Dobell's Nasal Wash, 476 
Dock, Yellow, 365 
Dog-wood, 211 

Jamaica, 337 
Domestic Measures, 438 
Donovan's Solution, 131 



INDEX. 



73 3 



Dorema Ammoniacum, 107 
Dosage of Medicines, 55 
Doses, Table of, 772* 
Dover's Powder, 276, 312 

Fluid, 276, 312 
Drastic Purgatives, 38 
Draught, 475 

Black, 386, 475 

Effervescing, 475 
Drink, 491 

Imperial, Formula, 491 
Drops, 438 

Table of Drops to a Drachm, 438, 77; 
Dropsy, 568 
Drosera, 225 

Drowning, — See Asphyxia, 517 
Drugs, Their Constituents, 432 
Drug-experimentation, 19 
Dryopteris Filix-mas, 136 

Marginalis, 136 
Duboisia, 225 
Duboisine, 225 
Dulcamara, 226 
Dulcamarin, 226 
Duodenal Catarrh, 569 
Dutch Liquid, 185 
Dyscrasiae, — See Cachexia, 531 
Dysentery, 569 
Dysmenorrhcea, 571 
Dyspepsia, 572 
Dysphagia, 574 
Dyspnoea, 574 
Dysuria, 575 



Ear Affections, 575 

Agents affecting it, 30 
Earache, 665 
Eau Sedative, 108, 164 
Ebullition, 464 
Ecballium Elaterium, 227 
Ecbolics, 48 
Ecboline, 228 
Ecchymosis, 575 
Ecgonine, 200 

Eclampsia, — See Puerp. Convulsions, 687 
Ecthyma, 575 
Ectropium, 576 
Eczema, 576 
Efflorescence, 456 
Efflorescent Salts, List of, 488 
Egg, Yolk of, 424 
Eights, The Three, 709 
Elastica, 227 
Elaterin, 227 
Elaterium, 227 
Elder, 375 
Elecampane, 270 
Electuaria, 467 
Electuary for Piles, 467 
Elettaria repens, 172 
Elixir, Aromatic, 138 

McMunn's, 312 

50 



Elixir, Simple, 138 

of Vitriol, 79 

Yvon's Hypnotic, 630 
Elixiria, 468 
Elm, Slippery, 417 
Elutriation, 463 
Ely's Cream Balm, 745 
Emaciation, 578 
Embrocation, 478 
Emetics, 37 

General or Systemic, 37 

Local, 37 
Emetine, 275, 276 
Emissions, 578 
Emmenagogues, 48 

Formulae for, 511 

Pills, 490 
Emollients, 51 
Emphysema of Lungs, 578 
Emplastra, 469 
Empyema, 579 
Emulsa, 469 
Emulsification, 470 
Emulsin, 74, in, 350 
Emulsions, 469 
Encephaloma, — See Cancer, 533 

Diagnosis of, 749 
Endarteritis, — See Atheroma, 521 
Endocarditis, 579 

Diagnosis of, 749 
Endometritis, 579 
Enema of Tobacco, 407 
Enemas, Formulae for, 476, 580 
Enemata, 476, 580 

Enteralgia, — See Colic, Intestinal, 546 
Enteric Fever, — See Typhoid, 715, 752 
Enteritis, 581 
Entropium, 576 
Enuresis, 581 
Epididymitis, 582 
Epilation, — See Tinea Circin., 711 
Epilepsy, 582 

Diagnosis of, 750 
Epispastics, 50 
Epistaxis, 584 
Epsom Salt, 290 
Epulis, — See Teeth, 709 
Equinia, — See Glanders, 597 
Erections, 578 
Ergot of Rye, 228 

of Corn, — See Ustilago, 426 
Ergota, 228 
Ergotin, 228, 229 
Ergotine, 228 
Ergotinine, 228 
Ergotism, 229 
Ericolin, 242, 417 
Erigeron, 231 
Eriodictyon, 231 
Errhines, 32 
Eructations, 572, 592 
Eruptions caused by Drugs, 584 
Erysipelas, 585 



;8 4 



INDEX. 



Erythema, 586 
Erythrophloein, 174 
Erythrophloeum Guinense, 174 
Erythroretin, 357 
Erythroxylon Coca, 157, 199 
Escharotics, 50 
Eserine, 330 
Essence of Bitter Almond, 112 

of Lemon, 285 

of Nutmeg, 302 

of Peppermint, 297 

of Spearmint, 298 
Ethene, 88 

Chloride, 89 ' 

Dichloride, 89 
Ether, 86 

Acetic, 86, 89 

Chloric, 185 

Chlorinated Muriatic, 186 

Hydrobromic, 86, 89 

Hydriodic, 86, 89 

Methylene-di-methyl, 180 

Methylic, 89 

Nitrous, 89 

Petroleum, 144 
Ethereal Oil, 86 

Preparations, 464 
Ethyl Acetate, 86 

Alcohol, 92 

Bromide, 86, 88 

Carbamate, 181 

Chloride, 88 

Hydrate, 92 

Hydride, 89 

Hydrosulphide, 400 

Iodide, 86, 272 

Nitrite, 87, 113 

Oxide, 86 
Ethylate of Sodium, 391, 652 
Ethylene Bichloride, 185 
Ethylidene Chloride, 186 
Ethylirtes Chloral urethan, 393 
Eucalyptene, 232 
Eucalyptol, 232 
Eucalyptolen, 232 
Eucalyptus, 232 
Eugenia aromatica, 173 

Jambolana, 279 
Eugenin, 173 
Eugenol, 174 
Euonymin, 233 
Euonymus, 233 
Eupatorin, 233 
Eupatorium, 233 

perfoliatum, 233 

purpureum, 234 
Euphrasia, 234 
Europhen, 274 
Evaporation, 463 

Spontaneous, 464 
Exalgin, 58 

Exanthemata, Diagnosis of, 750 
Excipients, 481, 486 



Excipients for Emulsions, 470 

for Mixtures, 481 

for Pills, 485 
Excitants, Cerebral, 26 

Ciliary, 33 
Excoriation, — See Intertrigo, 632 
Excretion, Agents affecting, 44 
Exhaustion, 587 
Exodyne, 58 
Exophthalmos, 587 
Exostosis, 587 
Expectorants, 32 
Explosive Compounds, 448 
Expression, 458 
Exsiccation, 456, 458 
Extemporaneous Pharmacy, 452 

Preparations, 465 

Prescriptions, 439 
Extract, Goulard's, 340 

Pond's, 252 
Extracta, 471 
Extracta Fluida, 472 
Extractive, 472 
Extracts, 471 
Eye-bright, 234 
Eye-Diseases, 588 

Ointments, Formulae for, 548 

Sensibility, Agents affecting it, 29 

Water, Formulae for, 548, 747 
Eyelids, 588 

Fabiana imbricata, 332 
Face, 588 

Face-ache, — See Neuralgia, Tic Doulou- 
reux, 655, 711 
Fainting, — See Syncope, 707 
False Pains, 589 
Farcy, 597 
Fat, — See Obesity, 660 

Hog, 85 

Wool, 85 
Fats and Oils, 300 
Fatigue, — See Exhaustion, 587 
Favus, — See Tinea Favosa, 712 
Febricula, — See Fever, Simple, 591 
Febrifuge, 195 
Feet, 589 

Fehling's Solution, 215 
Fel Bovis, 234 

Purificatum, 234 
Felon, — See Onychia, 662 
Fennel, 240 

Fermentation, Lactic, 370 
Fern, Male, 136 

Marginal Shield, 136 
Ferrier's Snuff, Formula, 537 
Ferro-cyanide of Potass., 74, 76 
Ferrum, 234 

Dialysatum, 237 

Reductum, 234 
Ferula fcetida, 134 

Galbaniflua, 241 

Sumbul, 406 



INDEX. 



785 



Fever, 589 

Bilious Remittent, Diagnosis, 753 

Cerebro-spinal, 647 

Hay, 604 

Hectic, 610 

Intermittent, 631 

Miliary, 65 1 

Milk, — See Lactation, 636 

Pernicious, — See Intermittent Fever, 
Remittent Fever. 

Puerperal, 688 

Relapsing, 691 

Remittent, 691 

Diagnosis of, 753 

Rheumatic, 692 

Scarlet, 697 

Diagnosis of, 750 

Simple, 591 

Spotted, — See Typhus Fever, also 
Meningitis, Cerebro-spinal. 

Surgical, 706 

Traumatic, — See Surgical Fever, 706 

Typhoid, 715 

Diagnosis of, 752 

Typho-malarial, — See Typhoid, 715 

Typhus, 717 

Diagnosis of, 752 

Yellow, 730 

Diagnosis of, 753 
Ficus (Fig), 240 
Filix Mas, 136 
Filtering-paper, 458 
Filtration, 458 
Fir, Balsam of, 409 

Scotch, 339 

Silver, 409 
Firs, 338 
Fish-berries, 332 
Fistula, 591 

Fits, — See Apoplexy, Convulsions, Epi- 
lepsy, Hysteria, Syncope. 
Flatulence, 592 
Flavoring Agents, 481 
Flaxseed, 286 
Flea-bane, 231 

Fleming's Tincture of Aconite, 8^ 
Flooding, — See Hemorrhage Post-partum 

Menorrhagia, and Metrorrhagia. 
Fluavil, 227 
Fluid, Antiseptic, 414 

Condy's, 293 

Disinfecting, 411 

Extracts, 472 
Flushing-heats, 592 
Fly-agaric, 91 
Foeniculum, 240 
Fomentation, 478 
Food, Horlick's, 292 
Mellin's, 292 
Parrish's, 327 
Foods, 41 

Foreign Bodies, 592 
Formamide, 183 



Formulae, Hypodermic, 741 
Formyl Iodide, 270 
Fotus, 478 

Fowler's Solution, 131 
Fox-glove, 219 
Fractures, 593 
Franciscea uniflora, 292 
Frangula, 241 
Frangulin, 24I 
Frankincense, 410 
Franklinite, 427 
Fraxin, 295 
Fraxinus Ornus, 294 
Freckles, 593 
Friar's Balsam, 145, 400 
Fuchsin, 241 
Fucus Vesiculosus, 241 
Furuncle, — See Boils, 523 
Fusel Oil, 94 
Fusion, 458 



Gaduin,299 

Gadus Morrhua, 299 

Galactagogues, 49 

Galbanum, 241 

Galla, 71, 242 

Galena, 340 

Gallipots, 501 

Gall-stones, — See Calculi, Biliary, 532 

Gallus Bankiva, 424 

Gamboge, 163 

Gangrene, 593 

of Lungs, 643 
Garcinia Hanburii, 163 

mangostana, 294 
Garfield Tea, 745 
Gargarysma, 474 

Gargles, Formulae for, 474, 567, 71 r. 
Garlic, 103 

Gaseous Preparations, 476 
Gastralgia, 594 
Gastric Dilatation, 595 

Fever, — See Fever, Simple, — Typhoid 
Fever, Gastritis. 

Pain, 37 

Sedatives, 37, 492 

Tonics, 35 

Ulcer, 596 

Vomiting, Diagnosis, 753 
Gastritis, Acute, 595 

Chronic, 595 
Gastrodynia, 594 
Gaultheria, 242, 370 
Gaultherilene, 242 
Gauze of Carbolic Acid, 64 

of Thymol, 414 
Gelatin, 268 

Capsules, 466 
Gelsemine, 242 
Gelsemium, 242 

Generative System, Agents affecting, 47 
Genitive Case-endings, 740 



;86 



INDEX. 



Gentian, 244 

Gentianin, 244 

Gentopicrin, 244 

Geranium, 71, 245 

Gigartina, 190 

Gin, 94 

Ginger, 429 

Glanders, 597 

Glandular Enlargements, 598 

Glass, Soluble, 346, 388 

Glauber's Salt, 391 

Glaucoma, 598 

Gleet, 495, 598 

Glonoin, 1 12 

Glossitis, 599 

Glottis, (Edema of, 599 

Gluco-pepsine, 322 

Glucose, 368 

Glucosides, 434 

Glycerin, 245 

Preparations, 475 
Glycerita, 475 
Glycerite of Boroglycerin, 62 

of Carbolic Acid, 64 

of Hydrastis, 263 

of Starch, 115 

of Tannic Acid, 81 

of Yolk of Egg, 424 
Glyceryl, 310 

Trinitrate, 1 12 
Glycocholate, Sodium, 234 
Glycocoll, 325 
Glycogen, 369 

Agents affecting its production, 40 
Glyconin, 424 

Emulsion, 300 
Glycozone, 246 
Glycyrrhetin, 246 
Glycyrrhiza, 246 
Glycyrrhizin, 246 

Glycyrrhizinum Ammoniatum, 247 
Gnoscopine, 311 
Goa-powder, 190 
Goitre, 599 
Gold, 138 

Chloride of, 138, 745 
Golden Seal, 262 
Gonorrhoea, 476, 600 
Gossypii Radicis Cortex, 247 
Gossypium, 247 
Goulard's Cerate, 341 

Extract, 340 
Gout, 602 

Diagnosis of, 751 
Granatum, 7 1 , 249 

Granular Lids, — See Conjunctivitis, Oph- 
thalmia. 
Granulation, 459 
Granule, 484 
Grass, Ribbed, 340 

Worm, 394 
Gravel root, 234 
Graves' Disease, — See Exophthalmos, 587 



Gray Powder, 256 
Griffith's Mixture, 235 
Grindelia, 250 

Grippe, — See Influenza, 628 
Guaiac, 250 
Guaiacol, 212 
Guarana, 157, 251 
Guaranine, 157, 251 
Gum Arabic, 58 
Sweet, 400 
Gumboil, — See Gums, 603 
Gum-tree, Blue, 232 
Gums, 603 

Gun-cotton, 248, 369 
Gunjah, 167 
Gurjun Balsam, 252 
Gutta, 227 
Gutta-percha, 227 
Guttae (Drops), 438 
Gynocardia odorata, 177 
Gypsum, 160 



Haematics, 41 

Hematoxylin, 252 

Haematoxylon, 71, 252 

Hagenia abyssinica, 218 

Hager's Tincture, 194 

Hair, 603 

Hair-tonic, 603 

Hair Washes, Formulae, 509, 603 

Haller's Dictum, 18 

Hamamelin, 252 

Hamamelis, 71, 252 

Hamburg Tea, 745 

Hamlin's Wizard Oil, 745 

Hands, — See Chapped Hands, 540 

Hashish, 167 

Haustus, 475 

Haw, Black, 423 

Hayah, 174 

Hay -fever, 604 

Head-ache, Bilious Sick, 605 

Congestive, 605 

Nervous, 606 
Heart, Dilated, 608 

Diseases, 607 

Fatty, 608 

Hypertrophied, 608 

Palpitation, 609 

Valvular Disease, 609 
Heartburn, — See Pyrosis, 690 
Heart's-ease, 424 
Hectic Fever, 610 
Hedeoma, 253 
Helenin, 270 
Hellebore, 252, 423 

American, 420 

Swamp, 420 

White, 420 
Helleborein, 253 
Helleborin, 253 
Helleborus, 253 



INDEX. 



787 



Helmbold's Buchu, 745 
Hematemesis, 610 

Diagnosis of, 751 
Hematocele, Pelvic, 611 
Hematuria, 61 1 
Hemeralopia, 612 
Hemicrania, 612 
Hemiopia, 614 
Hemiplegia, 614 
Hemlock, 207 

Spruce, 338 
Hemoptysis, 614 

Diagnosis of, 751 
Hemorrhage, 615 

Intestinal, 616 

Post-partum, 616 
Hemorrhagic Diathesis, 615 
Hemorrhoids, 467, 616 
Hemostatics, 51 
Hemp, 166 

American, 166 

Canadian, 121 

Indian, 166 
Henbane, 266 
Hepar Sulphuris, 403 
Hepatalgia, 618 
Hepatic Abscess, 620 

Cirrhosis, 618 

Congestion, 618 

Depressants, 40 

Diseases, 619 

Stimulants, 39 

Vomiting, Diagnosis, 753 
Hepatitis, 620 
Hernia, 621 
Herpes, 621 

Zoster, 621 
Hesperidin, 137, 285 
Heuchera, 71 
Hevea, 227 
Hiccough, 622 
Hip-joint Disease, 555 
Hive Mixture, 116, 382 

Syrup, 116, 382 
Hives, — See Urticaria, 720 
Hoang Nan, 254 
Hoarseness, — See Aphonia, 513 
Hoffman's Anodyne, 40, 87, 90 
HofFs Malt Extract, 292 
Holloway's Ointment, 745 

Pills, 745 
Homatropine, 142 
Homoeopathic Practices, 446 
Honduras Bark, 174 
Honey, 296 

Clarified, 296 

of Rose, 296, 364 
Honeys (Mellita), 479 
Hong- Pang Chong, 359 
Hooper's Female Pills, 490 
Hope's Mixture, 565 
Hop Tree, 360 
Hops, 255 i 



Hordeolum, — See Eyelids, 588 

Hordeum distichum, 292 

Horehound, 295 

Horlick's Food, 292 

Hostetter's Bitters, 745 

Housemaid's Knee, — See Bursitis, 531 

Humulus, 255 

Hunger, — See Appetite, 515 

Hunyadi Water, 551 

Huxham's Tincture of Bark, 193 

Hwang-Nao, 254 

Hydragogue Purgatives, ^S 

Hydrangea, 256 

Hydrargyrism, 258 

Hydrargyrum, 256 

Ammoniatum, 256 

cum Creta, 256 
Hydrastin, 263 
Hydrastine, 263 
Hydrastinine, 263 
Hydrastis, 262 

Hydrates, — See their basylous titles. 
Hydrides. — *' " " " 

Hydrobromates, — See their basylous titles. 
Hydrocele, 622 
Hydrocephalus, 623 

Hydrochlorates, — See their basylous titles. 
Hydrocotarnine, 311 
Hydrocotyle, 264 
Hydrogen Dioxide, 264 

Peroxide, 264 

Sulphuretted, 403 
Hydroleine, 300 
Hydronaphtol, 304 
Hydrophobia, 623 
Hydroquinone, 195, 196, 355, 417 
Hydrothorax, 623 
Hydroxymethane, 93 
Hygrine, 200 
Hygroscopic Bodies, 456 
Hyoscine, 180, 266 
Hyoscyamus, 266 
Hyoscyamine, 266 
Hyperidrosis, 672 
Hypnal, 119, 180 
Hypnone, 180 
Hypnotics, 27, 180, 630 
Hypochondriasis, 624 
Hypodermic Formulae, 741 

Injections, 21, 742 

Method, 21 

Solutions, 742 

Tablets, 22,499 
Hypophosphites, — See their basylous titles. 
Hyposulphites, — " " " " 

Hysteria, 624 

Diagnosis of, 750 



Ice, 126 

Iceland Moss, 177 
Ichthyocolla, 268 
Ichthyol, 403 



INDEX. 



Ichthyosis, 625 

Icterus, — See Jaundice, 634 

Igasurine, 306 

Ignatia, 269 

Ignition, 459 

Ileus, — See Intestinal Obstruction, 632 

Ilex Paraguay ensis, 157 

Illicium, 269 

Impetigo, 625 

Impotence, 625 

Incineration, 459 

Incompatibility, 446 

Chemical, 446 

Pharmaceutical, 449 

Rules for avoiding, 450 

Therapeutical, 450 
India-rubber, 226 
Indian Corn, 114, 426 

Hemp, 166 

Poke, 420 

Tobacco, 288 
Indigestion, — See Dyspepsia, 572 
Indigo, Wild, 140 
Inflammation, 626 
Influenza, 628 
Infusa, 475 
Infusions, 475 
Ingluvin, 322 

Inhalation of Thymol, 414 
Inhalations, Formulae for, 477 
Injection Brou, 476 

of Morphine, Hypodermic, 313 
Injections, 476 

Formulae, 476, 601 
Injuries, — See Bruises, Burns, Ecchymosis, 

Fractures, Sprains, Wounds. 
Inoculation, 22 
Inosit, 369 
Insanity, 627 

Insolation — See Sunstroke, 706 
Insoluble Salts, 448 
Insomnia, 629 
Intemperance, — See Alcoholism, Delirium 

Tremens. 
Intermittent Fever, 631 
Intertrigo, 632 
Intestinal Astringents, 39 
Intestinal Diseases, — See Colic, Constipa- 
tion, Diarrhoea, Duodenitis, Dysentery, 
Enteritis, Hemorrhoids, Hernia, Intes- 
tinal Obstruction, Intussusception, Ty- 
phlitis, Tabes Mesenterica, Worms. 
Intestinal Obstruction, 632 

Parasites, — See Worms, 728 
Intussusception, 633 
Inula, 270 
Inulin, 129, 270 

Iodides, 270, — See also their basylous titles. 
Iodine, 270 

Carbolated, 270 
Iodism, 271 
Iodized Cotton, 611 

Phenol, 270 



Iodol, 275 

Iodoform, 270 

Iodum, 275 

Ipecacuanha, 275 

Ipomcea Jalapa, 278 

Iridin, 277 

Iris, 277 

Irish Moss, 190 

Irisin, 277 

Iritis, 633 

Iron, 234 

Dialysed, 237, 457 

Pills, 490 

and Tannic Acid, 451 
Irritability, 633 
Irritants, Cutaneous, 49 
Ischuria. — See Urinary Disorders, 719 
Isinglass, 268 

Isobutyl-orthocresol Iodide, 274 
Isonandra Gutta, 227 
Iso-naphtol, 304 
Itch, — See Scabies, 696 
Itching, — See Lichen, Prurigo, Pruritus, 

Pediculi, Scabies, Urticaria, etc. 
Ivy, Poison, 359 



Jaborandi, 334 

Jaborine, 334 

Jalap, 278 

Jalapin, 278, 381 

Jambul, 279 

James' Powder, 116 

Jamestown Weed, 396 

Jamun, 279 

Japaconitine, 83 

Jasmine, Yellow, 242 

Jateorhiza palmata, 163 

Jaundice, 634 

Jequirity, 57 

Jervine, 420 

Joint Affections, 634 

Juglans, 279 

Juniperin, 279 

Juniper, 279 

Juniperus communis, 279 
Oxycedrus, 279 
Sabina, 367 
Virginiana, 367 



Kairin, 195 
Kairoiin, 196 
Kalium, 344 
Kalmia Latifolia, 296 
Kamala, 280 
Kavahin, 280 
Kava-kava, 280 
Kawin, 280 

Keeley's Gold Cure, 745 
Kefir, 282 
Keratitis, 635 
Kermes Mineral, 116 



INDEX. 



789 



Kidneys, Diseases of, — See Albuminuria, 
Bright's Disease, Calculi, Diabetes, 
Dropsy, Hematuria, Lithaemia, Ne- 
phritis. 

Kino, 71, 281 

Kinoin, 281 

Kino-red, 281 

Kinovin, 193 

Kombe arrow-poison, 398 

Koomiss, 281 

Koussin, 218 

Kousso, 218 

Krameria, 71, 281 

Kumyss, 95, 281 

Kumysgen, 282 

Kurung Oil, 344 



Labarraque's Solution, 52, 189 

Labor, 635 

Lac Sulphuris, 402 

Lactation, 636 

Lactopeptine, 322 

Lactose, 368, 369 

Lactuca virosa, 283 

Lautucerin, 283. 

Lactucin, 283 

Lactucarium, 283 

Ladies' Slipper, 219 

La Fayette's Mixture, 210 

Lallemand's Specific, 601 

Lanolin, 85 

Lanthopine, 31 1 

Lapathin, 366 

Lappa, 283 

Larch, 90 

European, 90, 410 
Lard, 85 

Benzoinated, 85, 145 

Oil, 85 
Larix Europsea, 410 
Laryngismus Stridulus, 637 
Laryngitis, 637 
Laryngotomy, 638 
Latin Phrases and Terms, 731 
Laudanine, 31 1 
Laudanosine, 31 1 
Laudanum, 312 
Laurel, Cherry, 74 

Mountain, 296 
Laurocerasus, 74 
Lavandula, 284 
Lavender, 284 

Water, 284 
Laville's Anti-gout Remedy, 206, 745 
Laxatives, 38 

Powder, 492 
Lead, 340 

Colic, 546 

Plaster, 341 

Sugar of, 340 

Water, 341 

and Laudanum, 342, 478 



Lead, White, 340 
Leek, 103 

Legal's Disease, 657 
Lemon, 285 

Juice, 285 

Peel, 285 
Lentigo, — See Freckles, 593 
Leopard's Bane, 129 
Leprosy, 638 
Leptandra, 284 
Leptandrin, 284 
Lettuce, 283 
Leucocythsemia, 639 
Leucolin, 178 

Leucoma, — See Corneal Opacities, 552 
Leucorrhcea, 639 
Levigation, 463 
Levulose, 369 
Lice, — See Pediculi, 670 
Lichen, 640 
Lichenin, 177 

Licoperdon giganteum, 284 
Lignum Vitae, 250 
Lily-of-the-Valley, 209 
Lily, Water, 309 
Lime, 160, 285 

Chlorinated, 189 

Kinovate, 193 

Sulphurated, 403 

Water, 161 
Limon, 285 
Limonis Cortex, 285 

Succus, 285 
Liniment, Anodyne, 477 

Army, 477 

Chloroform, Compound, 185, 477 

Lime, 161, 286, 378 

Stokes', 477 
Linimenta, 477 
Liniments, Formulae, 477 
Linseed, 286 
Lint, Boracic, 62 
Linum, 286 

Lips, — See Chapped Lips, 540 
Lip-salve, Red, 413 
Liquid-ambar orientalis, 400 
Liquids, Normal, 474 
Liquores, 478 
Liquorice Root, 246 

Wild, 57 
Lithsernia, 640 
Litharge, 340 
Lithium, 287 
Lith<5ntriptics, 46 
Liver, — See Hepatalgia, etc., 618 
Liver of Sulphur, 403 
Lixiviation, 459 
Lobelacrin, 288 
Lobelia, 288 
Lobelin, 288 
Lobeline, 288 
Lochia, — See Labor, 635 
Lock-jaw, — See Tetanus, 710 



79Q 



INDEX. 



Locomotor Ataxia, 641 
Log- wood, 71, 252 
Lotion, 478 

Black, of Mercury, 257 

Boric, 62 

Yellow, of Mercury, 257 
Loxopterygium Lorentzii, 136 
Lozenges, 499 
Lugol's Solution, 270 
Lumbago, 641 

Lumbrici, — See Worms, 728 
Lungs, Diseases of, 642 

Gangrene of, 643 
Lupulin, 255 
Lupuline, 255 
Lupus, 643 
Lycopodium, 289 
Lyctonine, 83 
Lymphangeitis, 643 
Lysol, 68 



Mace, 302 

Oil of, 302 
Maceration, 459 
Macis, 302 
Macrotin, 191 
Magendie's Solution, 313 
Magenta, 241 
Magma, 461 
Magnesia, 290 

Ponderosa, 290 
Magnesium, 290 
Magnolia, 291 
Magnolin, 292 
Maize, 114, 426 
Malaria, 644 
Male Fern, 136 
Mallotus phillipinensis, 280 
Malt, 292 

Extract, Hoff's, 292 
Maltum, 292 
Mammary Abscess, 504 
Manaca, 292 
Mandrake, 343 
Manganese, 292 

Oxide, 292 
Manganum, 292 
Mangifera indica, 294 
Mango, 294 
Mango-fruit, 294 
Mangosteen, 294 
Mania, 644 
Mania, Puerperal, 688 
Manna, 294 
Mannit, 294 
Mannite, 249 
Manzanita, 417 
Marasmus, — See Atrophy, Emaciation, 

Tabes Mesenterica. 
Marc, 473 
Margarin, 85 
Marginal Shield Fern, 136 



Marigold, 162 
Marjoram, Wild, 319 
Marrubiin, 295 
Marrubium, 295 
Marsh-mallow, 105 
Mass of Copaiba, 210 

of Ferrous Carbonate, 235 
of Mercury, 256 
Vallet's, 235 
Massae, 478 
Mastic, 295 
Mastichin, 295 
Mastitis, 645 
Mastodynia, 646 

Masturbation. — See Emissions, Spermator- 
rhoea, 578, 702 
Mate, 157 

Materia Medica, 17, 57 
Matico, 295 
Matricaria, 296 

Chamomilla, 296 
May Apple, 343 

McMunn's Elixir of Opium, 312 
Meadow Anemone, 350 

Saffron, 205 
Measles, 646 

Diagnosis of, 750 
False, — See Roseola, 696 
Temperature in, 755 
Measures, Approximate, 438 
Domestic, 438 
and Weights, 435, 771 
Meconidine, 311 
Meconoiosin, 311 
Meconin, 311 
Medicines, Administration of, 20 

Classification of, 23 
Meerschaum, 388 
Mel, 296 

Despumatum, 296 
Rosse, 296 
Melaleuca Leucadendron, 160 
Melancholia, 647 

Puerperal, 688 
Melia Azedarach, 139 
Melissa, 296 
Mellin's Food, 292 
Mellita, 479 

Meningitis, Cerebral, 647 
Cerebro-spinal, 647 
Spinal, 648 

Tubercular, — See Hydrocephalus, 623 
Menispermin, 332 
Menispermum, 297 
Cocculus, 332 
Menopause, — See Climacteric, 545 
Menorrhagia, 649 
Menstrual Disorders, 649 
Menstruum, 459 
Mentagra, 650 
Mentha arvensis, 297 
Canadensis, 297 
Piperita, 297 



INDEX. 



7 9 I 



Mentha Viridis, 298 
Menthol, 297 
Mercaptan, 400 
Mercaptol, 400 
Mercurial Ointment, 256 

Plaster, 256 
Mercuric Chloride, 256 

Iodide, 257 
Mercurio-vegetal, 292 
Mercurous Chloride, 256 

Iodide, 257 
Mercury, 256 

Ammoniated, 256 

with Chalk, 256 

Vegetable, 292 
Mesenteric Disease, — See Tabes Mesen- 

terica, 709 
Metabolism, Agents affecting, 41 
Metadioxybenzol, 355 
Methacetin, 325 
Methane, 89 
Methene Chloride, 89 
Methol, 93 
Methyl-acetanilid, 58 
Methyl Alcohol, 89, 93 

Bromide, 89 

Chloride, 184, 186, 420 
Bichlorinated, 184 

Conifne, 207 

Creosol, 212 

Ether of Protocatechuic Aldehyde, 420 

Hydrate, 93 

Pyrocatechin, 212 

Salicylate, 242, 371 

Terchloride, 184 
Methyl al, 89, 180 
Methylated Spirit, 94 
Methylene Bichloride, 186 

Blue, 299 
Methylene-dimethyl Ether, 180 
Methysticin, 280 
Metric Prescriptions, 443 

System of Weights, etc., 436, 771 

Table for Converting, 772 
Metritis, Acute, 650 
Metrorrhagia, 650 
Mezereon, 299 
Mezereum, 299 
Microbe-killer, 746 
Microbes in Water, 125 
Migraine, 612 
Miliary Fever, 651 

Milk, — See Agalactia, Lactation, 507, 636 
Milk of Asafetida, 134 

of Sulphur, 402 
Milk-fever, — See Lactation, 636 
Mindererus, Spirit of, 108 
Mineral Green, 132 
Mineral Waters, 123 
Mint, 298 

Miscarriage, — See Abortion, 503 
Mistletoe, 424 
Misturse, 479 



Mixture, Basham's, 236, 569 

Bismuth, for children, 482 

Brown, 247 

Chalk, 161 

Clarke's, 745 

Copaiba, Compound, 210 

Coxe's Hive, 116, 382 

Ferro-saline, 238 

Griffith's, 235 

Hope's, 565 

Iron, Aromatic, 237 
Compound, 235 
Laxative, 238 

Lafayette's, 210 

Laville's, 206, 745 

Liquorice, Compound, 247 

Magnesia and Asafetida, 135, 290 

Neutral, 345 

Quinine, 482 

Potassium Citrate, 345 

Rhubarb and Soda, 358 

Scudamore's, 601 

Squibb's, 312, 542 
Mixtures, 479 

Anaesthetic, 87 

Compounding of, 481 

Substances suitable to, 479 
Moccasin-plant, 219 
Molasses, 369 
Mole, — See Naevus, 652 
MollitiesOssium, — See Bone Diseases, 524, 

Rachitis, 690 
Monkshood, 82 
Monsel's Solution, 236 
Moonseed, Canadian, 297 
Morbilli,— See Measles, 646 
Morphine, 31 1, 313 

and Atropine, 319 

Habit, 663 
Morrhuae Oleum, 299 
Morrison's Pills, 163, 746 
Moschus, 301 
Mosquitoes, 705 
Motor Depressants, 24 

Excitants, 24 
Mouth Diseases, — See Aphthae, Cancrum 
Oris, Gums, Parotitis, Ptyalism, Stomatitis, 
Toothache, Tongue. 
Mouth Washes, Formulae, 603 
Mucilagines, 483 
Mucus in Urine, Test for, 759 
Mullein, 423 

Mumps, — See Parotitis, 670 
Muscae Volitantes, 651 
Muscarine, 91 

Muscular Disorders, — See Atrophy, Chorea, 
Hydrophobia, Laryngismus, Lumbago, 
Myalgia, Pleurodynia, Rheumatism, Te- 
tanus, Torticollis. 
Musk, 301 
Mustard, 388 
Myalgia, 651 
Mydriasis, 143 



792 



INDEX. 



Mydriatics, 28 
Myelitis, 652 
Mykose, 228 
Myopia, 652 
Myotics, 29 
Myrcia, 302 
Myrica, 71 

cerifera, 176 
Myricin, 176 
Myristica, 302 
Myristicol, 302 
Myronate, Potassium, 389 
Myrosin, 389 
Myrrh, 303 
Myrrhin, 303 
Myrrhol, 303 
Myrtle, 71 
Myrtol, 511 



Nsevus, 652 
Nails, Ingrowing, 652 
Napelline, 83 
Naphtalin, 195, 303 
Naphtol, 304 

Camphorated, 304 
Narceine, 311 
Narcotics, 26 
Narcotine, 311 
Nasal Affections, 652 

Injections, Formulae, 567 
Natrium, 390 
Nausea, 653 
Necrosis, 653 
Nectandra, 320 
Nervous Affections, 653 

Exhaustion, 654 
Nervousness, 633, 655 
Nervous System, Agents affecting, 24 
Neuralgia, 655 

Ovarian, 666 
Neurasthenia, 658 
Neuritis, 659 
Nicotiana Tabacum, 407 
Nicotianin, 407 
Nicotine, 407 
Niemeyer's Pill, 678 
Nightmare, 659 
Nightshade, Black, 226 

Deadly, 141 

Woody, 226 
Night Sweats, — See Hectic Fever, Per- 
spiration, Phthisis. 
Nipples, Fissured, 659 

Sore, 659 
Nitrates, — See their basylous titles. 
Nitre, 345, 391 

Chili, 391 

Sweet Spirit of, 87 
Nitrites, — See their basylous titles. 
Nitro-benzene, 195 

-benzol, 1 1 1 

-glycerin, 112 



Nitrous Ether, 87, 90 

Oxide, 89 
Nodes, 660 
Normal Liquids, 474 
Norwood's Tincture, 42] 
Norway Spruce, 338 
Nucin, 279 
Nutgall, 71, 242 
Nutmeg, 302 
Nux Vomica, 305 
Nyctalopia, 612 
Nymphaea, 71 

Odorata, 309 
Nymphomania, 660 



Oak-bark, 71, 353 

Black, 353 
Oak, Dyer's, 242 

Poison, 360 

White, SS3 
Oat, 139 
Obesity, 660 
Odontalgia, 661 
CEsophagus, Affections of, 661 
Official Operations, 455 

Preparations, 464 
Officinal, — See Preface. 
Oil of Allspice, 336 

of Almond, Bitter, in 
Expressed, 112 

of Amber, 400, 411 

of Anise, 115, 269 

of Anthemis, 115 

of Aurantium Cortex, 138 
Flores, 138 

of Bay, 302 

Benne, 387 

of Bergamot, 147 

of Betula, 371 

of Birch, 371 

of Cade, 279 

of Cadinum, 279 

of Cajuput, 160 

of Caraway, 173 

of Carum, 173 

Carron, 16 1, 286 

of Cassia, 199 

Castor, 361 

of Caryophyllus, 173 

of Cedar, 377 

Chamomile, 115 

Chaulmoogra, 177 

of Chenopodium, 178 

of Cinnamon, 199 

of Cloves, 173 

Cod-liver, 299 

Hydrated, 300 

of Copaiba, 210 

of Coriander, 211 

of Cotton-seed, 248 

Croton, 415 



INDEX. 



793 



Oil of Cubeb, 215 
Disinfection, 69 
of Erigeron, 231 
Ethereal, 86 
of Eucalyptus, 232 
of Fennel, 241 
of Fleabane, 231 
Fusel, 94 

of Gaultheria, 242, 371 
of Gossypium-seed, 248 
Hamlin's Wizard, 745 
of Hedeoma, 253 
of Hemlock, 339 
Hydrated, 300 
Jecoris Aselli, 299 
of Juniper, 279 
Kurung, 344 
Lard, 85 

of Lavender-flowers, 284 
of Lemon, 285 
of Linseed, 286 
of Linum, 286 
of Mace, 302 
of Mentha Piperita, 297 
of Mentha Viride, 298 
of Mirbane, in 
of Morrhua, 299 
of Mustard, Volatile, 389 
of Myrcia, 302 
of Myristica, 302 
of Neroli, 138 
of Nutmeg, 302 
Olive, 309 

of Orange flowers, 138 
of Orange-peel, 138 
of Origanum, 319 
of Pennyroyal, 253 
of Peppermint, 297 
Phosphorated, 326 
of Pimenta, 336 
of Pinus Silvestris, 339 
of Pix Liquida, 338 
of Pongamia, 344 
of Ricinus, 361 
of Rose, 363 
of Rosemary, 364 
of Rue, 366 
of Ruta, 366 
of Sabina, 367 
Salad, 309 
of Sandalwood, 377 
of Santal, 377 
of Sassafras, 380 
of Savine, 367 
of Scotch Fir, 339 
Sequah's, 747 
of Sesamum, 387 
of Sinapis, Volatile, 389 
of Spearmint, 298 
of Spruce, 339 
St. Jacob's, 747 
Sweet, 309 
of Succinum, 400, 411 



Oil of Tabacum, 407 

of Tanacetum, 409 

of Tansy, 409 

of Tar, 338 

Teel, 387 

of Terebinthina, 410 

of Theobroma, 413 

of Thuja, 411, 413 

of Thyme, 414 

of Tiglium, 415 

of Turpentine, 410 

of Valerian, 418 

of VVintergreen, 242, 371 

Wizard, 745 

Wood, 252 
Oils, Expressed, 458 

Fixed, 458 
Ointment, 176 

Antipruritic, 501 

Basilicon, 354 

Blue, 256 

Calamine, 429 

Citrine, 257 

Diachylon, 341 

Holloway's, 745 

Pagenstecker's, 549 

Tar, 338 

White Precipitate, 256 
Ointments, 499 

Compounding, 500 

Formulae for, 501 
Olea Europsea, 309 
Oleaginous Preparations, 464 
Oleata, 483 
Oleates, 483 
Olein, 85, 299, 310 
Oleoresina, 483 
Oleoresins, 483 
Olive, 309 
Onion, 103 
Onychia, 662 

Operations, Pharmaceutical, 455 
Ophthalmia, 662 

Opisthotonos, — See Tetanus, 710 
Opium, 310 

Denarcotized, 312 

Deodorized, 312 

Habit, 663 
Opodeldoc, 379 
Orange, 137, 285 

Blossom, 746 
Orchitis, 665 
Ordeal Bark, 174 
Oregon Grape, 146 
Origanum, 319 
Otalgia, 665 
Otitis, 665 
Otorrhoea, 666 
Ouabain, 399 
Ovarian Neuralgia, 666 

Tumors, — See Cysts, 558 
Ovaritis, 666 
Ovis Aries, 388 



794 



INDEX. 



Oxaluria, 667 

Ox-gall', 234 

Oxides, — See their basylous titles. 

Oxidizers, 448 

Oxyethyl-acetanilid, 324 

Oxymel, 296, 479 

Oxymethyl-acetanilid, 325 

Oxytocics, 48 

Oyster-shell, 161 

Ozaena, 667 



Pagliari's Styptic, 615 
Pain, 318, 668 

Chest, 540 

Gastric, 37 
Pains, After-, 507 

False, 589 
Paints, 483 

Palmitateof Cetyl, 177 
Palmitin, 310 
Pancoast's Styptic, 615 
Pancreas, Agents affecting, 40 
Pancreatin, 322 
Pancreopepsin , 322 
Panus, — See Corneal Opacities, 552 
Pansy, 424 
Papain, 322 
Papaiva, 322 

Papaver Somniferum, 310 
Papaverine, 311 
Papaw Milk, 323 
Papers (Chartae), 467 
Papine, 312 
Papoid, 323 
Para Rubber, 227 
Parachinanisols, 196 
Paraconiine, 207 
Paracoto Bark, 211 
Paracotoin, 211 
Paraldehyde, 319 
Paralysis, 669, 703 

Agitans, 670 
Para-acetphenetidin, 324 
Paramenispermin, 332 
Paramorphine, 311 
Paraphimosis, — See Phimosis, 675 
Paraplegia, — See Paralysis, 669, 703 
Parasiticides, 53 
Paregoric, 312 
Pareira, 320 
Parigenin, 379 
Parilla, Yellow, 297 
Parillin, 379 
Paris Green, 132 
Paronychia, 662 
Parotitis, 670 
Parsley, 12 1 

Parrish's Chemical Food, 327 
Participles, 740 
Parvule, 484 
Paste, Black, 601 

Vienna, 345 



Pasteur's Inoculation, 623 
Pastilles, 498 
Pasque-flower, 350 
Patent Medicines, 744 
Paullinia cupana, 157, 251 
Pavy's Solution, 756 
Pearson's Solution, 131 
Pectin, 353 
Pediculi, 670 
Pelletierine, 249 
Pellitory, 352 

Persian, 352 
Pelosine, 320 
Pemphigus, 671 
Pencils, 494 
Penis, — See Chancre, Chancroid, Chordee, 

Gleet, Gonorrhoea, Phimosis, Urethra. 
Pennyroyal, 253 
Pennywort, 264 
Pental, 88 
Pepo, 321 
Pepper, African, 170 

Black, 336 

Cayenne, 170 

Water, 344 
Peppermint, 297 
Pepper-vine, 336 
Pepsin, 321 

Liquid, 322 

Saccharated, 322 
Pepsinum, 321 

Peptogenic Milk Powder, 322 
Perchloride, Iron, 235 
Percolation, 459 
Pericarditis, 671 

Diagnosis of, 749 
Periostitis, 671 
Peritonitis, 672 

Puerperal, 689 
Permanganate, Potassium, 293 
Pernicious Fever, — See Intermittent Fever, 

Remittent Fever. 
Peroxide, Barium, 141 

Hydrogen, 264 
Perry Davis's Pain-Killer, 746 
Persimmon, 71 
Perspiration, 672 
Pertussis, 673 
Peruvian Bark, 192 
Petrolatum, 324 
Petroleum Ether, 144 

Ointment, 324 
Petroselinum sativum, 1 2 1 
Peumus Boldo, 149 
Phseoretin, 357 
Phagedena, — See Chancre, Chancroid, 

Gangrene, Ulcers. 
Pharmaceutical Incompatibility, 449 

Preparations, 465 

Rules, 454 
Pharmaceutists, — Their objectionable prac- 
tices, 445, 452,475 
I Pharmacology, 17 



INDEX. 



795 



Pharmacopoeias, List of, 431 
Pharmacy, 17, 431 

Extemporaneous, 452 

Official, 455 

Rules for neophytes, 454 
Pharyngitis, 674 
Phaseo-mannit, 369 
Phenacetin, 196, 324 
Phenazone, 1 18 
Phenocoll Hydrochloride, 325 
Phenol, 63, 195 

Camphor, 64 

Iodized, 64 

Sodique, 64 
Phenolid, 58 
Phenols, 64 
Pheno-resorcin, 196 
Phenyl, 195 

Hydride, 145 

Salicylate, 371 
Phenyl-acetamide, 58 
Phenyl-methyl-acetone, 180 
Phenylic Alcohol, 63 
Phimosis, 675 
Phlebitis, 675 

Phlegmasia Alba Dolens, 675 
Phlegmon, 676 
Phlorol, 212 

Phosphates, 326. — See, also, their basylous 
titles. 

Syrup of, 327 
Phosphide, Zinc, 327 
Phosphites, 326 
Phosphorus, 326 
Photophobia, 676 
Phthisis, 676 

Diagnosis of, 752 

Temperature in, 755 
Physeter macrocephalus, 177 
Physiological Antagonists, 450 
Physostigma, 330 
Physostigmine, 330 
Phytolacca, 331 
Phytoline, 332 
Pichi, 332 

Picraena excelsa, 352 
Picrates, 79 
Picroglycion, 226 
Picropodophyllin, 343 
Picrotoxin, 332 
Pierce's Favorite Prescription, 746 

Golden Discovery, 746 
Pigmenta, 483 
Piles, 469, 616 
Pill, Blancard's, 235 

Blaud's, 235 

Blue, 256 

Cathartic, Compound, 206 
Vegetable, 206 

Ferruginous, 235 

Lady Webster's, 105 

Niemeyer's, 678 

Plummer's, 116 



Pill, Tanjore, 705 
Pill-masses, 478, 485 
Pills, 484 

Ayer's, 744 

Brandreth's, 744 

Coated, 488 

Compressed, 489, 493 

Excipients for, 485 

Formulae for, 490 

Holloway's, 745 

Morrison's, 163, 746 

Official, 484 

Process of making, 484 

Substances suitable for, 487 
Pilocarpine, 334 
Pilocarpus, 334 
Pilulse, 484 
Pimenta, 336 
Pimpinella Anisum, 115 
Pimples, — See Acne, 505 
Pine, Prince's, 178 

Yellow, 409 
Pinene, 410 
Pines, 338 
Pinipicrin, 413 
Pinites succinifer, 400, 411 
Pink, Carolina, 394 
Pink-root, 394 
Pinus, 338 

Australis, 410 

Palustris, 338, 409 

Syivestris, 339 

Taeda, 410 
Piper, 336 

angustifolium, 295 

cubeba, 214 

methysticum, 280 
Piperazin, 336 
Piperin, 336 
Pipsissewa, 178 
Piscidia, 337 
Piscidin, 337 
Pissenlit, 409 
Pistaceae Terebinthus, 410 
Pistacia Lentiscus, 295 
Pitaya Bark, 192 
Pitch, 33 S 
Pityriasis, 679 
P'x, 338 

Pix Liquida, 338 
Planat's Tincture, 333 
Plantago, 340 
Plantain, 340 
Plaster, Adhesive, 354 

Court, 268 

Diachylon, 341 

Isinglass, 268 

Strengthening, 236 

Vesicating, 469 

Warming, 168, 170, 338 
Plasters, 469 

Formulae for, 469 

Preparations of, 469 



y 9 6 



INDEX. 



Plethora, 679 

Abdominal, 503 
Pleurisy, 679 

Diagnosis of, 752 
Pleurisy-root, 135 
Pleuritis, 679 
Pleurodynia, 680 
Pleuro-pneumonia, 681 
Plum, 349 
Plumbum, 340 
Plummer's Pills, 1 16 
Pneumonia, 68 1 

Diagnosis of, 752 
Podophyllin, 343 
Podophyllitoxin, 343 
Podophyllum, 343 
Poison Ivy, 359 

Oak, 360 

Sumach, 359 
Poisoning, 53, 758. — See also the several 
poisons under their titles in Part I. 

Antidotes and Antagonists, 53, 758 

Treatment of, — Indications for, 53 
General Principles of, 758 
Poisonous Compounds, 448 
Poisons, Energetic, 758 
Poke-berry, 331 
Poke, Indian, 420 
Poke-root, 331, 420 
Polygala Senega, 385 
Polygonum, 344 
Polyporus fomentarius, 91 

officinalis, 90 
Polypus, 682 

Polyuria, — See Diabetes Insipidus, 561 
Pomade de Bareges, 679 
Pomegranate, 71, 249 
Pond's Extract, 252 
Pond Lily, 71 
Pongamia, 344 
Poppy, White, 310 
Porphyrization, 463 
Porphyroxin, 31 1, 375 
Porrigo Capitis, — Tinea Tonsurans, 712 
Porter, 95 
Port Wine, 94 
Potash, 344 
Potassa, 344 

Alum, fo6 

cum Cake, 345 

Sulphurata, 403 
Potassio-ferric Tartrate, 237 
Potassium, 344 

Permanganate, 293 
Potato, 226 
Potato-spirit, 94 
Potentilla Sarmentosa, 672 
Pot us, 491 
Poultices, 466, 682 

List of Br. Official, 466 
Powder, Aromatic, 199 

Dover's, 276, 312 

Effervescing, 346 



Powder, Gray, 256 

James', 116 

Purgative, 278 

Seidlitz, 346 

Tully's, 313 
Powders, 491 

Formulae for, 492 

Substances suitable to, 492 
Prairie Flower, 747 
Precipitant Solutions, Table of, 447 
Precipitate, White, 256 

Red, 257 
Precipitation, 461 
Pregnancy, Disorders of, 683 

Vomiting of, 726 
Premna tatiensis, 416 
Preparations, Acetous, 464 * 

Alcoholic, 464 

Aqueous, 464 

Ethereal, 464 

Gaseous, 476 

Glycerin, 464 

Liquid, 464 

Oleaginous, 464 

Pharmaceutical, 465 

Solid, 464 
Prepositions, 740 
Prescriptions, 439 

Analysis of, 439 

Blanks for, 444 

Contractions, 444, 731 

Filling of, 453 

Metric, 443 

Renewals, 445 

Table of Doses, 772* 

Tonic, 507, 511, 659 
Prescription Writing, 442 

Latin Words used in, 731 
Prickly Heat, — See Lichen, 640 
Pride of China, 139 
Prince's Pine, 178 
Principles in Drugs, 432 
Prinos, 349 

Proctitis, — See Rectum, 690 
Prolapsus Ani, 683 

Uteri, 683 
Pronunciation, 739 
Propyl Oxide, 299 
Propylamine, 130 
Prosopalgia, — See Neuralgia, Odontalgia,. 

Tic Douloureux. 
Prostate, Hypertrophied, 684 
Prostatitis, 684 
Prostatorrhoea, 684 
Protectives, 51 
Protiodide of Mercury, 257 
Protopine, 311 
Prune, 349 
Prunum, 349 
Prunus Amygdalus, in 

domestica, 349 

Laurocerasus, 74 

Serotina, 350 



INDEX. 



797 



Prunus Virginiana, 74, 350 
Prurigo, 684 
Pruritus, 685 
Pseudaconitine, 83 
Pseudo-jervine, 420 
Pseudo-morphine, 31 1 
Pseudotropine, 266 
Psoriasis, 686 
Ptelea trifoliata, 360 
Pterocarpus marsupium, 281 

santalinus, 377 
Pterygium, 687 
Ptosis, 687 

Ptyalism, 35, 259, 687 
Puccine, 375 
Puerperal Convulsions, 687 

Disorders, 688 

Fever, 688 

Mania, 688 

Melancholia, 688 

Peritonitis, 689 
Puff-ball, 284 
Pulmonary Sedatives, 31 
Pulsatilla, 350 
Pulse, 689 

and Temperature, 755 
Pulveres, 491 
Pulverization, 463 
Pumpkin-seed, 321 
Punica Granatum, 249 
Purgatives, ^8 
Purging Agaric, 90 

Cassia, 175 
Purpura, 689 

Pus in Urine, Test for, 757 
Pustule, Malignant, 690 
Pustules, — See Ecthyma, Eruptions, Im- 
petigo, Pustule Malignant. 
Pustulants, 50 
Pyaemia, 690 
Pyrethrine, 352 
Pyrethrum, 352 

Roseum, 352 
Pyridine, 195, 407 
Pyrocatechin, 195, 196, 338, 355 
Pyrogallol, 71, 195 
Pyrrol, 275 
Pyrophosphate of Iron, Soluble, 236 

of Sodium, 327 
Pyrosis, 690 
Pyroxylin, 248, 369 
Pyrozone, 266 



Quantities, Table of, 772 * 
Quassia, 352 

Surinam, 352 
Quassin. 353 
Quebrachine, 136 
Quebracho, 136 
Queen's Delight, 395 

Root, 395 
Quercin, 353 



Quercitrin, 353 
Quercus Alba, 71, 353 

Lusitanica, 242, 353 

Tinctoria, 353 
Quicksilver, 256 
Quillaja, 354 
Quince-seed, 218 
Quinetum, 195 
Quinicin, 195 
Quinidine, 193 
Quinine, 193 

Mixture, 480, 482 

Solutions of, 480 
Quinoidin, 194 
Quinquinina, 195 
Quinsy, — See Tonsillitis, 713 



Rabies, — See Hydrophobia, 623 
Rachitis, 690 

Radam's Microbe-killer, 746 
Radway's Ready Relief, 746 

Resolvent, 746 
Raspail's Eau Sedative, 108, 164 
Raspberry, 365 
Recamier Balm, etc., 746 
Rectum, Absorption by, 20 

Diseases of, 690 

Prolapse of, 683 

Ulceration of, 691 
Red Gum, — See Strophulus, 706 
References and Bibliography, 502 
Refrigerants, 35 
Relapsing Fever, 691 
Remijia, 192 
Remittent Fever, 691 

Diagnosis of, 753 
Renal Depressants, 44 
Renewals of Prescriptions, 445 
Repercolation, 461 
Resin, 354, 410 

Cerate, 354 

of Copaiba, 210 

of Guaiac, 250 

of Jalap, 278 

Plaster, 354 

of Podophyllum, 343 

of Scammony, 381 
Resina, 354, 410 
Resinae, 493 
Resinol, 339 
Resolvents, 42 
Resorcin, 64, 195, 355 
Resorcinol, 355 

Respiration, — See Bronchitis, Croup, Dysp- 
noea, Emphysema, Pneumonia, etc. 
Respiration, Agents affecting, 30 

Artificial, 517 
Respiratory Depressants, 30 

Stimulants, 30 
Restoratives, 41 
Retina, Affections of, 692 
Retinol, 339 



; 9 8 



INDEX. 



Revalenta Arabica, 746 
Rhamnoxanthin, 241 
Rhamnus Frangula, 241 

Purshiana, 357 
Rhaphidophora vitiensis, 416 
Rhatanine, 281 
Rhatany, 71, 281 
Rheum, 357 

Rheumatic Arthritis, 515 
Rheumatism, Acute, 692 

Chronic, 694 

Diagnosis of, 751 

Gonorrhceal, 695 

Muscular, 695 
Rhinacanthin, 359 
Rhinacanthus, 359 
Rhinitis, — See Catarrh, Acute Nasal, also 

Nasal Affections. 
Rhoeadine, 31 1 
Rhubarb, 357 
Rhus Aromatica, 359 

diversiloba, 360 

glabra, 359 

pumila, 360 

radicans, 359 

Toxicodendron, 359 

venenata, 360 
Ricinus communis, 361 
Rickets, — See Rachitis, 690 
Rigors, — See under Fever, 589 
Ring-worm, 711, 712 
Roasting, 462 
Rochelle Salt, 345 
Rosa centifolia, 363 

Damascena, 363 

Gallica, 71, 363 
Rosanilin, 241 
Rose, 71,363 

Attar of, 363 

Cabbage, 363 

Pale, 363 

Red, 71,363 
Roseine, 241 
Rosemary, 71, 364 
Roseola, 696 
Rosin, 354 
Rosmarinus, 364 
Rottlera, 280 

tinctoria, 280 
Rottlerin, 280 
Rubber, India, 226 
Rubefacients, 50 
Rubeola, — See Measles, 646 
Rubidium, 364 
Rubijervine, 420 
Rubini's Tincture, 164 
Rubus, 71, 365 

Canadensis, 365 

Idseus, 365 

occidentalis, 365 

trivialis, 365 

strigosus, 365 

villosus, 365 



Rue, 366 

Rules for Incompatibility, 448 

for Pharmaceutists, 454 
Rum, 94 

Bay, 302 
Rumex, 365 
Rumicin, 366 

Rupia, — See Pemphigus, 67 1 
Ruta, 366 
Russian Spirit, 695 
Rye, 228 



Sabadilla, 421 
Sabina, 367 
Saccharin, 368 
Saccharum, 368 

Lactis, 368, 369 
Sacred Bark, 357 
Safflower, 214 
Saffron, 214 

American, 214 

Meadow, 205 
Saffron-tea, 214 
Safrol, 164, 380 
Sage, 374 

Sage's Catarrh Remedy, 746 
Sal-ammoniac, 108 
Salbromalide, 58 
Salicin, 370 
Salicylate, Para-amidol, 371 

Sodio-Theobromine, 159 
Salicylates, — See their basylous titles. 
Salicyl-bromalide, 58 
Saligenin, 371 
Saline Mineral Waters, 124 

Purgatives, 38 
Salipyrin, 119, 37i» 374 
Saliva, Agents affecting, 35 
Salivation, 35, 259, 687 
Salix, 370 

Nigra, 374 
Salol, 371 
Salophen, 371, 374 
Salt, common, 391 

Epsom, 290 

Glauber's, 391 

Rochelle, 345 
Saltpetre, 345 

Chili, 391 
Salt-rheum, — See Eczema, 576 
Salts, Deliquescent, List of, 488 

Efflorescent, List of, 488 

Insoluble, 448 
Salve, Red Lip, 413 
Salvia, 374 
Salviol, 374 
Sambucus, 375 
Sandal-wood Oil, 377 

White, 376 

Yellow, 376 
Sanford's Catarrh Cure, 746 
Sanguinaria, 375 



INDEX. 



799 



Sanguinarine, 375 
Sanitas, 52, 411 
Santalum Album, 376 

citrinura, 376 

Rubrum, 377 
Santonica, 377 
Santonin, 377 
Sapo, 378 
Sapogenin, 385 
Saponification, 378 
Saponin, 176, 354 
Saprol, 69 
Sarcinse, 696 

Sarcocele, — See under Cancer, Testicles. 
Sarsaparilla, 379 

Ayer's, 744 
Sassafras, 380 

Swamp, 291 
Sassy Bark, 1 74 
Saunders, Red, 377 
Savine, 367 

Sayre's Method for Chloroform, 188 
Scabies, 696 

Scald-head, — See Eczema, Tinea. 
Scalds, 530 
Scammonium, 381 
Scammony, 381 
Scarlatina, 697 
Scarlet Fever, 697 

Diagnosis of, 750 

Temperature in, 755 
Scheele's Acid, 74 

Green, 132 
Sciatica, 698 
Scilla, 381" 
Scillin, 381 
Scillipicrin, 381 
Scillitin, 381 
Scillitoxin, 381 
Scirrhus, — See Cancer, 533 

Diagnosis of, 749 
Sclererythrin, 228 
Scleroderma, 699 
Scleromucin, 228 
Sclerosis, 699 
Scleroxanthin, 228 
Scoparin, 382 
Scoparius, 382 
Scorbutus, — See Scurvy, 700 
Screaming, — See Nightmare, 659 
Scrofulosis, 699 
Scudamore's Mixture, 602 
Scurvy, 700 
Scutellaria, 384 
Scutellarin, 384 
Sea-sickness, 700 
Seborrhcea, 700 
Sea- wrack, 241 
Secale cereale, 228 
Secaline, 426 
Sedatives, 24, 37 

Cardiac, 33 

Gastric, 37 

51 



Sedatives, Pulmonary, 31 
Urinary, 45 
Uterine, 49 
Vascular, 34 
Vesical, 45 

Seidlitz Powder, 346 

Seigel's Syrup, 746 

Senega, 385 

Senegin, 385 

Senna, 244, 385 

Sennacrol, 386 

Sennapicrin, 386 

Separation, 461 

Septicaemia, 690 

Sequah's Oil, 747 

Prairie Flower, 747 

Serpentaria, 387 

Serpent-bites, — See Poisoning by Reptiles, 
also Stings. 

Serum, Artificial, 659 

Sesamum, Oil of, 387 

Sevum, 388 

Shampoo Mixtures, 603 

Sheep, 388 

Sherry Wine, 94 

Shingles, — See Herpes Zoster, 621 

Shock, Surgical, 701 

Sialogogues, 35 

Sickness at Stomach, — See Nausea, Sea- 
sickness, Vomiting. 

Sick-room, 701 

Siddhi, 167 

Silicates, — See their basylous titles. 

Silicious Mineral Waters, 124 

Silver, 127 

Sinalbin, 389 

Sinapine, 389 

Sinapis, 388 

Singultus, — See Hiccough, 622 

Sinigrin, 389 

Sinistrin, 381 

Skin, Agents affecting, 49 
as an Absorbent, 21 

Skin Diseases, — See Acne, Boils, Burns, 
Carbuncles, Chapped Hands and Lips, 
Chilblains, Condylomata, Ecchymosis, 
Ecthyma, Eczema, Elephantiasis, 
Eruptions, Erysipelas, Erythema, 
Freckles, Herpes, Herpes Zoster, Ich- 
thyosis, Impetigo, Intertrigo, Lichen, 
Lupus, Mentagra, Naevus, Onychia, 
Pemphigus, Phlegmon, Pityriasis, 
Prurigo, Pruritus, Psoriasis, Roseola, 
Scabies, Scleroderma, Seborrhoea, 
Strophulus, Syphilis, Tinea, Ulcer, 
Urticaria, Wart, Wen. 

Skull-cap, 384 

Sleep, Abnormal, — See Delirium, Insom- 
nia, Nightmare, Somnambulism. 

Slippery Elm Bark, 417 

Smallpox, 724 

Diagnosis of, 750 

Smart-weed, 344 



8oo 



INDEX. 



Smell, Agents affecting, 30 
Smilacin, 379 
Smilax, 379 
Snake-root, Black, 191 

Virginia, 387 
Sneezing, 701 

Agents producing, 32 

See also Catarrh, Hay Fever, Influ- 
enza. 
Soaloin, 104 
Soap, 378 

Bark, 354 

Curd, 379 

Green, 378 

Insoluble, 378 

of Lead Monoxide, 368 

of Lime, 368 

Soft, 368 
Soda, Caustic, 390 

Chlorata, 189 

Chlorinated, 189 
Soda-water, 123, 126 
Sodio-Theobromine Salicylate, 159 
Sodium, 390 
Solanine, 226 
Solanum Dulcamara, 226 
Solid Preparations, 464 
Soluble Substances, 480 
Solution, 461 

Aids to, 480 

Alkaline Cupric Tartrate, 215 

Antiseptic, 262 

Circulatory, 462 

Clemens', 132 

Donovan's, 131 

Fehling's, 215 

Fowler's, 131 

Glass, 388 

Labarraque's, 52, 189 

Lugol's, 270 

Magendie's, 313 

Monsel's, 236 

Pavy's, 756 

Pearson's, 13 1 

Quinine, 480 
Solutions (Liquores), 478 

Hypodermic, 742 

Precipitant, Table of, 447 

Stock, 454 
Solutol, 69 
Solvents, 461 
Solved, 69 
Somnal, 393 
Somnambulism, 702 
Sores, 717 

Bed, 521 
Sorghum, 368 
Sorrel, 365 
Sozodont, 747 
Spanish Flies, 168 
Sparteine, 382 
Spasmodic Affections, 702 
Spearmint, 298 



Specific Gravity and Volume, 439 

Table of, 770 
Spermaceti, 177 
Spermatorrhoea, 702 
Spigelia, 394 
Spina Bifida, 703 
Spinal Concussion, 703 

Congestion, 703 

Inflammation, — See Meningitis, Mye- 
litis. 

Irritation, 703 

Paralysis, 703 

Softening, 703 
Spirit, Methylated, 94 

Perfumed, 94 

Potato, 94 

Proof, 94 

Rectified, 94 

Russian, 695 

Wood, 93 
Spirits (Spiritus), 493 
Spleen, Affections of, 704 
Spongia Usta, 699 

Spotted Fever, — See Typhus Fever, Men- 
ingitis Cerebro-spinal. 
Sprains, 704 
Spruces, 338 
Spunk, 91 

Squamae, — See Ichthyosis, Pityriasis, Pso- 
riasis. 
Squaw-root, 176 
Squibb's Mixture, 3 12, 542 
Squill, 381 

St. Ignatius' Bean, 269 
St. Jacob's Oil, 83, 747 
St. Mary's Thistle, 173 
Stains, 704 
Stammering, 704 
Staphisagria, 394 
Starch, 114 
Statice, 71 
Stavesacre, 394 
Stearin, 85 
Sterility, 704 
Sternutatories, 32 
Stigmata Maydis, 426 
Stillingia, 395 
Stimulants, 23 

Cardiac, ^ 

Hepatic, 39 

Local, 25 

Pancreatic, 40 

Respiratory, 30 

Vascular, 34 
Stings, 705 
Stock Solutions, 454 
Stomach Diseases, — See Dyspepsia, Gas- 

tralgia, Gastric Ulcer, Gastritis, etc. 
Stomachics, 35 
Stomatitis, 705 
Stone,— See Calculi, 46, 532 
Storax, 400 
Strabismus, 706 



INDEX. 



80I 



Straining, 455 

Stramonium, 396 

Strangury, — See Cystitis, Dysuria. 

Stricture, — See Rectum, 690 

Urethral, 719 
Strontium, 397 
Strophanthin, 398 
Strophantus glabrus, 399 

hispidus, 398 
Strophulus, 706 
Strychnine, 254, 269, 306 
Strychnos Ignatii, 269 

Gauthen'ana, 254 

Nux Vomica, 305 
Sturgeon, 268 
Stye,— See Eyelids, 588 
Styptic Collodion, 81 
Styptics, 51, 615 
Styracin, 400 
Styrax, 400 

Benzoin, 145 
Styrol, 400 
Sublimation, 462 
Subnitrate of Bismuth, 147 
Substances best given alone, 451 

difficult to combine in pill, 487 

suitable for mixtures, 479 

suitable for pills, 487 

suitable for powders, 491 

unsuited to pill-form, 488 
Succinum, 400 
Sudorifics, 46 
Suet, 388 
Sugar, 368 

Beet, 368 

Cane, 368 

Diabetic, 368 

Fruit, 369 

Grape, 368 

of Lead, 340 

of Milk, 368, 369 

Starch, 368 

in Urine, Tests for, 756 
Sulphates, — See their basylous titles. 
Sulphides, — " " " " 

Sulphites, — " " " " 

Sulpho-carbolates, 64, 68 
Sulpho-cyanate, Acrinyl, 389 
Sulpho-cyanide, Allyl, 389 
Sulpho-ichthyolates, 403 
Sulphonal, 400 
Sulphur, 402 
Sulphurated Antimony, 1 16 

Lime, 403 

Potassa, 403 
Sulphuretted Hydrogen, 403 
Sulphurous Mineral Waters, 124 
Sumach, Poison, 359 

Smooth, 359 

Swamp, 360 

Sweet, 359 
Sumbul, 406 
Sun-dew, 225 



Sunstroke, 706 
Suppositoria, 493 
Suppositories, Formulae, 495 

of Glycerin, 245 

Official in Br. Phar. , 495 

of Tannic Acid, 81 
Suppuration, 706 
Surgeon's Agaric, 91 
Surgical Fever, 706 
Svapnia, 312 
Swallowing, — See Dysphagia; OEsopha- 

gus, Disorders of. 
Swamp Sassafras, 291 
Sweet Bay, 291 

Flag, 160 

Gum, 400 
Swertia Chirata, 179 
Swift's Specific, S. S. S., 747 
Sycosis, 706 

Sydenham's Laudanum, 312 
Syncope, 707 
Synovitis, 707 
Syphilis, 707 
Syrupi (Syrups), 495 



Tabacum, 407 

Tabes Mesenterica, 709 

Table of Drops, etc., in fgj, 438, 771 

of Latin Words, Phrases, etc, 748 

of Metric Conversion, 772 

of Precipitant Solutions, 447 

of Prescription Doses and Quantities, 
772* 

of Specific Gravities and Volumes, 770 
Tables of Differential Diagnosis, 748 

of Weights and Measures, 435, 771 
Tablets, 498 

Compressed, List of, 499 

Hypodermic, List of, 22, 499 

of Nitroglycerin, 113 
Tag Alder, 104 
Tamarind, 408 
Tamar-Indien, 386, 747 
Tamarindus, 408 
Tanacetin, 409 
Tanacetum, 409 
Tannin, 81 
Tansy, 409 

Tapeworm, 136, 249, 728 
Tar, 338 
Tar- water, 338 
Taraxacerin, 409 
Taraxacin, 409 
Taraxacum, 409 
Tartar, Crude, 344 

Emetic, 116 
Tartraborate, Potassium, 62, 533 
Tartrates, 82, — See also their basylous titles. 
Taste, Agents affecting, 30 

Disordered, 709 
Taurocholate, Sodium, 234 



802 



INDEX. 



Taeniafuges, 40, 249 
Taeniae, — See Worms, 728 
Tea, 157 

Boneset, 234 

Flaxseed, 286 

Garfield, 745 

German Breast, 106 

Hamburg, 745 

Linseed, 286 

Saffron, 214 

Tansy, 409 

Worm, 394 
Teel Oil, 387 
Teeth, 709 

Agents affecting, 34 
Teething, — See Dentition, 561 
Temperature of the Body, 753 

Drugs affecting, 43 
Tenesmus, — See Dysentery, 569 
Terebene, 410 
Terebinthene, 410 
Terebinthina, 409 
Terpin, 410 
Terpinene, 410 
Terpinol, 411 
Testa Praeparata, 1 61 
Testicles, 709 
Testing, 462 
Tests for Morphine, 314 

Urinary Constituents, 755 
Tetanus, 710 
Tetraborate, Sodium, 62 
Tetrachloride, Carbon, 89, 186 
Tetra-iodo-pyrrol, 275 
Tetra-methyl-thionine Chloride, 299 
Tetronal, 402 

Tetter, — See Herpes, Pityriasis, Psoriasis. 
Thallin, 195, 196 
Thea sinensis, 155 
Thebaina, 311 
Theine, 155 

Theobroma Cacao, 157, 413 
Theobromine, 157, 413 
Therapeutical Incompatibility, 450 
Therapeutics, 17, 502 

Applied, 18, 503 

Empirical, 18 

Natural, 17 

Rational, 18 

Special, 502 
Theriaca, 369 

Thermometer, Clinical, 753 
Thimble-berry, 365 
Thiol, 404, 406 
Thirst, 710 

Agents allaying, 35 
Thistle, Blessed, 173 

St. Mary's, 173 
Thompson's Eye-water, 747 

Tincture, 327 
Thorn-apple, 396 
Thorough- wort, 233 
Throat, — See Aphonia, Croup, Diphtheria, 



Laryngitis, Pharyngitis, Scarlet Fever, 
Tonsillitis, etc. 
Throat, Sore, 710 
Thrush, — See Aphthae, 514 
Thuja, 413 
Thujetin, 413 
Thujin, 413 

Thus Americanum, 410 
Thyme, Garden, 414 
Thymene, 414 
Thymol, 414 
Thymus vulgaris, 414 
Tic Douloureux, 711 
Tiglii Oleum, 415 
Tincture, Hager's, 194 

Huxham's, 193 

Norwood's, 421 

Planat's, 333 

Pyrexialis, 194, 198 

Thompson's, 327 

Warburg's, 194, 198 
Tincturae (Tinctures), 496 
Tinea Circinata, 7 1 1 

Decalvans, 712 

Favosa, 712 

Sycosis, — See Mentagra, 650 

Tonsurans, 712 
Tobacco, 407 

Indian, 288 

Symptoms, — See Amaurosis, Nervous- 
ness. 
Toe-nails, — See Nails, 652 
Tolene, 140 
Toluene, 368 
Toluifera Pereirae, 140 

Balsamum, 140 
Tomato, 226 
Tonga, 416 
Tongine, 416 
Tongue, 712 
Tonics, 41 

Cardiac, 3s 

Formulae, 507, 511, 659 

Gastric, 35 

Hair, 509, 603 

Nerve, 654, 655, 664 

Pills for Women, 490 

Uterine, 49 

Vascular, 34 

Vesical, 45 
Tonsillitis, 713 
Tonsils, Enlarged, 713 

Ulcerated, 714 
Toothache, — See Odontalgia, 661 
Toothrash, — See Strophulus, 706 
Torrefaction, 462 
Torticollis, 714 
Torulae, — See Sarcinae, 696 
Tracheitis, — See Croup, 556 
Trachoma, — See Conjunctivitis, Granular, 

549 ; Ophthalmia, 662 
Tragacantha, 416 
Traumaticin, 227 



INDEX. 



80 3 



Traumatic Fever, 706 

Treacle, 369 

Tree of Heaven, 92 

Tremor, 670 

Tri-bromo-methane, 150 

Trichiniasis, 714 

Trichloraldehyde, 179 

Tricophytosis capitis, — See Tinea, 7 1 1 

Trimethylamine, 129, 130,228, 255 

Trihydroxy-benzene, 71, 195 

Trimethyl -ethylene, 88 

Trinitrophenol, 79 

Trinitrin, 112 

Trional, 402 

Trismus, 714 

Triticin, 417 

Triticum, 417 

Trituration, 463 

of Elaterih, 228 
Triturationes, 497 
Triturations, their advantages, 498 

Formulae, 498 

of Mercury, 257,498 
Troches, 498 
Trochisci, 498 
Tropeius, 142 

Tropical Fruit-Laxative, 386 
Tropin, 142 
Trypsin, 322 

Tubercular Meningitis, — See Hydroceph- 
alus, Acute, 623 
Tuberculin, 678 

Tuberculosis, — See Phthisis, Scrofulosis. 
Tully's Powder, 313 
Tumenol, 404, 406 
Tumors, 714 

Diagnosis of, 749 

Uterine, 722 
Turnera aphrodisiaca, 219 
Turpentine, 409 

Canada, 409 

Chian, 410 

Oil of, 410 

Venice, 410 
Turpeth Mineral, 257 
Tympanites, 715 
Typhlitis, 715 
Typhoid Fever, 715 

Diagnosis of, 752 

Temperature in, 755 
Typho-malarial Fever, — See Typhoid. 
Typhus Fever, 717 

Diagnosis of, 752 



Ulcers and Sores, 717 
of Rectum, 691 
Stomach, 596 
of Tonsils, 714 
of Uterus, 723 

Ulmus, 417 

Umbelliferon, 241 

Umbrella-tree, 291 



Unguenta, 499 
Unguentum, 176 
Uraemia, 718 
Urea, Agents affecting, 40 

in Urine, Test for, 756 
Urethan, 181 
Urethra, Stricture of, 719 
Urethral Injections, 476 
Urethritis, 719 
Urginea Maritima, 381 
Uric Acid Diathesis. — See Lithaemia, 640 
Urinary Astringents, 45 

Disorders, 719 

Sedatives, 45 
Urine, Acidifiers of, 45 

Alkalinizers of, 45 

Articles coloring, 756 

Examination of, 755 
Urticaria, 720 
Ursone, 242, 417 
Ustilago, 426 
Uterine Alteratives, 49 

Cancer, 720 

Congestion, 721 

Depressants, 49 

Diseases, 722 

Displacements, 722 

Hypertrophy, 721 

Prolapse, 722 

Tonics, 49 

Tumors, 722 

Ulceration, 723 
Uva Ursi, 417 
Uvula, 723 



Vaccination, 723 
Vaginismus, 723 
Vaginitis, 723 
Valerene, 418 
Valerian, 219, 418 
Valerianate, Butyl, 108 
Valerianates, 419 
Valerol, 255,418 
Vallett's Mass, 235 
Van Buskirk's Sozodont, 747 
Vanilla, 420 
Vanillin, 420 
Vao, 217 
Vapores, 476 , 
Vaporization, 463 
Vapors, 476 
Varicella, 541, 724 
Varicocele, 724 
Varicosis, 724 
Variola, 724 

Diagnosis of, 750 
Vascular Sedatives, 34 

Stimulants, 34 

Tonics, 34 
Vaseline, 324 
Vegetable Drugs, their Constituents, 432 



804 



INDEX. 



Veins, — See Phlebitis, Phlegmasia, Vari- 

cosis. 
Veins, Transfusion by, 20 
Velatine, 199, 232 
Vellarine, 264 
Venous Medication, 20 
Veratralbine, 420 
Veratrine, 421 
Veratroidine, 420 
Veratrum Album, 420 

Sabadilla, 420 

Viride, 420 
Verbascum, 423 
Verbs, 739 
Vermicides, 40 
Vermifuges, 40, 728 
Veronica Virginica, 284 
Vertigo, 725 

Verruca, — See Warts, 727 
Vesical Tonics, 45 

Sedatives, 45 
Vesicants, 50 
Viburnin, 423 
Viburnum, 423 

Compound, 423 

Opulus, 423 

Prunifolium, 423 
Vienna Paste, 345 
Villate's Solution, 535 
Vina (See also Wines), 501 
Vinegar, 61 

Bitters, 747 
Vinegars (Aceta), 465 
Vinum, 94 

Album, 94 

Aromaticum, 94 

Official (See Wine of—) 

Portense, 94 

Rubrum, 94 

Xericum, 94 
Viola Cucullata, 424 

Tricolor, 424 
Violet, 424 
Violine, 424 
Viscin, 424 
Viscum, 424 

Visions, Agents producing, 30 
Vita Nuova, 747 
Vitellin, 424 
Vitellus, 424 
Vitriol, Elixir of, 79 
Volkmann's Antiseptic Fluid, 414 
Vomiting, 725 

of Pregnancy, 726 

Diagnosis of, 753 
Vulva, Eczema, etc., of, 727 
Vulvitis, 727 



Wade's Bougies, 495 

Wafers, 491 

Wahoo, 233 

Walker's Vinegar Bitters, 747 



Walnut, White, 279 
Warburg's Tincture, 194, 198 
Warming-plaster, 338 
Warner's Safe Cure, 747 
Warts, 727 
Wash, 478 

Black, 257 

-Hair, 603 

Mouth, 603 

Yellow, 257 
Washing, 464 

Waste, Agents promoting, 42 
Wasting, — See Atrophy, Emaciation. 

Diseases, 578 
Water, 122 

Carbonated, 123, 126 

Cologne, 94 

of Crystallization, 456 

Distilled, 123 

Hunyadi, 551 

Oxygenated, 264 

Sedative, 108, 164 

Soda, 123, 126 
Water-lily, 309 

-pepper, 344 
Waters (Aquas), 465 

Mineral, 123 

Nomenclature, 123 
Wax, 176 

Myrtle, 71, 176 
Weakness, — See Adynamia, Exhaustion. 
Weights and Measures, 435, 771 

Apothecaries', 435 

British Pharmacopceial, 436 

Metric, 436, 772 
Wen, 728 
t Whiskey, 94 
White leg, — See Phlegmasia, 675 
White-swelling, — See Joints, Synovitis. 
Whitlow, — See Onychia, 662 
Whooping-Cough, 673 
Willow, 370 

Pussy, 374 
Wine, 94 

Aromatic, 94 

Port, 94 

Red, 94 

Sherry, 94 

White, 94 
Wines (Vina), 94, 501 
Winterberry, 349 
Wintergreen, 242, 370 
Witch-hazel, 71, 252 
Wood Oil, 252 
W T oorara, 217 
Words and Phrases, Latin, 731 

Sundry, 740 
Worms, 40, 728 
Worm-grass, 394 
Wormseed, 178 

Levant, 377 
Worm Tea, 394 
Wormwood, 58 



INDEX. 



805 



Wounds, 729 

Writers' Cramp, — See Spasmodic Affec- 
tions, 702 
Wry-neck, — See Torticollis, 714 



Xantho-puccine, 263 
Xanthoxyline, 425 
Xanthoxylum, 425 
Xeroderma, — See Ichthyosis, 625 



Yam, Wild, 225 



Yellow Fever, 730 

Diagnosis of, 753 
Yerba Santa, 23 1 
Yolk of Egg, 424 
Yvon's Hypnotic Elixir, 630 



Zea, 426 

Zea Mays, 1 14, 368, 426 

Zinc, 427 

Zincite, 427 

Zincum, 427 

Zingiber, 429 

Zona. — See Herpes Zoster, 621 



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COOPER AND EDWARDS. Diseases of the Rectum and Anus. By Alfred 
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COPLIN and BEVAN. Practical Hygiene. By W. M. L. Coplin, m.d., Adjunct 
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DAVIS. Biology. An Elementary Treatise. By J. R. Ainsworth Davis, of 
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DULLES. What to Do First, In Accidents and Poisoning. By C. W. Dulles, m.d. 
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FAGGE. The Principles and Practice of Medicine. By C. Hilton Fagge, m.d., 
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GOULD. The Illustrated Dictionary of Medicine, Biology, and Allied Sciences. 

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BONES. 
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NERVOUS SYSTEM. 
EYE. 



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SURGICAL AND TOPOGRAPH- 
ICAL ANATOMY. 



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Surgeon and Lecturer on Physiology to the London Hospital, etc. 



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A HANDBOOK 



Local Therapeutics 



JUST PUBLISHED. 



A Handbook of Local Therapeutics, being a practical description of all those 
agents used in the local treatment of disease, such as Ointments, Plasters, Powders, 
Lotions, Inhalations, Suppositories, Bougies, Tampons, etc., and the proper methods 
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Polyclinic and College for Graduates in Medicine ; Surgeon to the Wills Eye Hospital, 
and Eye and Ear Department of the Pennsylvania Hospital. Richard H. Harte, 
m.d., Surgeon to the Episcopal and St. Mary's Hospital; Ass't Surgeon University 
Hospital; Demonstrator of Osteology, University of Pennsylvania; and Arthur Van 
Harlingen, m.d., Professor of Diseases of the Skin in the Philadelphia Polyclinic and 
College for Graduates in Medicine ; late Clinical Lecturer on Dermatology injefferson 
Medical College ; Dermatologist to the Howard Hospital. 

In One Handsome Compact Volume. Clotb, $4.00 



ANNOUNCEMENT. 

The importance of the local application of simple remedies in slight ailments of 
special organs is not always realized by the general practitioner, and the average 
text-book omits altogether any mention of many agents that in the hands of the 
specialist become valuable aids to cure. The diseases which chiefly require local 
treatment are those of the Respiratory Passages, Ear, Eye, Skin, together with certain 
general Surgical affections, including the Diseases of Women. In order, therefore, 
that the various uses of each remedy should be thoroughly set forth, it was necessary 
to have a combination of authors who have had a large practical experience in these 
various branches of Medicine and Surgery. 

Each remedy is taken up in alphabetical order, and after a succinct description 
of its pharmaceutical properties is considered with reference to the local treatment 
of the affections above outlined. The publishers believe that the information con- 
tained in this work will not be found elsewhere, as much of it is the results obtained 
in private and hospital practice, by eminent professors and specialists. The activity 
in the various lines of special medicine is one of the most striking phases of the times, 
and has materially changed many of the older methods of treating disease by local 
means. The greater part of the literature which has appeared is not accessible to 
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titioners as well as to those who, like the authors, are especially interested in sub- 
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The work forms a compact octavo volume, arranged in a manner to facilitate 
reference, and contains, besides the usual index, a complete index of diseases, that 
will greatly enhance its usefulness. 



Published Annually for 43 Years. 



The Physician's Visiting List. 



(LINDSAY & BLAKISTON'S. ) 

Contents.— Special Revised Edition for 1894. 



CALENDAR, 1893-1894. 

TABLE OF SIGNS, to be used in keeping records. 

THE METRIC OR FRENCH DECIMAL SYSTEM OF 
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INCOMPATIBILITY (Dr. S. O. L. Potter). 



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EXAMINATION OF URINE (Dr. J. Daland, based upon 

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DISEASES OF THE EYE (Dr. George M. Gould). 
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